Article: Flexion-relaxation ratio in sitting: Application in low back pain rehabilitation
| Title | Flexion-relaxation ratio in sitting: Application in low back pain rehabilitation | ||||||
|---|---|---|---|---|---|---|---|
| Authors | Mak, JNF1 Hu, Y1 Cheng, ACS2 Kwok, HY1 Chen, YH1 Luk, KDK1 | ||||||
| Keywords | flexion-relaxation ratio low back pain sitting surface electromyography | ||||||
| Issue Date | 2010 | ||||||
| Publisher | Lippincott, 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?] DOI: http://dx.doi.org/10.1097/BRS.0b013e3181ba021e | ||||||
| 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. | ||||||
| ISSN | 0362-2436 2011 Impact Factor: 2.078 2011 SCImago Journal Rankings: 0.137 | ||||||
| DOI | http://dx.doi.org/10.1097/BRS.0b013e3181ba021e | ||||||
| ISI Accession Number ID | WOS:000279959900005
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 | References in Scopus |
| dc.contributor.author | Mak, JNF | ||||||
|---|---|---|---|---|---|---|---|
| dc.contributor.author | Hu, Y | ||||||
| dc.contributor.author | Cheng, ACS | ||||||
| dc.contributor.author | Kwok, HY | ||||||
| dc.contributor.author | Chen, YH | ||||||
| dc.contributor.author | Luk, KDK | ||||||
| dc.date.accessioned | 2011-10-28T02:44:30Z | ||||||
| dc.date.available | 2011-10-28T02:44:30Z | ||||||
| dc.date.issued | 2010 | ||||||
| dc.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 ± 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.nature | Link_to_subscribed_fulltext | ||||||
| dc.identifier.citation | Spine, 2010, v. 35 n. 16, p. 1532-1538 [How to Cite?] DOI: http://dx.doi.org/10.1097/BRS.0b013e3181ba021e | ||||||
| dc.identifier.citeulike | 6707394 | ||||||
| dc.identifier.doi | http://dx.doi.org/10.1097/BRS.0b013e3181ba021e | ||||||
| dc.identifier.epage | 1538 | ||||||
| dc.identifier.hkuros | 174056 | ||||||
| dc.identifier.hkuros | 196980 | ||||||
| dc.identifier.isi | WOS:000279959900005
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.issn | 0362-2436 2011 Impact Factor: 2.078 2011 SCImago Journal Rankings: 0.137 | ||||||
| dc.identifier.issue | 16 | ||||||
| dc.identifier.pmid | 20072090 | ||||||
| dc.identifier.scopus | eid_2-s2.0-77954962019 | ||||||
| dc.identifier.spage | 1532 | ||||||
| dc.identifier.uri | http://hdl.handle.net/10722/142374 | ||||||
| dc.identifier.volume | 35 | ||||||
| dc.language | eng | ||||||
| dc.publisher | Lippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com | ||||||
| dc.publisher.place | United States | ||||||
| dc.relation.ispartof | Spine | ||||||
| dc.relation.references | References in Scopus | ||||||
| dc.subject.mesh | Exercise Tolerance - physiology | ||||||
| dc.subject.mesh | Low Back Pain - diagnosis - physiopathology - rehabilitation | ||||||
| dc.subject.mesh | Muscle, Skeletal - anatomy and histology - physiopathology | ||||||
| dc.subject.mesh | Physical Therapy Modalities - trends | ||||||
| dc.subject.mesh | Postural Balance - physiology | ||||||
| dc.subject | flexion-relaxation ratio | ||||||
| dc.subject | low back pain | ||||||
| dc.subject | sitting | ||||||
| dc.subject | surface electromyography | ||||||
| dc.title | Flexion-relaxation ratio in sitting: Application in low back pain rehabilitation | ||||||
| dc.type | Article |
Author Affiliations
- The University of Hong Kong
- The Duchess of Kent Children's Hospital at Sandy Bay