Quantifying trunk neuromuscular control using seated balancing and stability threshold.

Journal: Journal of biomechanics
Published Date: Sep 9, 2020

Abstract

Performance during seated balancing is often used to assess trunk neuromuscular control, including evaluating impairments in back pain populations. Balancing in less challenging environments allows for flexibility in control, which may not depend on health status but instead may reflect personal preferences. To make assessment less ambiguous, trunk neuromuscular control should be maximally challenged. Thirty-four healthy subjects balanced on a robotic seat capable of adjusting rotational stiffness. Subjects balanced while rotational stiffness was gradually reduced. The rotational stiffness at which subjects could no longer maintain balance, defined as critical stiffness (k), was used to quantify the subjects' trunk neuromuscular control. A higher k reflects poorer control, as subjects require a more stable base to balance. Subjects were tested on three days separated by 24 hours to assess test-retest reliability. Anthropometric (height and weight) and demographic (age and sex) influences on k and its reliability were assessed. Height and age did not affect k; whereas, being heavier (p < 0.001) and female (p = 0.042) significantly increased k. Reliability was also affected by anthropometric and demographic factors, highlighting the potential problem of inflated reliability estimates from non-control related attributes. k measurements appear reliable even after removing anthropometric and demographic influences, with adjusted correlations of 0.612 (95%CI: 0.433-0.766) versus unadjusted correlations of 0.880 (95%CI: 0.797-0.932). Besides assessment, trainers and therapists prescribing exercise could use the seated balance task and k to precisely set difficulty level to a percentage of the subject's stability threshold to optimize improvements in trunk neuromuscular control and spine health.

Authors

  • N Peter Reeves
    Sumaq Life LLC, East Lansing, MI, USA; MSU Center for Orthopedic Research, Michigan State University, Lansing, MI, USA. Electronic address: reevesn@icloud.com.
  • Victor Giancarlo Sal Y Rosas Celi
    Sección de Matemáticas, Departamento de Ciencias, Pontificia Universidad Católica del Perú, Peru.
  • Ahmed Ramadan
    MSU Center for Orthopedic Research, Michigan State University, Lansing, MI, USA; Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, MD, USA.
  • John M Popovich
    MSU Center for Orthopedic Research, Michigan State University, Lansing, MI, USA; Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA.
  • Clark J Radcliffe
    MSU Center for Orthopedic Research, Michigan State University, Lansing, MI, USA; Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA; Department of Mechanical Engineering, College of Engineering, Michigan State University, East Lansing, MI, USA.
  • Jongeun Choi
    MSU Center for Orthopedic Research, Michigan State University, Lansing, MI, USA; School of Mechanical Engineering, Yonsei University, Seoul, Republic of Korea.
  • Jacek Cholewicki
    MSU Center for Orthopedic Research, Michigan State University, Lansing, MI, USA; Department of Osteopathic Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA.

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