The effects of lumbosacral orthoses on spine stability: what changes in EMG can be expected?
Antagonistic trunk muscle activity is normally required to stabilize the spine. A lumbosacral orthosis (LSO) might reduce the need for this antagonistic activity by providing passive stiffness to the trunk and increasing spine stability. The maximum reduction in trunk muscle EMG and in the resultant spine compression force due to the LSO was estimated using a biomechanical model. The lumbar spine stability was first quantified for the average trunk muscle EMG recorded from 11 male subjects performing various isometric trunk exertion tasks. Subsequently, the spine-stiffening effects of the LSO were implemented in the model and trunk muscle forces were reduced iteratively until the original level of spine stability without the LSO was achieved. The upper bound estimates of the reduction in trunk muscle EMG due to LSO ranged from 0.6% to 14.1% of the maximum voluntary activation depending on the task and the muscle. The resultant spine compression force averaged across all tasks decreased by only 355 N. A much larger variance of the experimental data precluded the detection of these effects at statistically significant levels. However, the small effects size does not necessarily exclude the possibility of functional benefits of slightly reducing muscle activity in patients with low back pain.
Biomechanics Research Laboratory, Department of Orthopaedics and Rehabilitation and Department of Biomedical Engineering, Yale University School of Medicine, P.O. Box 208071, New Haven, CT 06520-8071, USA. jacek.cholewicki@yale.edu
Jacek
J
Cholewicki
D019245:Compressive Strength; D004576:Electromyography; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000628:therapy*; D008159:Lumbar Vertebrae; D009989:Orthotic Devices