Neutral spine control exercises in rehabilitation after lumbar spine fusion

Document Type

Journal Article

Publisher

Lippincott Williams & Wilkins

Faculty

Faculty of Health, Engineering and Science

School

School of Exercise and Health Sciences / ECU Health and Wellness Institute

RAS ID

16892

Comments

This is a non-final version of an article published in final form in: Tarnanen, S., Neva, M., Häkkinen, K., Kankaanpää, M., Ylinen, J., Kraemer, W., Newton, R. , & Häkkinen, A. (2014). Neutral spine control exercises in rehabilitation after lumbar spine fusion. Journal of Strength and Conditioning Research, 28(7), 2018-2025. Original article available here

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.

DOI

10.1519/JSC.0000000000000334

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