Biomechanics of increased exposure to lumbar injury caused by cyclic loading: part 1. Loss of reflexive muscular stabilization

Study Design. The recording of electromyographic responses from the in vivo lumbar multifidus of the cat, obtained while cyclic loading was applied as in occupational bending/lifting motion over time. Objectives. To determine whether the effectiveness of stabilizing reflexive muscular activity diminishes during prolonged cyclic activity; the recover y of lost muscle activity by a 10-minute rest; and whether such diminished muscular activity is caused by fatigue, neurologic habituation, or desensit ization of mechanoreceptors in spinal viscoelastic tissues resulting from i ts laxity. Summary of Background Data. The literature repeatedly confirms observation that cyclic occupational functions expose workers to a 10-fold increase in episodes of low back injury and pain. The biomechanical evidence indicates that creep in the viscoelastic tissues of the spine causes increased laxity in the intervertebral joints. The impact of cyclic activity on the functio n of the muscles, which are the major stabilizing structures of the spine, is not known. Methods. Electromyography was performed from the L1 to L7 in vivo multifidu s muscles of the cat, while cyclic passive loading of 0.25 Hz was applied t o L4-L5. Cyclic loading was applied for 50 minutes, followed by 10 minutes rest and a second 50-minute cyclic loading session. A third 50-minute cycli c loading period also was applied after the preload was reset to 0.5 N to o ffset the effect of laxity. Results. Reflexive muscular activity was recorded from the multifidus muscl es of all lumbar levels at the initiation of the first 50 minutes of cyclic loading. Activity recorded on electromyography quickly diminished with eac h cycle during the first 8 minutes of loading to 15% of its initial value. A slower decrease in muscular activity was evident throughout the remaining period, settling at 5% to 10% of its initial level by the end of 50 minute s. A 10-minute rest provided a 20% to 25% recovery of the electromyographic activity, but that was lost within the first minute of cycling. Offsetting the laxity in the spine resulted in full restoration of the electromyograp hic activity at all lumbar levels. Conclusions. The creep induced in the viscoelastic tissues of the spine as a result of cyclic loading desensitizes the mechanoreceptors within, which is manifest in dramatically diminished muscular activity, allowing full exp osure to instability and injury, even before fatigue of the musculature set s in.