Alterations and Asymmetries in Trunk Mechanics and Neuromuscular Control among Persons with Lower-Limb Amputation: Exploring Potential Pathways of Low Back Pain
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Eight males with unilateral LLA and a matched sample of non-amputation controls completed three studies in which several measures of trunk passive properties, neuromuscular control, and spine biomechanics were quantified using laboratory experiments and biomechanical analyses. Each study involved a distinct task to investigate potential alterations and/or asymmetries in trunk passive properties and neuromuscular control. The first study used a seated balance task to assess trunk postural control and stability. The second study used multidirectional trunk perturbations to assess trunk mechanical and neuromuscular behaviors. Finally, the third study used controlled quasi-static trunk movements to assess load-sharing mechanisms between active and passive low back tissues.
Significant alterations and asymmetries in trunk passive properties and trunk neuromuscular responses were present among participants with LLA, specifically reduced and asymmetric trunk stiffness and reflex response; decreased and asymmetric passive contributions to trunk movements; and increased trunk muscle activities. Significant increases in trunk postural sway and trunk muscle activities were also present during seated stability measures. Such alterations in these behaviors may be a result of repetitive exposures to abnormal gait and movement subsequent to LLA and the use of a prosthetic device, and could play a contributing role in the development of LBP in this population. Future work should investigate the temporal relationship between altered trunk behaviors and repeated exposure to abnormal gait and movement subsequent to LLA, to better identify critical years for rehabilitation and preventative care.
- Doctoral Dissertations