Changes in Spinal Height Following Sustained Lumbar Flexion and Extension Postures: A Clinical Measure of Intervertebral Disc Hydration Using Stadiometry
Received 1 August 2008; received in revised form 3 April 2009; accepted 6 April 2009.
Abstract
Background
Decreased intervertebral disc height can result in diminished load carrying capacity of the spinal segment. Clinical means of assessing postures able to rehydrate the discs were investigated.
Objective
The purposes of this study were 3-fold: (1) to determine if our test protocol using a commercially available stadiometer demonstrated findings consistent with prior laboratory-based protocols; (2) to determine if hyperextension in the prone position and trunk flexion in the supine position caused increased spine height after sustained loading; and (3) to compare the effects of hyperextension in the prone position and trunk flexion in the supine position on spine height changes after a period of sustained loading.
Methods
This study used a pretest, posttest crossover design. Ten women and 11 men (mean age, 24 ± 2.6 years) participated. Subjects held either 10 minutes of hyperextension in the prone position or 10 minutes of trunk flexion in the supine position in the recovery phase. Spine height was measured using a commercially available stadiometer. Spinal height change was determined from measurements taken after loaded sitting and measurements taken after hyperextension in the prone position and trunk flexion in the supine position.
Results
A 1-sample t test indicated no significant difference existed between our mean height change after 5 minutes of sitting and previously published validated findings. A paired t test indicated significant increase in height after both supine flexion and prone extension lying (P< .0001). The mean height gain was 3.11 mm using prone extension and 3.19 mm using the supine flexion protocol. A paired t test indicated no significant difference between these 2 recovery positions (P = .927).
Conclusion
The stadiometer measurement protocol demonstrated that hyperextension in the prone position and trunk flexion in the supine position were easily effective positions for the temporary recovery of spine height after sustained loading. These findings lay the foundation for future research into the viscoelastic creep properties of the intervertebral disk under loading and therapeutic conditions.
aResearch Associate, Center for Rehabilitation Research, Clinical Musculoskeletal Research Laboratory, Texas Tech University Health Sciences Center, Lubbock, Tex, USA
bAssociate Professor, Center for Rehabilitation Research, Clinical Musculoskeletal Research Laboratory, Texas Tech University Health Sciences Center, Lubbock, Tex, USA
cAdjunct Faculty, Regis University, Denver, Colo, USA
dAssistant Professor, Center for Rehabilitation Research, Clinical Musculoskeletal Research Laboratory, Texas Tech University Health Sciences Center, Lubbock, Tex, USA
eProfessor and Program Director of the ScD Program in Physical Therapy, and Director of the Clinical Musculoskeletal Research Laboratory, Texas Tech University Health Sciences Center, Lubbock, Tex, USA
fAssociate Professor and Director of the Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, Tex, USA
Submit requests for reprints to: Jean-Michel Brismée, ScD, PT, Associate Professor, Texas Tech University Health Sciences Center, Department of Rehabilitation Sciences, Center of Rehabilitation Research, 3601 4th Street, Mail Stop 6226, Lubbock, TX 79430, USA
ABSTRACT