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Article: Flexion-relaxation ratio in sitting: Application in low back pain rehabilitation

TitleFlexion-relaxation ratio in sitting: Application in low back pain rehabilitation
Authors
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
Citation
Spine, 2010, v. 35 n. 16, p. 1532-1538 How to Cite?
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 ± 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.
Persistent Identifierhttp://hdl.handle.net/10722/142374
ISSN
2013 Impact Factor: 2.447
ISI Accession Number ID
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).

References

 

Author Affiliations
  1. The University of Hong Kong
  2. The Duchess of Kent Children's Hospital at Sandy Bay
DC FieldValueLanguage
dc.contributor.authorMak, JNFen_HK
dc.contributor.authorHu, Yen_HK
dc.contributor.authorCheng, ACSen_HK
dc.contributor.authorKwok, HYen_HK
dc.contributor.authorChen, YHen_HK
dc.contributor.authorLuk, KDKen_HK
dc.date.accessioned2011-10-28T02:44:30Z-
dc.date.available2011-10-28T02:44:30Z-
dc.date.issued2010en_HK
dc.identifier.citationSpine, 2010, v. 35 n. 16, p. 1532-1538en_HK
dc.identifier.issn0362-2436en_HK
dc.identifier.urihttp://hdl.handle.net/10722/142374-
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.en_HK
dc.languageengen_US
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_HK
dc.relation.ispartofSpineen_HK
dc.subjectflexion-relaxation ratioen_HK
dc.subjectlow back painen_HK
dc.subjectsittingen_HK
dc.subjectsurface electromyographyen_HK
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.titleFlexion-relaxation ratio in sitting: Application in low back pain rehabilitationen_HK
dc.typeArticleen_HK
dc.identifier.emailHu, Y:yhud@hku.hken_HK
dc.identifier.emailChen, YH:yhchen@hkucc.hku.hken_HK
dc.identifier.emailLuk, KDK:hcm21000@hku.hken_HK
dc.identifier.authorityHu, Y=rp00432en_HK
dc.identifier.authorityChen, YH=rp00099en_HK
dc.identifier.authorityLuk, KDK=rp00333en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/BRS.0b013e3181ba021een_HK
dc.identifier.pmid20072090en_HK
dc.identifier.scopuseid_2-s2.0-77954962019en_HK
dc.identifier.hkuros174056en_US
dc.identifier.hkuros196980-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77954962019&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume35en_HK
dc.identifier.issue16en_HK
dc.identifier.spage1532en_HK
dc.identifier.epage1538en_HK
dc.identifier.isiWOS:000279959900005-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridMak, JNF=35980187600en_HK
dc.identifier.scopusauthoridHu, Y=7407116091en_HK
dc.identifier.scopusauthoridCheng, ACS=7402075181en_HK
dc.identifier.scopusauthoridKwok, HY=36174121300en_HK
dc.identifier.scopusauthoridChen, YH=7601430448en_HK
dc.identifier.scopusauthoridLuk, KDK=7201921573en_HK
dc.identifier.citeulike6707394-

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