Human trunk strength profile in flexion and extension

Abstract

Study design: Isometric and isokinetic trunk flexion-extension strengths were studied among 73 subjects (41 males and 32 females) and 10 patients (9 males and 1 female). The isometric strengths were measured in four postures of trunk flexion. The isokinetic trunk strengths were measured through the range of these postures.

Objectives: The study had two objectives: to develop a database for isometric flexion-extension strength at different levels of trunk flexion and isokinetic strength at corresponding angles and to determine the decrement in strength characteristics among patients of idiopathic low back pain.

Summary of background data: Though flexion-extension strength among normal subjects and patients has been studied, its variation due to standardized postural change has not been reported extensively. The influence of postural deviation on flexion-extension ratios are also largely unknown.

Methods: To achieve the objectives of the study, a device flexion-extension-lateral flexion tester (FELT) was designed and fabricated. The male and female subjects performed isometric flexion and extension at 0 degree, 20 degrees, 40 degrees and 60 degrees of trunk flexion; and isokinetic flexion starting at neutral posture, and isokinetic extension starting at 60 degrees of trunk flexion. The patients performed isometric flexion and extension in neutral posture only; and isokinetic flexion-extension similar to normal sample.

Results: The average strength in each activity was between 70 and 80% of the corresponding peak strength. The isokinetic activity strengths ranged between 60 and 70% of the corresponding isometric activities in each group. The strength of females ranged between 60 and 70% of males. The ANOVA revealed that posture had a significant effect on strength. The multiple regression explained 73% of variance in isometric and 34% in isokinetic modes.

Conclusions: A patient's strength profile should be determined in a posture that simulates activities of daily living to determine impairment and plan rehabilitation.