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Published in: Journal of NeuroEngineering and Rehabilitation 1/2013

Open Access 01-12-2013 | Research

Changes in flexion-relaxation phenomenon and lumbo-pelvic kinematics following lumbar disc replacement surgery

Authors: Julie O’Shaughnessy, Jean-François Roy, Martin Descarreaux

Published in: Journal of NeuroEngineering and Rehabilitation | Issue 1/2013

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Abstract

Background

A single group prospective study. Disc prostheses are believed to contribute to the restoration of the segmental movement and the preservation of the adjacent segments. The study’s main objective was to determine if changes in neuromuscular patterns assessed using the flexion-relaxation phenomenon (FRP) can be observed following disc replacement surgery.

Methods

Fifteen subjects participated in this study; they were evaluated before and after lumbar disc replacement surgery. Both assessments included ten repetitions of a trunk flexion and extension movement (with and without a load), where the surface electromyography (EMG) and kinematic data were recorded.

Results

Following the disc replacement procedure (17.3 weeks ± 8.4), participants reported a significant reduction in their ODI and FABQ - physical activity scores. Increases in pelvic flexion as well as in erector spinae (ES) muscle activity at L5 in the flexion phase were observed. Following the disc replacement surgery, ES activity at L2 decreased during the quiet standing position.

Conclusion

The results of this study suggest that although improvements in disability scores and fear-avoidance related to physical activities scores were noted after a disc replacement surgery, the lumbar ROM was not modified. Nevertheless, a significant increase in the hip ROM during the flexion-extension task as well as an increase in ES muscle activity in flexion was observed following surgery. The VAS, FABQ I and ODQ scores were positively correlated with change in the muscular activities during the FRP.
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Literature
1.
go back to reference Fritzell P, Hagg O, Wessberg P, Nordwall A: 2001 Volvo Award Winner in Clinical Studies: Lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group. Spine 2001,26(23):2521-2532. discussion 2532–2524CrossRefPubMed Fritzell P, Hagg O, Wessberg P, Nordwall A: 2001 Volvo Award Winner in Clinical Studies: Lumbar fusion versus nonsurgical treatment for chronic low back pain: a multicenter randomized controlled trial from the Swedish Lumbar Spine Study Group. Spine 2001,26(23):2521-2532. discussion 2532–2524CrossRefPubMed
2.
go back to reference Carey TS, Evans A, Hadler N, Kalsbeek W, McLaughlin C, Fryer J: Care-seeking among individuals with chronic low back pain. Spine 1995,20(3):312-317.CrossRefPubMed Carey TS, Evans A, Hadler N, Kalsbeek W, McLaughlin C, Fryer J: Care-seeking among individuals with chronic low back pain. Spine 1995,20(3):312-317.CrossRefPubMed
3.
go back to reference Du Bois M, Szpalski M, Donceel P: Patients at risk for long-term sick leave because of low back pain. Spine J 2009,9(5):350-359.CrossRefPubMed Du Bois M, Szpalski M, Donceel P: Patients at risk for long-term sick leave because of low back pain. Spine J 2009,9(5):350-359.CrossRefPubMed
4.
go back to reference Davis H: Increasing rates of cervical and lumbar spine surgery in the United States, 1979–1990. Spine (Phila Pa 1976) 1994,19(10):1117-1123. discussion 1123–1114CrossRef Davis H: Increasing rates of cervical and lumbar spine surgery in the United States, 1979–1990. Spine (Phila Pa 1976) 1994,19(10):1117-1123. discussion 1123–1114CrossRef
5.
go back to reference Bono CM, Lee CK: Critical analysis of trends in fusion for degenerative disc disease over the past 20 years: influence of technique on fusion rate and clinical outcome. Spine 2004,29(4):455-463. discussion Z455CrossRefPubMed Bono CM, Lee CK: Critical analysis of trends in fusion for degenerative disc disease over the past 20 years: influence of technique on fusion rate and clinical outcome. Spine 2004,29(4):455-463. discussion Z455CrossRefPubMed
7.
go back to reference Cunningham BW: Basic scientific considerations in total disc arthroplasty. Spine J 2004,4(6 Suppl):219S-230S.CrossRefPubMed Cunningham BW: Basic scientific considerations in total disc arthroplasty. Spine J 2004,4(6 Suppl):219S-230S.CrossRefPubMed
8.
go back to reference Singh K, Vaccaro AR, Albert TJ: Assessing the potential impact of total disc arthroplasty on surgeon practice patterns in North America. Spine J 2004,4(6 Suppl):195S-201S.CrossRefPubMed Singh K, Vaccaro AR, Albert TJ: Assessing the potential impact of total disc arthroplasty on surgeon practice patterns in North America. Spine J 2004,4(6 Suppl):195S-201S.CrossRefPubMed
9.
go back to reference Blumenthal S, McAfee PC, Guyer RD, Hochschuler SH, Geisler FH, Holt RT, Garcia R Jr, Regan JJ, Ohnmeiss DD: A prospective, randomized, multicenter Food and Drug Administration investigational device exemptions study of lumbar total disc replacement with the CHARITE artificial disc versus lumbar fusion: part I: evaluation of clinical outcomes. Spine 2005,30(14):1565-1575. discussion E1387-1591CrossRefPubMed Blumenthal S, McAfee PC, Guyer RD, Hochschuler SH, Geisler FH, Holt RT, Garcia R Jr, Regan JJ, Ohnmeiss DD: A prospective, randomized, multicenter Food and Drug Administration investigational device exemptions study of lumbar total disc replacement with the CHARITE artificial disc versus lumbar fusion: part I: evaluation of clinical outcomes. Spine 2005,30(14):1565-1575. discussion E1387-1591CrossRefPubMed
10.
go back to reference Zigler J, Delamarter R, Spivak JM, Linovitz RJ, Danielson GO 3rd, Haider TT, Cammisa F, Zuchermann J, Balderston R, Kitchel S, et al.: Results of the prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of the ProDisc-L total disc replacement versus circumferential fusion for the treatment of 1-level degenerative disc disease. Spine 2007,32(11):1155-1162. discussion 1163CrossRefPubMed Zigler J, Delamarter R, Spivak JM, Linovitz RJ, Danielson GO 3rd, Haider TT, Cammisa F, Zuchermann J, Balderston R, Kitchel S, et al.: Results of the prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of the ProDisc-L total disc replacement versus circumferential fusion for the treatment of 1-level degenerative disc disease. Spine 2007,32(11):1155-1162. discussion 1163CrossRefPubMed
11.
go back to reference Sasso RC, Foulk DM, Hahn M: Prospective, randomized trial of metal-on-metal artificial lumbar disc replacement: initial results for treatment of discogenic pain. Spine 2008,33(2):123-131.CrossRefPubMed Sasso RC, Foulk DM, Hahn M: Prospective, randomized trial of metal-on-metal artificial lumbar disc replacement: initial results for treatment of discogenic pain. Spine 2008,33(2):123-131.CrossRefPubMed
12.
go back to reference Delamarter R, Zigler JE, Balderston RA, Cammisa FP, Goldstein JA, Spivak JM: Prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of the ProDisc-L total disc replacement compared with circumferential arthrodesis for the treatment of two-level lumbar degenerative disc disease: results at twenty-four months. J Bone Joint Surg Am 2011,93(8):705-715.CrossRefPubMed Delamarter R, Zigler JE, Balderston RA, Cammisa FP, Goldstein JA, Spivak JM: Prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of the ProDisc-L total disc replacement compared with circumferential arthrodesis for the treatment of two-level lumbar degenerative disc disease: results at twenty-four months. J Bone Joint Surg Am 2011,93(8):705-715.CrossRefPubMed
13.
go back to reference Bertagnoli R, Yue JJ, Nanieva R, Fenk-Mayer A, Husted DS, Shah RV, Emerson JW: Lumbar total disc arthroplasty in patients older than 60 years of age: a prospective study of the ProDisc prosthesis with 2-year minimum follow-up period. J Neurosurg Spine 2006,4(2):85-90.CrossRefPubMed Bertagnoli R, Yue JJ, Nanieva R, Fenk-Mayer A, Husted DS, Shah RV, Emerson JW: Lumbar total disc arthroplasty in patients older than 60 years of age: a prospective study of the ProDisc prosthesis with 2-year minimum follow-up period. J Neurosurg Spine 2006,4(2):85-90.CrossRefPubMed
14.
go back to reference Park P, Garton HJ, Gala VC, Hoff JT, McGillicuddy JE: Adjacent segment disease after lumbar or lumbosacral fusion: review of the literature. Spine 2004,29(17):1938-1944.CrossRefPubMed Park P, Garton HJ, Gala VC, Hoff JT, McGillicuddy JE: Adjacent segment disease after lumbar or lumbosacral fusion: review of the literature. Spine 2004,29(17):1938-1944.CrossRefPubMed
15.
go back to reference Bertagnoli R, Yue JJ, Fenk-Mayer A, Eerulkar J, Emerson JW: Treatment of symptomatic adjacent-segment degeneration after lumbar fusion with total disc arthroplasty by using the prodisc prosthesis: a prospective study with 2-year minimum follow up. J Neurosurg Spine 2006,4(2):91-97.CrossRefPubMed Bertagnoli R, Yue JJ, Fenk-Mayer A, Eerulkar J, Emerson JW: Treatment of symptomatic adjacent-segment degeneration after lumbar fusion with total disc arthroplasty by using the prodisc prosthesis: a prospective study with 2-year minimum follow up. J Neurosurg Spine 2006,4(2):91-97.CrossRefPubMed
16.
go back to reference Harrop JS, Youssef JA, Maltenfort M, Vorwald P, Jabbour P, Bono CM, Goldfarb N, Vaccaro AR, Hilibrand AS: Lumbar adjacent segment degeneration and disease after arthrodesis and total disc arthroplasty. Spine 2008,33(15):1701-1707.CrossRefPubMed Harrop JS, Youssef JA, Maltenfort M, Vorwald P, Jabbour P, Bono CM, Goldfarb N, Vaccaro AR, Hilibrand AS: Lumbar adjacent segment degeneration and disease after arthrodesis and total disc arthroplasty. Spine 2008,33(15):1701-1707.CrossRefPubMed
17.
go back to reference Gao SG, Lei GH, He HB, Liu H, Xiao WF, Wen T, Liang JY, Li KH: Biomechanical comparison of lumbar total disc arthroplasty, discectomy, and fusion: effect on adjacent-level disc pressure and facet joint force. J Neurosurg Spine 2011,15(5):507-514.CrossRefPubMed Gao SG, Lei GH, He HB, Liu H, Xiao WF, Wen T, Liang JY, Li KH: Biomechanical comparison of lumbar total disc arthroplasty, discectomy, and fusion: effect on adjacent-level disc pressure and facet joint force. J Neurosurg Spine 2011,15(5):507-514.CrossRefPubMed
18.
go back to reference Auerbach JD, Wills BP, McIntosh TC, Balderston RA: Evaluation of spinal kinematics following lumbar total disc replacement and circumferential fusion using in vivo fluoroscopy. Spine 2007,32(5):527-536.CrossRefPubMed Auerbach JD, Wills BP, McIntosh TC, Balderston RA: Evaluation of spinal kinematics following lumbar total disc replacement and circumferential fusion using in vivo fluoroscopy. Spine 2007,32(5):527-536.CrossRefPubMed
19.
go back to reference McAfee PC, Cunningham B, Holsapple G, Adams K, Blumenthal S, Guyer RD, Dmietriev A, Maxwell JH, Regan JJ, Isaza J: A prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of lumbar total disc replacement with the CHARITE artificial disc versus lumbar fusion: part II: evaluation of radiographic outcomes and correlation of surgical technique accuracy with clinical outcomes. Spine 2005,30(14):1576-1583. discussion E1388-1590CrossRefPubMed McAfee PC, Cunningham B, Holsapple G, Adams K, Blumenthal S, Guyer RD, Dmietriev A, Maxwell JH, Regan JJ, Isaza J: A prospective, randomized, multicenter Food and Drug Administration investigational device exemption study of lumbar total disc replacement with the CHARITE artificial disc versus lumbar fusion: part II: evaluation of radiographic outcomes and correlation of surgical technique accuracy with clinical outcomes. Spine 2005,30(14):1576-1583. discussion E1388-1590CrossRefPubMed
20.
go back to reference Auerbach JD, Jones KJ, Milby AH, Anakwenze OA, Balderston RA: Segmental contribution toward total lumbar range of motion in disc replacement and fusions: a comparison of operative and adjacent levels. Spine 2009,34(23):2510-2517.CrossRefPubMed Auerbach JD, Jones KJ, Milby AH, Anakwenze OA, Balderston RA: Segmental contribution toward total lumbar range of motion in disc replacement and fusions: a comparison of operative and adjacent levels. Spine 2009,34(23):2510-2517.CrossRefPubMed
21.
go back to reference Panjabi MM: The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord 1992,5(4):383-389. discussion 397CrossRefPubMed Panjabi MM: The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement. J Spinal Disord 1992,5(4):383-389. discussion 397CrossRefPubMed
22.
go back to reference Panjabi MM: The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. J Spinal Disord 1992,5(4):390-396. discussion 397PubMed Panjabi MM: The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. J Spinal Disord 1992,5(4):390-396. discussion 397PubMed
23.
go back to reference Colloca CJ, Hinrichs RN: The biomechanical and clinical significance of the lumbar erector spinae flexion-relaxation phenomenon: a review of literature. J Manipulative Physiol Ther 2005,28(8):623-631.CrossRefPubMed Colloca CJ, Hinrichs RN: The biomechanical and clinical significance of the lumbar erector spinae flexion-relaxation phenomenon: a review of literature. J Manipulative Physiol Ther 2005,28(8):623-631.CrossRefPubMed
24.
go back to reference Allen CE: Muscle action potentials used in the study of dynamic anatomy. Br J Phys Med 1948,11(3):66-73.PubMed Allen CE: Muscle action potentials used in the study of dynamic anatomy. Br J Phys Med 1948,11(3):66-73.PubMed
25.
go back to reference Floyd WF, Silver PH: Function of erectores spinae in flexion of the trunk. Lancet 1951,1(6647):133-134.CrossRefPubMed Floyd WF, Silver PH: Function of erectores spinae in flexion of the trunk. Lancet 1951,1(6647):133-134.CrossRefPubMed
27.
go back to reference Zedka M, Prochazka A, Knight B, Gillard D, Gauthier M: Voluntary and reflex control of human back muscles during induced pain. J Physiol 1999,520(Pt 2):591-604.PubMedCentralCrossRefPubMed Zedka M, Prochazka A, Knight B, Gillard D, Gauthier M: Voluntary and reflex control of human back muscles during induced pain. J Physiol 1999,520(Pt 2):591-604.PubMedCentralCrossRefPubMed
28.
go back to reference Dubois JD, Piche M, Cantin V, Descarreaux M: Effect of experimental low back pain on neuromuscular control of the trunk in healthy volunteers and patients with chronic low back pain. J Electromyogr Kinesiol 2011. IN PRESS Dubois JD, Piche M, Cantin V, Descarreaux M: Effect of experimental low back pain on neuromuscular control of the trunk in healthy volunteers and patients with chronic low back pain. J Electromyogr Kinesiol 2011. IN PRESS
29.
30.
go back to reference McGill SM, Kippers V: Transfer of loads between lumbar tissues during the flexion-relaxation phenomenon. Spine (Phila Pa 1976) 1994,19(19):2190-2196.CrossRef McGill SM, Kippers V: Transfer of loads between lumbar tissues during the flexion-relaxation phenomenon. Spine (Phila Pa 1976) 1994,19(19):2190-2196.CrossRef
31.
go back to reference Sarti MA, Lison JF, Monfort M, Fuster MA: Response of the flexion-relaxation phenomenon relative to the lumbar motion to load and speed. Spine (Phila Pa 1976) 2001,26(18):E421-426.CrossRef Sarti MA, Lison JF, Monfort M, Fuster MA: Response of the flexion-relaxation phenomenon relative to the lumbar motion to load and speed. Spine (Phila Pa 1976) 2001,26(18):E421-426.CrossRef
32.
go back to reference Neblett R, Mayer TG, Brede E, Gatchel RJ: Correcting abnormal flexion-relaxation in chronic lumbar pain: responsiveness to a new biofeedback training protocol. Clin J Pain 2010,26(5):403-409.PubMedCentralCrossRefPubMed Neblett R, Mayer TG, Brede E, Gatchel RJ: Correcting abnormal flexion-relaxation in chronic lumbar pain: responsiveness to a new biofeedback training protocol. Clin J Pain 2010,26(5):403-409.PubMedCentralCrossRefPubMed
33.
go back to reference Neblett R, Mayer TG, Gatchel RJ, Keeley J, Proctor T, Anagnostis C: Quantifying the lumbar flexion-relaxation phenomenon: theory, normative data, and clinical applications. Spine (Phila Pa 1976) 2003,28(13):1435-1446. Neblett R, Mayer TG, Gatchel RJ, Keeley J, Proctor T, Anagnostis C: Quantifying the lumbar flexion-relaxation phenomenon: theory, normative data, and clinical applications. Spine (Phila Pa 1976) 2003,28(13):1435-1446.
34.
go back to reference Mayer TG, Neblett R, Brede E, Gatchel RJ: The quantified lumbar flexion-relaxation phenomenon is a useful measurement of improvement in a functional restoration program. Spine 2009,34(22):2458-2465.CrossRefPubMed Mayer TG, Neblett R, Brede E, Gatchel RJ: The quantified lumbar flexion-relaxation phenomenon is a useful measurement of improvement in a functional restoration program. Spine 2009,34(22):2458-2465.CrossRefPubMed
35.
go back to reference Marshall P, Murphy B: Changes in the flexion relaxation response following an exercise intervention. Spine (Phila Pa 1976) 2006,31(23):E877-883.CrossRef Marshall P, Murphy B: Changes in the flexion relaxation response following an exercise intervention. Spine (Phila Pa 1976) 2006,31(23):E877-883.CrossRef
36.
go back to reference Haig AJ, Weismann G, Haugh LD, Pope M, Grobler LJ: Prospective evidence for change in paraspinal muscle activity after herniated nucleus pulposus. Spine 1993,18(7):926-930.CrossRefPubMed Haig AJ, Weismann G, Haugh LD, Pope M, Grobler LJ: Prospective evidence for change in paraspinal muscle activity after herniated nucleus pulposus. Spine 1993,18(7):926-930.CrossRefPubMed
37.
go back to reference Wallbom AS, Geisser ME, Koch J, Haig AJ, Guido C, Hoff JT: Lumbar flexion and dynamic EMG among persons with single level disk herniation pre- and postsurgery with radicular low-back pain. American journal of physical medicine & rehabilitation /Association of Academic Physiatrists 2009,88(4):302-307.CrossRef Wallbom AS, Geisser ME, Koch J, Haig AJ, Guido C, Hoff JT: Lumbar flexion and dynamic EMG among persons with single level disk herniation pre- and postsurgery with radicular low-back pain. American journal of physical medicine & rehabilitation /Association of Academic Physiatrists 2009,88(4):302-307.CrossRef
38.
go back to reference Vogler D, Paillex R, Norberg M, de Goumoens P, Cabri J: Cross-cultural validation of the Oswestry disability index in French. Ann Readapt Med Phys 2008,51(5):379-385.CrossRefPubMed Vogler D, Paillex R, Norberg M, de Goumoens P, Cabri J: Cross-cultural validation of the Oswestry disability index in French. Ann Readapt Med Phys 2008,51(5):379-385.CrossRefPubMed
39.
go back to reference Chaory K, Fayad F, Rannou F, Lefevre-Colau MM, Fermanian J, Revel M, Poiraudeau S: Validation of the French version of the fear avoidance belief questionnaire. Spine (Phila Pa 1976) 2004,29(8):908-913.CrossRef Chaory K, Fayad F, Rannou F, Lefevre-Colau MM, Fermanian J, Revel M, Poiraudeau S: Validation of the French version of the fear avoidance belief questionnaire. Spine (Phila Pa 1976) 2004,29(8):908-913.CrossRef
40.
go back to reference Scrimshaw SV, Maher C: Responsiveness of visual analogue and McGill pain scale measures. J Manipulative Physiol Ther 2001,24(8):501-504.CrossRefPubMed Scrimshaw SV, Maher C: Responsiveness of visual analogue and McGill pain scale measures. J Manipulative Physiol Ther 2001,24(8):501-504.CrossRefPubMed
41.
go back to reference Davis DS, Quinn RO, Whiteman CT, Williams JD, Young CR: Concurrent validity of four clinical tests used to measure hamstring flexibility. Journal of strength and conditioning research /National Strength & Conditioning Association 2008,22(2):583-588.CrossRef Davis DS, Quinn RO, Whiteman CT, Williams JD, Young CR: Concurrent validity of four clinical tests used to measure hamstring flexibility. Journal of strength and conditioning research /National Strength & Conditioning Association 2008,22(2):583-588.CrossRef
42.
go back to reference Merletti R, Lo Conte L, Avignone E, Guglielminotti P: Modeling of surface myoelectric signals–Part I: Model implementation. IEEE Trans Biomed Eng 1999,46(7):810-820.CrossRefPubMed Merletti R, Lo Conte L, Avignone E, Guglielminotti P: Modeling of surface myoelectric signals–Part I: Model implementation. IEEE Trans Biomed Eng 1999,46(7):810-820.CrossRefPubMed
43.
go back to reference Grotle M, Brox JI, Vollestad NK: Reliability, validity and responsiveness of the fear-avoidance beliefs questionnaire: methodological aspects of the Norwegian version. J Rehabil Med 2006,38(6):346-353.CrossRefPubMed Grotle M, Brox JI, Vollestad NK: Reliability, validity and responsiveness of the fear-avoidance beliefs questionnaire: methodological aspects of the Norwegian version. J Rehabil Med 2006,38(6):346-353.CrossRefPubMed
44.
go back to reference Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY: Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. The spine journal : official journal of the North American Spine Society 2008,8(6):968-974.CrossRef Copay AG, Glassman SD, Subach BR, Berven S, Schuler TC, Carreon LY: Minimum clinically important difference in lumbar spine surgery patients: a choice of methods using the Oswestry Disability Index, Medical Outcomes Study questionnaire Short Form 36, and pain scales. The spine journal : official journal of the North American Spine Society 2008,8(6):968-974.CrossRef
45.
go back to reference Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM: Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 2001,94(2):149-158.CrossRefPubMed Farrar JT, Young JP Jr, LaMoreaux L, Werth JL, Poole RM: Clinical importance of changes in chronic pain intensity measured on an 11-point numerical pain rating scale. Pain 2001,94(2):149-158.CrossRefPubMed
46.
go back to reference Patel VV, Andrews C, Pradhan BB, Bae HW, Kanim LE, Kropf MA, Delamarter RB: Computed tomography assessment of the accuracy of in vivo placement of artificial discs in the lumbar spine including radiographic and clinical consequences. Spine 2006,31(8):948-953.CrossRefPubMed Patel VV, Andrews C, Pradhan BB, Bae HW, Kanim LE, Kropf MA, Delamarter RB: Computed tomography assessment of the accuracy of in vivo placement of artificial discs in the lumbar spine including radiographic and clinical consequences. Spine 2006,31(8):948-953.CrossRefPubMed
47.
go back to reference Park SA, Ordway NR, Fayyazi AH, Fredrickson BE, Yuan HA: Comparison of Cobb technique, quantitative motion analysis, and radiostereometric analysis in measurement of segmental range of motions after lumbar total disc arthroplasty. J Spinal Disord Tech 2009,22(8):602-609.CrossRefPubMed Park SA, Ordway NR, Fayyazi AH, Fredrickson BE, Yuan HA: Comparison of Cobb technique, quantitative motion analysis, and radiostereometric analysis in measurement of segmental range of motions after lumbar total disc arthroplasty. J Spinal Disord Tech 2009,22(8):602-609.CrossRefPubMed
48.
go back to reference Descarreaux M, Lafond D, Jeffrey-Gauthier R, Centomo H, Cantin V: Changes in the flexion relaxation response induced by lumbar muscle fatigue. BMC Musculoskelet Disord 2008, 9: 10.PubMedCentralCrossRefPubMed Descarreaux M, Lafond D, Jeffrey-Gauthier R, Centomo H, Cantin V: Changes in the flexion relaxation response induced by lumbar muscle fatigue. BMC Musculoskelet Disord 2008, 9: 10.PubMedCentralCrossRefPubMed
49.
go back to reference Kjellby-Wendt G, Styf J: Early active training after lumbar discectomy. A prospective, randomized, and controlled study. Spine 1998,23(21):2345-2351.CrossRefPubMed Kjellby-Wendt G, Styf J: Early active training after lumbar discectomy. A prospective, randomized, and controlled study. Spine 1998,23(21):2345-2351.CrossRefPubMed
50.
go back to reference Manniche C, Skall HF, Braendholt L, Christensen BH, Christophersen L, Ellegaard B, Heilbuth A, Ingerslev M, Jorgensen OE, Larsen E, et al.: Clinical trial of postoperative dynamic back exercises after first lumbar discectomy. Spine 1993,18(1):92-97.CrossRefPubMed Manniche C, Skall HF, Braendholt L, Christensen BH, Christophersen L, Ellegaard B, Heilbuth A, Ingerslev M, Jorgensen OE, Larsen E, et al.: Clinical trial of postoperative dynamic back exercises after first lumbar discectomy. Spine 1993,18(1):92-97.CrossRefPubMed
51.
go back to reference Danielsen JM, Johnsen R, Kibsgaard SK, Hellevik E: Early aggressive exercise for postoperative rehabilitation after discectomy. Spine 2000,25(8):1015-1020.CrossRefPubMed Danielsen JM, Johnsen R, Kibsgaard SK, Hellevik E: Early aggressive exercise for postoperative rehabilitation after discectomy. Spine 2000,25(8):1015-1020.CrossRefPubMed
52.
go back to reference Canbulat N, Sasani M, Ataker Y, Oktenoglu T, Berker N, Ercelen O, Cerezci O, Ozer AF, Berker E: A rehabilitation protocol for patients with lumbar degenerative disk disease treated with lumbar total disk replacement. Arch Phys Med Rehabil 2011,92(4):670-676.CrossRefPubMed Canbulat N, Sasani M, Ataker Y, Oktenoglu T, Berker N, Ercelen O, Cerezci O, Ozer AF, Berker E: A rehabilitation protocol for patients with lumbar degenerative disk disease treated with lumbar total disk replacement. Arch Phys Med Rehabil 2011,92(4):670-676.CrossRefPubMed
53.
go back to reference Geisser ME, Haig AJ, Wallbom AS, Wiggert EA: Pain-related fear, lumbar flexion, and dynamic EMG among persons with chronic musculoskeletal low back pain. Clin J Pain 2004,20(2):61-69.CrossRefPubMed Geisser ME, Haig AJ, Wallbom AS, Wiggert EA: Pain-related fear, lumbar flexion, and dynamic EMG among persons with chronic musculoskeletal low back pain. Clin J Pain 2004,20(2):61-69.CrossRefPubMed
54.
go back to reference van den Eerenbeemt KD, Ostelo RW, van Royen BJ, Peul WC, van Tulder MW: Total disc replacement surgery for symptomatic degenerative lumbar disc disease: a systematic review of the literature. Eur Spine J 2010,19(8):1262-1280.PubMedCentralCrossRefPubMed van den Eerenbeemt KD, Ostelo RW, van Royen BJ, Peul WC, van Tulder MW: Total disc replacement surgery for symptomatic degenerative lumbar disc disease: a systematic review of the literature. Eur Spine J 2010,19(8):1262-1280.PubMedCentralCrossRefPubMed
Metadata
Title
Changes in flexion-relaxation phenomenon and lumbo-pelvic kinematics following lumbar disc replacement surgery
Authors
Julie O’Shaughnessy
Jean-François Roy
Martin Descarreaux
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Journal of NeuroEngineering and Rehabilitation / Issue 1/2013
Electronic ISSN: 1743-0003
DOI
https://doi.org/10.1186/1743-0003-10-72

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