title: Neutral spine control exercises in rehabilitation after lumbar spine fusion.
abstract: Lumbar spine fusion (LSF) has been reported to change the biomechanics of the spine and therefore the rehabilitation after LSF is important. In this study, the effect of selected neutral spine control exercises on activation of trunk muscles after LSF was evaluated. Muscle activity was measured by surface electromyography of the rectus abdominis, external oblique, longissimus, and multifidus muscles during 6 exercises in 22 LSF patients (mean age = 59 years; age range = 25-84 years; 50% women). Muscle activity concurrent with trunk flexion and extension during maximal voluntary isometric contraction (MVIC) was used as a reference value. Pain during the effort was assessed with a visual analog scale (VAS). The highest activity in the rectus abdominis muscles was measured during bilateral shoulder extension (51% of MVIC), and in the external oblique, it occurred during unilateral shoulder horizontal adduction (48% of MVIC) and unilateral hip extension (46% of MVIC) exercises. The highest activation of the multifidus and longissimus muscles (60-104%) was measured during bilateral shoulder flexion and modified Roman chair exercises. The mean (SD) self-reported back pain VAS scores during exercises varied from 3 (7) to 16 (26). Neutral spine control exercises activate trunk muscles and cause minimal pain and are therefore feasible exercises for home-based training to improve muscle endurance and postural control after LSF. In addition, the level of muscle activity during bilateral shoulder flexion and modified Roman chair exercises was over 60% of MVIC, justifying their use in training for strength of the trunk extensor muscles.
authors.affiliation: 1Department of Health Sciences, University of Jyväskylä, Jyväskylä, Finland; 2Department of Orthopaedic and Trauma Surgery, Tampere University Hospital, Tampere, Finland; 3Department of Biology of Physical activity, University of Jyväskylä, Jyväskylä, Finland; 4Department of Physical Medicine and Rehabilitation, Tampere University Hospital, Tampere, Finland; 5Department of Physical Medicine and Rehabilitation, Central Finland Health Care District, Jyväskylä, Finland; 6Department of Kinesiology, University of Connecticut, Storrs, Connecticut; and 7Edith Cowan University Health and Wellness Institute, Edith Cowan University, Perth, Western Australia.
authors.forename: Sami P
authors.initials: SP
authors.lastname: Tarnanen
authors.forename: Marko H
authors.initials: MH
authors.lastname: Neva
authors.forename: Keijo
authors.initials: K
authors.lastname: Häkkinen
authors.forename: Markku
authors.initials: M
authors.lastname: Kankaanpää
authors.forename: Jari
authors.initials: J
authors.lastname: Ylinen
authors.forename: William J
authors.initials: WJ
authors.lastname: Kraemer
authors.forename: Robert U
authors.initials: RU
authors.lastname: Newton
authors.forename: Arja
authors.initials: A
authors.lastname: Häkkinen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004576:Electromyography; D005081:Exercise Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007537:Isometric Contraction; D017116:Low Back Pain / Q000209:etiology; D008297:Male; D008875:Middle Aged; D059352:Musculoskeletal Pain / Q000209:etiology; D010147:Pain Measurement; D064170:Paraspinal Muscles / Q000502:physiology*; D017568:Rectus Abdominis / Q000502:physiology*; D013123:Spinal Fusion / Q000534:rehabilitation*