| Popis: |
Management and control of the low back pain as an important health problem in the industrial societies necessitates to investigate how the risk of this disease is affected by aging. Since the abnormalities of the lumbopelvic kinematics are related to the existence or risk of low back injuries, the objective of this dissertation was set to find the age-related differences in lumbopelvic kinematics when performing basic trunk motions reaching to range of motion in different anatomical planes. A cross-sectional study was designed where sixty asymptomatic individuals between 20–70 years old with no confounding health condition, no current or previous highly physically demanding occupation and a body mass index between 22 and 30, were divided in five equally-sized and gender-balanced age groups, and attended two sessions of data collection to perform three repetitions of self-selected slow and fast trunk forward bending and backward return, as well as one left and right lateral bending and axial twist. Following an extensive literature review, the lumbar contribution (LC) to the trunk motion, the mean absolute relative phase (MARP) between the thoracic and pelvic motions as well as variation in MARP under repetitive motions, denoted by deviation phase (DP) were selected and used for the assessment of age-related differences in lumbopelvic kinematics during forward bending and backward return tasks. Lumbopelvic kinematics during the lateral bending and axial twist tasks were assessed using the lumbar and pelvic ranges of motion (ROMs) and coupled motion ratios (CMRs) as respectively the maximum flexion/rotation in the primary (i.e., intended) and the secondary (i.e., coupled) planes of trunk motion, where the latter was normalized to the conjugate ROM for better comparison. The results showed age-related differences between the age groups above and under 50 years of age generally. A smaller LC during the forward bending and backward return tasks were observed in the older versus younger age groups, suggesting that the synergy between the active and passive lower back tissues is different between the older and younger people, which may affect the lower back mechanics. Also, smaller MARP and DP suggesting a more in-phase and more stable lumbopelvic rhythm were observed in the older versus younger age groups, which may be a neuromuscular strategy to protect the lower back tissues from excessive strain, in order to reduce the risk of injury. Furthermore, the coupled motion of lumbar spine in the transverse plane during the lateral bending to the left, and the coupled motion of pelvis in the sagittal plane during the axial twist to the right were larger in older versus younger age groups. In summary, the lumbopelvic kinematics changes with aging, especially after the age of 50 which implies alterations in the active and passive tissue responses to the task demands, as well as the neuromuscular control patterns. Drawing a conclusion regarding ii the effect of aging on the risk of low back pain from these results requires a further detailed knowledge on age-related differences in spinal active and passive tissue properties. |
