Considering the socioeconomic burden of low back pain, there is a pervasive need to improve clinical assessments for treatment decisions, evaluation of outcome and compensation awards. While range of motion, strength or endurance are widely used in clinical practice, they may
not necessarily address physical impairments related to specific neuromuscular dysfunction often observed in chronic low-back pain patients [3–5]. A key feature of trunk neuromuscular control is the ability to deal with mechanical perturbations, resulting from internal (e.g.,breathing) and external (e.g., being pushed) perturbations. The ability to deal with perturbations (i.e., mechanical stability) is crucial to be able to perform reliably in avariety of tasks. When is impaired, small perturbations can lead to uncontrolled intervertebral movement with increased risk of injury. As such, the concept of mechanical stability is closely related to the concept of clinical stability, which was defined by White and Panjabi as the loss of the spine to limit its movements under physiological loads such that neurological disturbances, deformation, or pain are prevented. Panjabi has emphasized that stability is a property of a complex stabilizing system, comprising the osteoligamentous spine, the trunk musculature and the neural control system. Biomechanical models can give an estimate of this system’s stability but to date no empirical method allows measuring stability in static and a fortiori in dynamic conditions. Therefore, clinicians and surgeons who deal with spinal disorders can only approximate stability
impairments for diagnosis or improvements for treatment evaluation.
Considering the socioeconomic burden of low back pain, there is a pervasive need to improve clinical assessments for treatment decisions, evaluation of outcome and compensation awards. While range of motion, strength or endurance are widely used in clinical practice, they maynot necessarily address physical impairments related to specific neuromuscular dysfunction often observed in chronic low-back pain patients [3–5]. A key feature of trunk neuromuscular control is the ability to deal with mechanical perturbations, resulting from internal (e.g.,breathing) and external (e.g., being pushed) perturbations. The ability to deal with perturbations (i.e., mechanical stability) is crucial to be able to perform reliably in avariety of tasks. When is impaired, small perturbations can lead to uncontrolled intervertebral movement with increased risk of injury. As such, the concept of mechanical stability is closely related to the concept of clinical stability, which was defined by White and Panjabi as the loss of the spine to limit its movements under physiological loads such that neurological disturbances, deformation, or pain are prevented. Panjabi has emphasized that stability is a property of a complex stabilizing system, comprising the osteoligamentous spine, the trunk musculature and the neural control system. Biomechanical models can give an estimate of this system’s stability but to date no empirical method allows measuring stability in static and a fortiori in dynamic conditions. Therefore, clinicians and surgeons who deal with spinal disorders can only approximate stabilityimpairments for diagnosis or improvements for treatment evaluation.
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