The In Vivo Dynamic Response of the Human Spine to Rapid Lateral Bend Perturbation: Effects of Preload and Step Input Magnitude

Study Design. A repeated measures design was used to determine the effects that combinations of two preloads and two added loads have on spine mechanics both before and during the response to the added load. Objective. To investigate the effects of varying initial isometric and added step input load magnitudes on mechanical and electromyographic responses of the trunk during sudden loading that causes lateral bending moments. Summary of Background Data. Cocontractions of the antagonistic and agonistic muscles of the trunk are required for stability during loading of the spine. In several in vivo studies, it was observed that trunk muscle cocontraction serves a functional role before the application of unexpected or sudden loads. The response of agonistic and antagonistic trunk muscles to rapid lateral bend moments would provide further insight into the dynamic stability mechanisms of the spine. Methods. In this study, 13 men maintained an upright standing posture while resisting the application of lateral bend moments produced by four different loading conditions comprising combinations of two preloads (5% or 15% of the maximum isometric lateral bend moment) and two added loads (20% or 30%). The preloading was used to develop different initial levels of trunk stiffness before the application of the added loads. The lateral bend moment and angular rotation of the trunk were measured, as well as the surface electromyogram amplitudes of the bilateral internal oblique, external oblique, rectus abdominus, lumbar erector spinae, and thoracic erector spinae muscles. Dependent measures were recorded during the steady state preload conditions, and peak values were recorded after the load was added. Results. Higher added loads resulted in higher peak lateral bend rotations, and higher preloads resulted in lower rotations. The patterns of response were similar for the peak lateral bend moments and the electromyogram amplitudes from four of the five agonistic muscles. The thoracic erector spinae excepted, each of the other four muscles demonstrated larger responses in the agonistic muscles. However, all of the antagonistic muscles showed some increase in electromyogram activity in response to the added load. The thoracic erector spinae appeared to have the role of counteracting the flexor moments created by the abdominal muscles and the maintenance of spine stability. The agonistic external obliques and lumbar erector spinae had the largest responses to the added load. A comparison of the 35% loading conditions showed an increased response of the trunk to the 5% + 30% condition (with lower initial trunk stiffness), as compared with the 15% + 20% condition. Conclusions. The findings from this study show that higher levels of preactivation can serve to increase spine compression and trunk muscle stiffness, thereby attenuating the lateral displacements caused by rapid loading. Furthermore, antagonistic muscles were observed to respond rapidly to such perturbations with large increases in activation when preactivation and spine stability were low. The trunk muscles monitored all were larger, multisegmental muscles. The results from this study lend support to previous studies suggesting that the larger multisegmental muscles make a significant contribution to spinal stability.