Abstract
Objectives
The present study aimed to estimate the trunk muscles moment-arms in low back pain (LBP) patients and compare this data to those of healthy individuals. This research further explored whether the difference of the moment-arms between these two is a contributing factor to LBP.
Methodology
Fifty patients with CLBP (group A) and 25 healthy controls (group B) were enrolled. All participants were subjected to magnetic resonance imaging of lumbar spine. Muscle moment-arms were estimated on a T2W axial section parallel to the disc.
Results
There was statistically significant differences (p < 0.05) in the sagittal plane moment-arms at L1–L2 for right erector spinae (ES), bilateral psoas and rectus abdominis (RA), right quadratus lumborum (QL), and left obliques; bilateral ES, QL, RA, and right psoas at L2–L3; bilateral QL, RA, and obliques at L3–L4; bilateral RA and obliques at L4–L5; and bilateral psoas, RA, and obliques at L5–S1. There was no statistically significant difference (p < 0.05) in the coronal plane moment-arms except for left ES and QL at L1–L2; left QL and right RA at L3–L4; right RA and obliques at L4–L5; and bilateral ES and right RA at L5–S1.
Conclusions
There was a significant difference in muscle moment-arms of the lumbar spine's prime stabilizer (psoas) and primary locomotors (rectus abdominis and obliques) between LBP patients and healthy individuals. This difference in the moment-arms leads to altered compressive forces at intervertebral discs and may be one of the risk factors for LBP.
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Data availability
The datasets generated during and/or analyzed during the current study are available from the corresponding author on request.
References
Gungor C, Tang R, Sesek RF, Foreman KB, Gallagher S, Davis GA (2015) Prediction models for the erector spinae muscle cross-sectional area. ASME J Biomech Eng 137(7):071012. https://doi.org/10.1115/1.4029984
Gungor C (2013) Prediction of the erector spinae muscle lever arm distance for biomechanical models. Dissertation, Auburn University Gungor_Dissertation_May_2013.pdf. http://hdl.handle.net/10415/3569
Chaffin DB, Redfern MS, Erig M, Goldstein SA (1990) Lumbar muscle size and locations from CT scans of 96 women of age 40 to 63 years. Clin Biomech 5(1):9–16. https://doi.org/10.1016/0268-0033(90)90026-3
Marras WS, Parakkat J, Chany AM, Yang G, Burr D, Lavender SA (2006) Spine loading as a function of lift frequency, exposure duration, and work experience. Clin Biomech 21(4):345–352. https://doi.org/10.1016/j.clinbiomech.2005.10.004
Cole MH, Grimshaw PN, Burden AM (2004) Loads on the lumbar spine during a work capacity assessment test. Work 23(2):169–178
Macintosh JE, Bogduk N (1987) 1987 Volvo award in basic science. The morphology of the lumbar erector spinae. Spine 12(7):658–668. https://doi.org/10.1097/00007632-198709000-00004
McGill S, Juker D, Kropf P (1996) Appropriately placed surface EMG electrodes reflect deep muscle activity (psoas, quadratus lumborum, abdominal wall) in the lumbar spine. J Biomech 29(11):1503–1507. https://doi.org/10.1016/0021-9290(96)84547-7
Christophy M, Senan ADF, Lotz JC, O’Reilly OM (2012) A Musculoskeletal model for the lumbar spine. Biomech Model Mechanobiol 11:19–34. https://doi.org/10.1007/s10237-011-0290-6
Jorgensen MJ, Marras WS, Granata KP, Wiand JW (2001) MRI-derived moment-arms of the female and male spine loading muscles. Clin Biomech 16(3):182–193. https://doi.org/10.1016/s0268-0033(00)00087-5
Rab GT, Chao EY, Stauffer RN (1977) Muscle force analysis of the lumbar spine. Orthopedic Clin N Am 8(1):193–199
Dumas GA, Poulin MJ, Roy B, Gagnon M, Jovanovic M (1988) A three-dimensional digitalization method to measure trunk muscle lines of action. Spine 13:532–541
Moga PJ, Erig M, Chaffin DB, Nussbaum MA (1993) Torso muscle moment arms at intervertebral levels T10 through L5 from CT scans on eleven male and eight female subjects. Spine 18(15):2305–2309. https://doi.org/10.1097/00007632-199311000-00028
McGill SM, Patt N, Norman RW (1988) Measurement of the trunk musculature of active males using CT scan radiography: implications for force and moment generating capacity about the L4/L5 joint. J Biomech 21(4):329–341. https://doi.org/10.1016/0021-9290(88)90262-X
Reid JG, Costigan PA (1985) Geometry of adult rectus abdominis and erector spinae muscles. J Orthop Sports Phys Ther 6(5):278–280. https://doi.org/10.2519/jospt.1985.6.5.278
Tracy MF, Gibson MJ, Szypryt EP, Rutherford A, Corlett EN (1989) The geometry of the muscles of the lumbar spine determined by magnetic resonance imaging. Spine 14:186–193. https://doi.org/10.1097/00007632-198902000-00007
Seo A, Lee JH, Kusaka Y (2003) Estimation of trunk muscle parameters for a biomechanical model by age, height and weight. J Occup Health 45(4):197–201. https://doi.org/10.1539/joh.45.197
Lin YH, Chen CS, Cheng CK, Chen YH, Lee C, Chen WJ (2001) Geometric parameters of the in-vivo tissues at the lumbosacral joint of young Asian adults. Spine 26(21):2362–2367. https://doi.org/10.1097/00007632-200111010-00013
Wood S, Pearsall DJ, Ross R, Reid JG (1996) Trunk muscle parameters determined from MRI for lean to obese males. Clin Biomech 11(3):139–144. https://doi.org/10.1016/0268-0033(95)00018-6
Tsuang YH, Novak GJ, Schipplein OD, Hafezi A, Trafimow JH, Anderson GB (1993) Trunk muscle geometry and centroid location when twisting. J Biomech 26(4–5):537–546. https://doi.org/10.1016/0021-9290(93)90015-7
Tveit P, Daggfeldt K, Hetland S, Thorstensson A (1994) Erector spinae lever arm length variations with changes in spinal posture. Spine 19(2):199–204. https://doi.org/10.1097/00007632-199401001-00015
Guzik DC, Keller TS, Szpalski M, Park JH, Spengler DM (1996) A biomechanical model of the lumbar spine during upright isometric flexion, extension, and lateral bending. Spine 21(4):427–433. https://doi.org/10.1097/00007632-199602150-00005
Lee H, Lee S, Lee S (2006) Correlations between the cross-sectional area and moment arm length of the erector spinae muscle and the thickness of the psoas major muscle as measured by MRI and the body mass index in lumbar degenerative kyphosis patients. J Korean Soc Radiol 54(3):203–209. https://doi.org/10.3348/jkrs.2006.54.3.203
Jorgensen MJ, Marras WS, Gupta P, Waters TR (2003) Effect of torso flexion on the lumbar torso extensor muscle sagittal plane moment arms. Spine J 3(5):363–369. https://doi.org/10.1016/S1529-9430(03)00140-2
Bogduk N, Macintosh JE, Pearcy MJ (1992) A universal model of the lumbar back muscles in the upright position. Spine 17(8):897–913. https://doi.org/10.1097/00007632-199208000-00007
Osirix Imaging Software. http://www.osirix-viewer.com/license.pdf
IBM SPSS Statistics Software. https://www.ibm.com/in-en/marketplace/spss-statistics
Jorgensen MJ, Smith FW (2006) Sagittal plane moment arms of the male lumbar region rectus abdominis: upright vs. supine posture. Hum Fac Erg Soc P 50 (13):1270–1273. https://doi.org/10.1177/2F154193120605001303
McGill SM (1992) A myoelectrically based dynamic three-dimensional model to predict loads on lumbar spine tissues during lateral bending. J Biomech 25:395–414. https://doi.org/10.1016/0021-9290(92)90259-4
Bernard BP (1997) Musculoskeletal disorders and work place factors. Cincinnati: US Department of Health and Human Services
Cohen AL, Gjessing CC, Fine WJ, Bernard BP, McGlothlin JD (1997) Elements of ergonomics programs. Cincinnati: US Department of Health and Human Services
Nemeth G, Ohlsen H (1986) Moment arm lengths of trunk muscles to the lumbosacral joint obtained in vivo with computed tomography. Spine 11(2):158–160. https://doi.org/10.1097/00007632-198603000-00011
Pearcy MJ, Bogduk N (1988) Instantaneous axes of rotation of the lumbar intervertebral joints. Spine 13:1033–1041. https://doi.org/10.1097/00007632-198809000-00011
Fortin M, Yuan Y, Battié MC (2013) Factors associated with paraspinal muscle asymmetry in size and composition in a general population sample of men. Phys Ther 93(11):1540–1550. https://doi.org/10.2522/2Fptj.20130051
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Singh, R., Kumar, P., Wadhwani, J. et al. Do MRI-derived muscle moment-arms in patients with chronic low back pain differ from healthy individuals? A comparative study. Eur Spine J 32, 1115–1122 (2023). https://doi.org/10.1007/s00586-023-07601-y
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DOI: https://doi.org/10.1007/s00586-023-07601-y