journal article·2021-09-30Open access

Intramuscular Properties of Resting Lumbar Muscles in Patients with Unilateral Lower Limb Amputation

Yunhee Chang, Jungsun Kang, Gyoosuk Kim, Hyunjun Shin, Sehoon Park

Applied Sciences· Volume 11· Issue 19

Abstract

Lower limb amputees (LLAs) have a high incidence of low back pain (LBP), and identifying the potential risk factors in this group is key for LBP prevention. This study analyzed the intramuscular properties of the resting lumbar muscle in thirteen unilateral LLAs and age-matched controls to predict the onset of LBP. To measure the lumbar intramuscular properties, resting erector spinae muscles located in the upper and lower lumbar regions were examined using a handheld myotonometer. The dynamic stiffness, oscillation frequency, and logarithmic decrement were measured. In our results, the stiffness and frequency of the upper lumbar region were greater in the amputee group than in the control, whereas the decrement did not differ between the two groups. Additionally, the measured values in the lower lumbar region showed no significant difference. Within each group, all three factors increased at the upper lumbar region. In the LLAs, the frequency and stiffness values of the upper lumbar on the non-amputated side were significantly higher than those on the amputated side. These results indicate that the upper lumbar muscles of the amputees were less flexible than that of the control. This study can help in providing therapeutic strategies treating LBP in amputees.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Musculoskeletal pain and rehabilitation · Prosthetics and Rehabilitation Robotics · Muscle activation and electromyography studies

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Rehabilitation Engineering Research Institute, Incheon 21417, Korea

Funding

the Ministry of Science & ICT

References (44)

Show source-provided references
1. Back pain as a secondary disability in persons with lower limb amputations10.1053/apmr.2001.21962 ↗
2. Phantom pain, residual limb pain, and back pain in amputees: Results of a national survey10.1016/j.apmr.2005.03.031 ↗
3. Chronic low back pain in individuals with lower-limb amputation10.17305/bjbms.2006.3177 ↗
4. Biomechanical significance of the correct length of lower limb prostheses: A clinical and radiological study10.3109/03093648409146072 ↗
5. The relationship between lumbar spine kinematics during gait and low-back pain in transfemoral amputees10.1097/PHM.0b013e3181e71d90 ↗
6. Asymmetrical movements of the lumbopelvic region: Is this a potential mechanism for low back pain in people with lower limb amputation?10.1016/j.mehy.2013.11.012 ↗
7. Low-back pain in transfemoral amputees: Is there a correlation with static or dynamic leg-length discrepancy?10.1097/PHM.0b013e318194fbbc ↗
8. The influence of the length of lower-limb prosthesis on spinal kinematics10.1016/S0003-9993(03)00259-4 ↗
9. Paraspinal muscle activity during symmetrical and asymmetrical weight training in idiopathic scoliosis10.1123/jsr.19.3.315 ↗
10. Gailey, R., Allen, K., Castles, J., Kucharik, J., and Roeder, M. (2008). Review of secondary physical conditions associated with lower-limb amputation and long-term prosthesis use. J. Rehabil. Res. Dev., 45.10.1682/JRRD.2006.11.0147 ↗
11. Bone and joint changes in lower limb amputees10.1136/ard.37.3.252 ↗
12. Trunk muscle activation patterns during walking among persons with lower limb loss: Influences of walking speed10.1016/j.jelekin.2018.03.006 ↗
13. Persons with unilateral transfemoral amputation experience larger spinal loads during level-ground walking compared to able-bodied individuals10.1016/j.clinbiomech.2015.11.018 ↗
14. Effects of chronic low back pain on trunk coordination and back muscle activity during walking: Changes in motor control10.1007/s00586-004-0825-y ↗
15. Neuromuscular control of walking with chronic low-back pain10.1054/math.2002.0476 ↗
16. EMG profiles during normal human walking: Stride-to-stride and inter-subject variability10.1016/0013-4694(87)90003-4 ↗
17. Back muscle activation patterns in chronic low back pain during walking: A “guarding” hypothesis10.1097/AJP.0b013e3181b40eca ↗
18. Stiffness of resting lumbar myofascia in healthy young subjects quantified using a handheld myotonometer and concurrently with surface electromyography monitoring10.1016/j.jbmt.2015.12.005 ↗
19. A cross-bridge mechanism can explain the thixotropic short-range elastic component of relaxed frog skeletal muscle10.1111/j.1469-7793.1998.941bj.x ↗
20. Thixotropic Changes in Human Muscle Stiffness and The Effects of Fatigue10.1113/expphysiol.1988.sp003169 ↗
21. Lumbar muscle stiffness is different in individuals with low back pain than asymptomatic controls and is associated with pain and disability, but not common physical examination findings10.1016/j.msksp.2019.102078 ↗
22. Where tendons and ligaments meet bone: Attachment sites (‘entheses’) in relation to exercise and/or mechanical load10.1111/j.1469-7580.2006.00540.x ↗
23. Greater resting lumbar extensor myofascial stiffness in younger ankylosing spondylitis patients than age-comparable healthy volunteers quantified by myotonometry10.1016/j.apmr.2015.07.014 ↗
24. Quantifying paraspinal muscle tone and stiffness in young adults with chronic low back pain: A reliability study10.1038/s41598-018-32418-x ↗
25. Biomechanical properties of low back myofascial tissue in younger adult ankylosing spondylitis patients and matched healthy control subjects10.1016/j.clinbiomech.2018.06.006 ↗
26. Myometry revealed medication-induced decrease in resting skeletal muscle stiffness in Parkinson’s disease patients10.1016/j.clinbiomech.2012.02.001 ↗
27. Quantitative mechanical properties of the relaxed biceps and triceps brachii muscles in patients with subacute stroke: A reliability study of the myoton-3 myometer
28. Reliability of a new, hand-held device for assessing skeletal muscle stiffness10.1016/S0268-0033(03)00042-1 ↗
29. Relationship between mechanical factors and incidence of low back pain10.2519/jospt.2002.32.9.447 ↗
30. Merskey, H.E. (1986). Classification of chronic pain: Descriptions of chronic pain syndromes and definitions of pain terms. Pain, 3.
31. Pericranial muscle hardness in tension-type headache: A non-invasive measurement method and its clinical application10.1093/brain/118.2.523 ↗
32. Myoton (2013). Hand Helding Myoton Pro User Manual, Myoton Ltd.
33. Spinal loading patterns from biomechanical modeling explain the high incidence of vertebral fractures in the thoracolumbar region10.1002/jbmr.3113 ↗
34. Facilitating effects of fast and slope walking on paraspinal muscles10.5535/arm.2014.38.4.514 ↗
35. Lumbar muscles biomechanical characteristics in young people with chronic spinal pain10.1186/s12891-019-2935-z ↗
36. Jubany, J., Danneels, L., and Angulo-Barroso, R. (2017). The influence of fatigue and chronic low back pain on muscle recruitment patterns following an unexpected external perturbation. BMC Musculoskelet. Disord., 18.10.1186/s12891-017-1523-3 ↗
37. Three dimensional measurements of pelvic tilt in trans-tibial amputations: The effects of pelvic tilt on trunk muscles strength and characteristics of gait10.3109/03093649809164453 ↗
38. Individual muscle contributions to support in normal walking10.1016/S0966-6362(02)00073-5 ↗
39. Ceccato, J.-C., De Sèze, M., Azevedo, C., and Cazalets, J.-R. (2009). Comparison of trunk activity during gait initiation and walking in humans. PLoS ONE, 4.10.1371/journal.pone.0008193 ↗
40. 1C5-1 Measurement of Characteristic Change using MyotonPRO in Low Back Muscles during a Long-term Driving; Pilot Study
41. Mechanical properties and physical fitness of trunk muscles using Myoton
42. Crawford, R., Gizzi, L., Dieterich, A., Ni Mhuiris, Á., and Falla, D. (2018). Age-related changes in trunk muscle activity and spinal and lower limb kinematics during gait. PLoS ONE, 13.10.1371/journal.pone.0206514 ↗
43. Anatomy, biomechanics, and classification of thoracolumbar injuries10.1053/j.semss.2009.10.001 ↗
44. Static work loads and occupational myalgia-a new explanation model