Flexion-Relaxation Phenomenon in Children and Adolescents With and Without Nonspecific Chronic Low Back Pain: An Electromyographic and Kinematic Cross-Sectional Comparative Study.
- Tabard-Fougère A Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
- Dayer R Division of Paediatric Orthopaedics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
- Armand S Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
- Vuillerme N University Grenoble Alpes, AGEIS, Grenoble, France.
- 2018-03-07
Published in:
- Spine. - 2018
Adolescent
Biomechanical Phenomena
Child
Chronic Pain
Electromyography
Female
Humans
Low Back Pain
Male
Muscle Contraction
Muscle Relaxation
Muscle, Skeletal
Pain Measurement
Posture
Range of Motion, Articular
English
STUDY DESIGN
A cross-sectional comparative study.
OBJECTIVE
This study aimed to investigate the flexion-relaxation phenomenon (FRP), in standing trunk flexion and slumped sitting tasks, by comparing children and adolescents suffering from nonspecific chronic low back pain (NSCLBP) with controls (CTRL).
SUMMARY OF BACKGROUND DATA
The absence of the FRP can accurately discriminate adults with NSCLBP from those without during standing trunk flexion and slumped sitting tasks. Even if the FRP has been extensively studied in adults with NSCLBP, only one study has evaluated the FRP in adolescents, during a slumped sitting task, and this suggested that the FRP was also present in adolescents with NSCLBP.
METHODS
Thirty-seven children and adolescents with NSCLBP and 23 CTRL performed standing trunk flexion and slumped sitting tasks. All participants were equipped with surface electromyography (EMG) electrodes on the erector spinae longissimus (ESL) and multifidus (M) muscles and reflective markers on the spinous processes of C7, L1, and S1. Global (C7-S1), thoracic (C7-L1), and lumbar (L1-S1) trunk flexion absolute angle were measured. The FRP was reported using visual inspection and a flexion-relaxation ratio (FRR). A self-reference threshold was used to identify the time of FRP onset. Repeated-measures analysis of variance (ANOVA) was used to determine the main and interaction effects of task, group and muscle on FRR, and the relative maximal angle at FRP onset of the global trunk (C7-S1).
RESULTS
Results showed three main findings: (1) the FRP's low sensitivity in discriminating between NSCLBP and CTRL participants in groups, tasks, or muscles; (2) similar observed maximal flexion angles in both groups during flexion tasks; and (3) similar observed relative maximal global trunk flexion angles at FRP onset in groups, tasks, and muscles.
CONCLUSION
These results are not consistent with the literature on adults and could lead to modified therapeutic management of NSCLBP in children and adolescents.
LEVEL OF EVIDENCE
3.
A cross-sectional comparative study.
OBJECTIVE
This study aimed to investigate the flexion-relaxation phenomenon (FRP), in standing trunk flexion and slumped sitting tasks, by comparing children and adolescents suffering from nonspecific chronic low back pain (NSCLBP) with controls (CTRL).
SUMMARY OF BACKGROUND DATA
The absence of the FRP can accurately discriminate adults with NSCLBP from those without during standing trunk flexion and slumped sitting tasks. Even if the FRP has been extensively studied in adults with NSCLBP, only one study has evaluated the FRP in adolescents, during a slumped sitting task, and this suggested that the FRP was also present in adolescents with NSCLBP.
METHODS
Thirty-seven children and adolescents with NSCLBP and 23 CTRL performed standing trunk flexion and slumped sitting tasks. All participants were equipped with surface electromyography (EMG) electrodes on the erector spinae longissimus (ESL) and multifidus (M) muscles and reflective markers on the spinous processes of C7, L1, and S1. Global (C7-S1), thoracic (C7-L1), and lumbar (L1-S1) trunk flexion absolute angle were measured. The FRP was reported using visual inspection and a flexion-relaxation ratio (FRR). A self-reference threshold was used to identify the time of FRP onset. Repeated-measures analysis of variance (ANOVA) was used to determine the main and interaction effects of task, group and muscle on FRR, and the relative maximal angle at FRP onset of the global trunk (C7-S1).
RESULTS
Results showed three main findings: (1) the FRP's low sensitivity in discriminating between NSCLBP and CTRL participants in groups, tasks, or muscles; (2) similar observed maximal flexion angles in both groups during flexion tasks; and (3) similar observed relative maximal global trunk flexion angles at FRP onset in groups, tasks, and muscles.
CONCLUSION
These results are not consistent with the literature on adults and could lead to modified therapeutic management of NSCLBP in children and adolescents.
LEVEL OF EVIDENCE
3.
- Language
-
- English
- Open access status
- green
- Identifiers
-
- DOI 10.1097/BRS.0000000000002621
- PMID 29509654
- Persistent URL
- https://sonar.ch/global/documents/46525
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