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Article: Flexion-relaxation ratio in sitting: Application in low back pain rehabilitation
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TitleFlexion-relaxation ratio in sitting: Application in low back pain rehabilitation
 
AuthorsMak, JNF1
Hu, Y1
Cheng, ACS2
Kwok, HY1
Chen, YH1
Luk, KDK1
 
Keywordsflexion-relaxation ratio
low back pain
sitting
surface electromyography
 
Issue Date2010
 
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
 
CitationSpine, 2010, v. 35 n. 16, p. 1532-1538 [How to Cite?]
DOI: http://dx.doi.org/10.1097/BRS.0b013e3181ba021e
 
AbstractStudy Design: A multiple-comparative study between normal and low back pain (LBP) patients before and after rehabilitation. Objective: To examine whether there is a change in flexion-relaxation phenomenon in sitting in LBP patient following a rehabilitation treatment. Summary of Background Data: There is an association between LBP and seated spine posture. Previous study has reported an absence of flexion-relaxation phenomenon in LBP patients during sitting. However, it is unknown whether there is a difference in flexion-relaxation phenomenon in sitting in LBP patients before and after rehabilitation treatment. Methods: A total of 20 normal subjects and 25 chronic LBP patients who underwent a 12 weeks rehabilitation program were recruited. Surface electromyography recordings during upright sitting and flexed sitting were taken from the paraspinal muscles (L3) bilaterally from the normal subjects, and in the LBP patients before and after the rehabilitation treatment. The main outcome measures for patients include the visual analogue scale, Oswestry disability index, subjective tolerance for sitting, standing and walking, trunk muscle endurance, lifting capacity, and range of trunk motion in the sagittal plane. Flexion-relaxation phenomenon in sitting, expressed as a ratio between the average surface electromyography activity during upright and flexed sitting, was compared between normal and patients; and in LBP patients before and after rehabilitation. Results: Flexion-relaxation ratio in sitting in normal subjects (Left: 6.83 ± 3.79; Right: 3.45 ± 2.2) presented a significantly higher (Left: P < 0.001; Right: P < 0.05) value than LBP patients (Left: 3.04 ± 2.36; Right: 2.02 ± 1.49). An increase in flexion-relaxation ratio in sitting was observed in LBP patients after rehabilitation (Left: 4.69 ± 3.94, P < 0.05; Right: 3.58 ± 2.97, P < 0.001), together with a significant improvement (P < 0.05) in subjective tolerance in sitting and standing, abdominal and back muscle endurance, lifting capacity, and range of motion. There were no significant changes in disability and pain scores, and subjective tolerance in walking. Conclusion: Flexion-relaxation ratio in sitting has demonstrated its ability to discriminate LBP patients from normal subjects, and to identify changes in pattern of muscular activity during postural control after rehabilitation. © 2010, Lippincott Williams & Wilkins.
 
ISSN0362-2436
2013 Impact Factor: 2.447
 
DOIhttp://dx.doi.org/10.1097/BRS.0b013e3181ba021e
 
ISI Accession Number IDWOS:000279959900005
Funding AgencyGrant Number
Research Grants Council of the Hong Kong SAR, ChinaCERG 712408E
S.K. Yee Medical Foundation207210/203210
Funding Information:

Supported by grants from the Research Grants Council of the Hong Kong SAR, China (CERG 712408E) and S.K. Yee Medical Foundation (207210/203210).

 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorMak, JNF
 
dc.contributor.authorHu, Y
 
dc.contributor.authorCheng, ACS
 
dc.contributor.authorKwok, HY
 
dc.contributor.authorChen, YH
 
dc.contributor.authorLuk, KDK
 
dc.date.accessioned2011-10-28T02:44:30Z
 
dc.date.available2011-10-28T02:44:30Z
 
dc.date.issued2010
 
dc.description.abstractStudy Design: A multiple-comparative study between normal and low back pain (LBP) patients before and after rehabilitation. Objective: To examine whether there is a change in flexion-relaxation phenomenon in sitting in LBP patient following a rehabilitation treatment. Summary of Background Data: There is an association between LBP and seated spine posture. Previous study has reported an absence of flexion-relaxation phenomenon in LBP patients during sitting. However, it is unknown whether there is a difference in flexion-relaxation phenomenon in sitting in LBP patients before and after rehabilitation treatment. Methods: A total of 20 normal subjects and 25 chronic LBP patients who underwent a 12 weeks rehabilitation program were recruited. Surface electromyography recordings during upright sitting and flexed sitting were taken from the paraspinal muscles (L3) bilaterally from the normal subjects, and in the LBP patients before and after the rehabilitation treatment. The main outcome measures for patients include the visual analogue scale, Oswestry disability index, subjective tolerance for sitting, standing and walking, trunk muscle endurance, lifting capacity, and range of trunk motion in the sagittal plane. Flexion-relaxation phenomenon in sitting, expressed as a ratio between the average surface electromyography activity during upright and flexed sitting, was compared between normal and patients; and in LBP patients before and after rehabilitation. Results: Flexion-relaxation ratio in sitting in normal subjects (Left: 6.83 ± 3.79; Right: 3.45 ± 2.2) presented a significantly higher (Left: P < 0.001; Right: P < 0.05) value than LBP patients (Left: 3.04 ± 2.36; Right: 2.02 ± 1.49). An increase in flexion-relaxation ratio in sitting was observed in LBP patients after rehabilitation (Left: 4.69 ± 3.94, P < 0.05; Right: 3.58 ± 2.97, P < 0.001), together with a significant improvement (P < 0.05) in subjective tolerance in sitting and standing, abdominal and back muscle endurance, lifting capacity, and range of motion. There were no significant changes in disability and pain scores, and subjective tolerance in walking. Conclusion: Flexion-relaxation ratio in sitting has demonstrated its ability to discriminate LBP patients from normal subjects, and to identify changes in pattern of muscular activity during postural control after rehabilitation. © 2010, Lippincott Williams & Wilkins.
 
dc.description.natureLink_to_subscribed_fulltext
 
dc.identifier.citationSpine, 2010, v. 35 n. 16, p. 1532-1538 [How to Cite?]
DOI: http://dx.doi.org/10.1097/BRS.0b013e3181ba021e
 
dc.identifier.citeulike6707394
 
dc.identifier.doihttp://dx.doi.org/10.1097/BRS.0b013e3181ba021e
 
dc.identifier.epage1538
 
dc.identifier.hkuros174056
 
dc.identifier.hkuros196980
 
dc.identifier.isiWOS:000279959900005
Funding AgencyGrant Number
Research Grants Council of the Hong Kong SAR, ChinaCERG 712408E
S.K. Yee Medical Foundation207210/203210
Funding Information:

Supported by grants from the Research Grants Council of the Hong Kong SAR, China (CERG 712408E) and S.K. Yee Medical Foundation (207210/203210).

 
dc.identifier.issn0362-2436
2013 Impact Factor: 2.447
 
dc.identifier.issue16
 
dc.identifier.pmid20072090
 
dc.identifier.scopuseid_2-s2.0-77954962019
 
dc.identifier.spage1532
 
dc.identifier.urihttp://hdl.handle.net/10722/142374
 
dc.identifier.volume35
 
dc.languageeng
 
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
 
dc.publisher.placeUnited States
 
dc.relation.ispartofSpine
 
dc.relation.referencesReferences in Scopus
 
dc.subject.meshExercise Tolerance - physiology
 
dc.subject.meshLow Back Pain - diagnosis - physiopathology - rehabilitation
 
dc.subject.meshMuscle, Skeletal - anatomy and histology - physiopathology
 
dc.subject.meshPhysical Therapy Modalities - trends
 
dc.subject.meshPostural Balance - physiology
 
dc.subjectflexion-relaxation ratio
 
dc.subjectlow back pain
 
dc.subjectsitting
 
dc.subjectsurface electromyography
 
dc.titleFlexion-relaxation ratio in sitting: Application in low back pain rehabilitation
 
dc.typeArticle
 
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<contributor.author>Kwok, HY</contributor.author>
<contributor.author>Chen, YH</contributor.author>
<contributor.author>Luk, KDK</contributor.author>
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<description.abstract>Study Design: A multiple-comparative study between normal and low back pain (LBP) patients before and after rehabilitation. Objective: To examine whether there is a change in flexion-relaxation phenomenon in sitting in LBP patient following a rehabilitation treatment. Summary of Background Data: There is an association between LBP and seated spine posture. Previous study has reported an absence of flexion-relaxation phenomenon in LBP patients during sitting. However, it is unknown whether there is a difference in flexion-relaxation phenomenon in sitting in LBP patients before and after rehabilitation treatment. Methods: A total of 20 normal subjects and 25 chronic LBP patients who underwent a 12 weeks rehabilitation program were recruited. Surface electromyography recordings during upright sitting and flexed sitting were taken from the paraspinal muscles (L3) bilaterally from the normal subjects, and in the LBP patients before and after the rehabilitation treatment. The main outcome measures for patients include the visual analogue scale, Oswestry disability index, subjective tolerance for sitting, standing and walking, trunk muscle endurance, lifting capacity, and range of trunk motion in the sagittal plane. Flexion-relaxation phenomenon in sitting, expressed as a ratio between the average surface electromyography activity during upright and flexed sitting, was compared between normal and patients; and in LBP patients before and after rehabilitation. Results: Flexion-relaxation ratio in sitting in normal subjects (Left: 6.83 &#177; 3.79; Right: 3.45 &#177; 2.2) presented a significantly higher (Left: P &lt; 0.001; Right: P &lt; 0.05) value than LBP patients (Left: 3.04 &#177; 2.36; Right: 2.02 &#177; 1.49). An increase in flexion-relaxation ratio in sitting was observed in LBP patients after rehabilitation (Left: 4.69 &#177; 3.94, P &lt; 0.05; Right: 3.58 &#177; 2.97, P &lt; 0.001), together with a significant improvement (P &lt; 0.05) in subjective tolerance in sitting and standing, abdominal and back muscle endurance, lifting capacity, and range of motion. There were no significant changes in disability and pain scores, and subjective tolerance in walking. Conclusion: Flexion-relaxation ratio in sitting has demonstrated its ability to discriminate LBP patients from normal subjects, and to identify changes in pattern of muscular activity during postural control after rehabilitation. &#169; 2010, Lippincott Williams &amp; Wilkins.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong
  2. The Duchess of Kent Children's Hospital at Sandy Bay