Abstract
Purpose: The purpose of this systematic review was to assess whether LBP patients demonstrate signs of splinting by evaluating the reactions to unexpected mechanical perturbations in terms of (1) trunk muscle activity, (2) kinetic and (3) kinematic trunk responses and (4) estimated mechanical properties of the trunk. Methods: The literature was systematically reviewed to identify studies that compared responses to mechanical trunk perturbations between LBP patients and healthy controls in terms of muscle activation, kinematics, kinetics, and/or mechanical properties. If more than four studies reported an outcome, the results of these studies were pooled. Results: Nineteen studies were included, of which sixteen reported muscle activation, five kinematic responses, two kinetic responses, and two estimated mechanical trunk properties. We found evidence of a longer response time of muscle activation, which would be in line with splinting behaviour in LBP. No signs of splinting behaviour were found in any of the other outcome measures. Conclusions: We conclude that there is currently no convincing evidence for the presence of splinting behaviour in LBP patients, because we found no indications for splinting in terms of kinetic and kinematic responses to perturbation and derived mechanical properties of the trunk. Consistent evidence on delayed onsets of muscle activation in response to perturbations was found, but this may have other causes than splinting behaviour.
| Original language | English |
|---|---|
| Pages (from-to) | 40-59 |
| Number of pages | 20 |
| Journal | European Spine Journal |
| Volume | 27 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - 1 Jan 2018 |
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Keywords
- Low back pain
- Perturbations
- Splinting
- Stiffness
- Trunk
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Evidence of splinting in low back pain? A systematic review of perturbation studies. / Prins, Maarten; Griffioen, Mariëtte; Veeger, Thom T.J.; Kiers, Henri; Meijer, Onno G.; van der Wurff, Peter; Bruijn, Sjoerd M.; van Dieën, Jaap H.
In: European Spine Journal, Vol. 27, No. 1, 01.01.2018, p. 40-59.Research output: Contribution to Journal › Article › Academic › peer-review
TY - JOUR
T1 - Evidence of splinting in low back pain?
T2 - A systematic review of perturbation studies
AU - Prins, Maarten
AU - Griffioen, Mariëtte
AU - Veeger, Thom T.J.
AU - Kiers, Henri
AU - Meijer, Onno G.
AU - van der Wurff, Peter
AU - Bruijn, Sjoerd M.
AU - van Dieën, Jaap H.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Purpose: The purpose of this systematic review was to assess whether LBP patients demonstrate signs of splinting by evaluating the reactions to unexpected mechanical perturbations in terms of (1) trunk muscle activity, (2) kinetic and (3) kinematic trunk responses and (4) estimated mechanical properties of the trunk. Methods: The literature was systematically reviewed to identify studies that compared responses to mechanical trunk perturbations between LBP patients and healthy controls in terms of muscle activation, kinematics, kinetics, and/or mechanical properties. If more than four studies reported an outcome, the results of these studies were pooled. Results: Nineteen studies were included, of which sixteen reported muscle activation, five kinematic responses, two kinetic responses, and two estimated mechanical trunk properties. We found evidence of a longer response time of muscle activation, which would be in line with splinting behaviour in LBP. No signs of splinting behaviour were found in any of the other outcome measures. Conclusions: We conclude that there is currently no convincing evidence for the presence of splinting behaviour in LBP patients, because we found no indications for splinting in terms of kinetic and kinematic responses to perturbation and derived mechanical properties of the trunk. Consistent evidence on delayed onsets of muscle activation in response to perturbations was found, but this may have other causes than splinting behaviour.
AB - Purpose: The purpose of this systematic review was to assess whether LBP patients demonstrate signs of splinting by evaluating the reactions to unexpected mechanical perturbations in terms of (1) trunk muscle activity, (2) kinetic and (3) kinematic trunk responses and (4) estimated mechanical properties of the trunk. Methods: The literature was systematically reviewed to identify studies that compared responses to mechanical trunk perturbations between LBP patients and healthy controls in terms of muscle activation, kinematics, kinetics, and/or mechanical properties. If more than four studies reported an outcome, the results of these studies were pooled. Results: Nineteen studies were included, of which sixteen reported muscle activation, five kinematic responses, two kinetic responses, and two estimated mechanical trunk properties. We found evidence of a longer response time of muscle activation, which would be in line with splinting behaviour in LBP. No signs of splinting behaviour were found in any of the other outcome measures. Conclusions: We conclude that there is currently no convincing evidence for the presence of splinting behaviour in LBP patients, because we found no indications for splinting in terms of kinetic and kinematic responses to perturbation and derived mechanical properties of the trunk. Consistent evidence on delayed onsets of muscle activation in response to perturbations was found, but this may have other causes than splinting behaviour.
KW - Low back pain
KW - Perturbations
KW - Splinting
KW - Stiffness
KW - Trunk
UR - http://www.scopus.com/inward/record.url?scp=85029184487&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85029184487&partnerID=8YFLogxK
U2 - 10.1007/s00586-017-5287-0
DO - 10.1007/s00586-017-5287-0
M3 - Article
VL - 27
SP - 40
EP - 59
JO - European Spine Journal
JF - European Spine Journal
SN - 0940-6719
IS - 1
ER -