Determination of trunk motion patterns associated with permanent or transient stenosis of the lumbar spine

Abstract

Dynamometric devices used to assess back function are becoming increasingly used in research as well as in clinical practice. These devices provide values for a variety of movement variables such as torque, displacement, and velocity, but they also enable the study of movement patterns. The purpose of this study was to determine the movement patterns of patients presenting with specific spinal pathologies. Thirteen patients with spinal stenosis and 14 patients with degenerative changes and a borderline spinal canal diameter, as well as a control group of 30 symptom-free subjects, were studied. An isoinertial trunk-testing dynamometric device was used. Sagittal velocity and position were measured against a resistance set to 50% of the subject's maximum isometric torque. A phase plane analysis (velocity against position) was performed for each subject. An ensemble averaging technique was used to average the repetitions of every subject and a normalization technique was employed to draw an average graph for each group. This graph showed distinct patterns of movement for the three groups. The differences appeared mostly during the extension phase of movement, as confirmed by statistical analysis. The spinal stenosis group showed lower velocities than the controls during the entire extension phase (P<0.05), while the borderline spinal canal group demonstrated a significant decrease in velocity at the end of the extension phase (P<0.01). These findings can be related to the increase in disk bulge and decrease in the diameter of the spinal canal during extension. This study shows the relation between some spinal pathologies and movement patterns. This type of functional assessment may be a valuable tool for assessing the relation between anatomical lesions and function and for determining the responsibility of findings such as bulging disk and/or facet syndrome in causing a patient's complaints.