Top

BMC Musculoskeletal Disorders

Published in:

Open Access 01-12-2010 | Research article

Load and speed effects on the cervical flexion relaxation phenomenon

Authors: Jean-Philippe Pialasse, Danik Lafond, Vincent Cantin, Martin Descarreaux

Published in: BMC Musculoskeletal Disorders | Issue 1/2010

Abstract

Background

The flexion relaxation phenomenon (FRP) represents a well-studied neuromuscular response that occurs in the lumbar and cervical spine. However, the cervical spine FRP has not been investigated extensively, and the speed of movement and loading effects remains to be characterized. The objectives of the present study were to evaluate the influence of load and speed on cervical FRP electromyographic (EMG) and kinematic parameters and to assess the measurement of cervical FRP kinematic and EMG parameter repeatability.

Methods

Eighteen healthy adults (6 women and 12 men), aged 20 to 39 years, participated in this study. They undertook 2 sessions in which they had to perform a standardized cervical flexion/extension movement in 3 phases: complete cervical flexion; the static period in complete cervical flexion; and extension with return to the initial position. Two different rhythm conditions and 3 different loading conditions were applied to assess load and speed effects. Kinematic and EMG data were collected, and dependent variables included angles corresponding to the onset and cessation of myoelectric silence as well as the root mean square (RMS) values of EMG signals. Repeatability was examined in the first session and between the 2 sessions.

Results

Statistical analyses revealed a significant load effect (P < 0.001). An augmented load led to increased FRP onset and cessation angles. No load × speed interaction effect was detected in the kinematics data. A significant load effect (P < 0.001) was observed on RMS values in all phases of movement, while a significant speed effect (P < 0.001) could be seen only during the extension phase. Load × speed interaction effect was noted in the extension phase, where higher loads and faster rhythm generated significantly greater muscle activation. Intra-session and inter-session repeatability was good for the EMG and kinematic parameters.

Conclusions

The load increase evoked augmented FRP onset and cessation angles as well as heightened muscle activation. Such increments may reflect the need to enhance spinal stability under loading conditions. The kinematic and EMG parameters showed promising repeatability. Further studies are needed to assess kinematic and EMG differences between healthy subjects and patients with neck pain.

Available only for authorised users

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. 10.1016/j.jmpt.2005.08.005.CrossRefPubMed

Panjabi MM: The stabilizing system of the spine. Part II. Neutral zone and instability hypothesis. J Spinal Disord. 1992, 5 (4): 390-396. 10.1097/00002517-199212000-00002. 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. 10.1097/00002517-199212000-00001. discussion 397CrossRefPubMed

Andersson EA, Oddsson LI, Grundstrom H, Nilsson J, Thorstensson A: EMG activities of the quadratus lumborum and erector spinae muscles during flexion-relaxation and other motor tasks. Clin Biomech (Bristol, Avon). 1996, 11 (7): 392-400. 10.1016/0268-0033(96)00033-2.CrossRef

McGill S, Juker D, Kropf P: Appropriately placed surface EMG electrodes reflect deep muscle activity (psoas, quadratus lumborum, abdominal wall) in the lumbar spine. J Biomech. 1996, 29 (11): 1503-1507. 10.1016/0021-9290(96)84547-7.CrossRefPubMed

Kippers V, Parker AW: Posture related to myoelectric silence of erectores spinae during trunk flexion. Spine. 1984, 9 (7): 740-745. 10.1097/00007632-198410000-00015.CrossRefPubMed

Olson M, Solomonow M, Li L: Flexion-relaxation response to gravity. J Biomech. 2006, 39 (14): 2545-2554. 10.1016/j.jbiomech.2005.09.009.CrossRefPubMed

Le B, Davidson B, Solomonow D, Zhou BH, Lu Y, Patel V, Solomonow M: Neuromuscular control of lumbar instability following static work of various loads. Muscle Nerve. 2009, 39 (1): 71-82. 10.1002/mus.21214.CrossRefPubMed

Solomonow D, Davidson B, Zhou BH, Lu Y, Patel V, Solomonow M: Neuromuscular neutral zones response to cyclic lumbar flexion. J Biomech. 2008, 41 (13): 2821-2828. 10.1016/j.jbiomech.2008.07.010.CrossRefPubMed

10.

Youssef J, Davidson B, Zhou BH, Lu Y, Patel V, Solomonow M: Neuromuscular neutral zones response to static lumbar flexion: muscular stability compensator. Clin Biomech (Bristol, Avon). 2008, 23 (7): 870-880. 10.1016/j.clinbiomech.2008.03.069.CrossRef

11.

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: 10-10.1186/1471-2474-9-10.CrossRefPubMedPubMedCentral

12.

Gupta A: Analyses of myo-electrical silence of erectors spinae. J Biomech. 2001, 34 (4): 491-496. 10.1016/S0021-9290(00)00213-X.CrossRefPubMed

13.

Dickey JP, McNorton S, Potvin JR: Repeated spinal flexion modulates the flexion-relaxation phenomenon. Clin Biomech (Bristol, Avon). 2003, 18 (9): 783-789. 10.1016/S0268-0033(03)00166-9.CrossRef

14.

Sarti MA, Lison JF, Monfort M, Fuster MA: Response of the flexion-relaxation phenomenon relative to the lumbar motion to load and speed. Spine. 2001, 26 (18): E421-426. 10.1097/00007632-200109150-00019.CrossRefPubMed

15.

Olson MW, Li L, Solomonow M: Flexion-relaxation response to cyclic lumbar flexion. Clin Biomech (Bristol, Avon). 2004, 19 (8): 769-776. 10.1016/j.clinbiomech.2004.05.007.CrossRef

16.

Olson MW, Li L, Solomonow M: Interaction of viscoelastic tissue compliance with lumbar muscles during passive cyclic flexion-extension. J Electromyogr Kinesiol. 2009, 19 (1): 30-38. 10.1016/j.jelekin.2007.06.011.CrossRefPubMed

17.

Othman SH, Ibrahim F, Omar SZ, Rahim RBA: Flexion relaxation phenomenon of back muscles in discriminating between healthy and chronic low back pain women. 4th Kuala Lumpur International Conference on Biomedical Engineering 2008. 2008, 199-203. full_text.CrossRef

18.

Shirado O, Ito T, Kaneda K, Strax TE: Flexion-relaxation phenomenon in the back muscles. A comparative study between healthy subjects and patients with chronic low back pain. Am J Phys Med Rehabil. 1995, 74 (2): 139-144. 10.1097/00002060-199503000-00010.CrossRefPubMed

19.

Watson PJ, Booker CK, Main CJ, Chen AC: Surface electromyography in the identification of chronic low back pain patients: the development of the flexion relaxation ratio. Clin Biomech (Bristol, Avon). 1997, 12 (3): 165-171. 10.1016/S0268-0033(97)00065-X.CrossRef

20.

Leeuw M, Goossens ME, Linton SJ, Crombez G, Boersma K, Vlaeyen JW: The fear-avoidance model of musculoskeletal pain: current state of scientific evidence. J Behav Med. 2007, 30 (1): 77-94. 10.1007/s10865-006-9085-0.CrossRefPubMed

21.

Thomas JSP, France CRP, Sha DP, Wiele NVDPT: The Influence of Pain-Related Fear on Peak Muscle Activity and Force Generation During Maximal Isometric Trunk Exertions. Spine. 2008, 33 (11): E342-E348. 10.1097/BRS.0b013e3181719264.CrossRefPubMed

22.

Vlaeyen JWS, Linton SJ: Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain. 2000, 85 (3): 317-332. 10.1016/S0304-3959(99)00242-0.CrossRefPubMed

23.

Holm S, Indahl A, Solomonow M: Sensorimotor control of the spine. J Electromyogr Kinesiol. 2002, 12 (3): 219-234. 10.1016/S1050-6411(02)00028-7.CrossRefPubMed

24.

Airaksinen MK, Kankaanpää M, Aranko O, Leinonen V, Arokoski JPA, Airaksinen O: Wireless on-line electromyography in recording neck muscle function: a pilot study. Pathophysiology. 2005, 12 (4): 303-306. 10.1016/j.pathophys.2005.09.012.CrossRefPubMed

25.

Burnett A, O'Sullivan P, Caneiro JP, Krug R, Bochmann F, Helgestad GW: An examination of the flexion-relaxation phenomenon in the cervical spine in lumbo-pelvic sitting. J Electromyogr Kinesiol. 2009, 19 (4): e229-236. 10.1016/j.jelekin.2008.04.015.CrossRefPubMed

26.

Meyer JJ, Berk RJ, Anderson AV: Recruitment patterns in the cervical paraspinal muscles during cervical forward flexion: evidence of cervical flexion-relaxation. Electromyogr Clin Neurophysiol. 1993, 33 (4): 217-223.PubMed

27.

Pauly JE: An electromyographic analysis of certain movements and exercises. I. Some deep muscles of the back. Anat Rec. 1966, 155 (2): 223-234. 10.1002/ar.1091550209.CrossRefPubMed

28.

Pialasse JP, Dubois JD, Pilon Choquette MH, Lafond D, Descarreaux M: Kinematic and electromyographic parameters of the cervical flexion-relaxation phenomenon: The effect of trunk positioning. Ann Phys Rehabil Med. 2009, 52 (1): 48-59.CrossRef

29.

Murphy B, Marshall P, Taylor H, Govorko D, Palmer S: The cervical flexion-relaxation ratio: reproducibility and comparison between chronic neck pain patients and controls. WFC's 9th Biennial Congress: 2007. 2007, 187-189.

30.

Strimpakos N, Georgios G, Eleni K, Vasilios K, Jacqueline O: Issues in relation to the repeatability of and correlation between EMG and Borg scale assessments of neck muscle fatigue. J Electrmyogro Kinesiol. 2005, 15 (5): 452-465. 10.1016/j.jelekin.2005.01.007.CrossRef

31.

Bravo G, Potvin L: Estimating the reliability of continuous measures with Cronbach's alpha or the intraclass correlation coefficient: toward the integration of two traditions. J Clin Epidemiol. 1991, 44 (4-5): 381-390. 10.1016/0895-4356(91)90076-L.CrossRefPubMed

32.

Thuresson M, Äng B, Linder J, Harms-Ringdahl K: Mechanical load and EMG activity in the neck induced by different head-worn equipment and neck postures. Int J Ind Ergon. 2005, 35 (1): 13-18. 10.1016/j.ergon.2004.06.008.CrossRef

33.

McGill SM, Kippers V: Transfer of loads between lumbar tissues during the flexion-relaxation phenomenon. Spine. 1994, 19 (19): 2190-2196. 10.1097/00007632-199410000-00013.CrossRefPubMed

34.

Solomonow M, Baratta RV, Banks A, Freudenberger C, Zhou BH: Flexion-relaxation response to static lumbar flexion in males and females. Clin Biomech (Bristol, Avon). 2003, 18 (4): 273-279. 10.1016/S0268-0033(03)00024-X.CrossRef

35.

Adams MA, Dolan P: Time-dependent changes in the lumbar spine's resistancc to bending. Clin Biomech. 1996, 11 (4): 194-200. 10.1016/0268-0033(96)00002-2.CrossRef

36.

Takeshita K, Peterson ET, Bylski-Austrow D, Crawford AH, Nakamura K: The nuchal ligament restrains cervical spine flexion. Spine. 2004, 29 (18): E388-393. 10.1097/01.brs.0000138309.11926.72.CrossRefPubMed

37.

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. 2003, 28 (13): 1435-1446. 10.1097/00007632-200307010-00015.PubMed

38.

Triano JJ, Schultz AB: Correlation of objective measure of trunk motion and muscle function with low-back disability ratings. Spine. 1987, 12 (6): 561-565. 10.1097/00007632-198707000-00010.CrossRefPubMed

39.

Allison GT: Trunk muscle onset detection technique for EMG signals with ECG artefact. J Electromyogr Kinesiol. 2003, 13 (3): 209-216. 10.1016/S1050-6411(03)00019-1.CrossRefPubMed

40.

Sommerich CM, Joines SM, Hermans V, Moon SD: Use of surface electromyography to estimate neck muscle activity. J Electromyogr Kinesiol. 2000, 10 (6): 377-398. 10.1016/S1050-6411(00)00033-X.CrossRefPubMed

The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2474/11/46/prepub

Title: Load and speed effects on the cervical flexion relaxation phenomenon
Authors: Jean-Philippe Pialasse
Danik Lafond
Vincent Cantin
Martin Descarreaux
Publication date: 01-12-2010
Publisher: BioMed Central
Published in: BMC Musculoskeletal Disorders / Issue 1/2010
Electronic ISSN: 1471-2474
DOI: https://doi.org/10.1186/1471-2474-11-46

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Load and speed effects on the cervical flexion relaxation phenomenon

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2010

MicroRNA-146a expresses in interleukin-17 producing T cells in rheumatoid arthritis patients

Prevalence of neck pain in subjects with metabolic syndrome - a cross-sectional population-based study

A patient with Pfeifer-Weber-Christian Disease - Successful Therapy with Cyclosporin A: case report

Anterolateral approach with tibial tubercle osteotomy versus standard medial approach for primary total knee arthroplasty: does it matter?

Protocol for Work place adjusted Intelligent physical exercise reducing Musculoskeletal pain in Shoulder and neck (VIMS): a cluster randomized controlled trial

Comparison of glucose derivatives effects on cartilage degradation