View Full Version : Summary of Responses to Lumbar Stabilization Question

04-06-2003, 08:31 PM
Dear All
Here follows a summary of the responses to my question. I have included the responses that provided references, information and/or stimulating questions. A few responders were interested in the same area of research and I have e-mailed them seperately.
Thank you all very much. The original question was:

>I am a graduate student at Seton Hall University. I am searching for
>information about how pelvic inclination affects the stability of the
>lumbar spine as it relates to low back pain.
>Functional segmental instability of the lumbar spine have been described
>extensively by Richardson, Jull, Hodges and Hides prescribing a specific
>exercise progression targeting the muscular stabilizing system of the
>lumbar spine. This is described in their book'"Therapeutic exercise for
>spinal segmental stabilization in low back pain", Churchill Livingstone,
>1999. The concept of functional instability of the lumbar spine is to a
>large degree founded on the work of Panjabi defining instability as; " a
>significant decrease in the capacity of the stabilising system of the
>spine to maintain the intervertebral neutral zones within the
>physiological limits so that there is no neurological dysfunction, and no
>incapacitating pain" Panjabi. 1992.
>I have been unable to locate litterature that specifically adresses how
>pelvic inclination plays a role in the compressive and shearing forces of
>the lumbar spine. These forces would have great impact on the stability of
>the lumbar spine.
>I would greatly appriciate if someone could direct me in a direction,
>where to find relevant research or if a certain research article is known.


A good review can be found in "Sitting Biomechanics part I: a review of the
literature" by Harrison DD, Harrison SO, Croft AC, Harrison DE, Troanovich
SJ, J Manipulative Physiol Ther 1999 Nov-Dec;22(9):564-609.

-Ari J Wilkenfeld
"The greatest adventure is what lies ahead" -The Hobbit
Ari Wilkenfeld, PhD
Case Western Reserve University School of Medicine
VA Medical Center
216-791-3800 x3804
ajw4@po.cwru.edu, awilkenfeld@alum.mit.edu
AOL Screenname: AriWilkenfeld

Dear Kim:

I don't know if this is relative to your question but:

I have been struggling with this problem for many years in clinical practice. The important relationships appear relative to motor control, diaphragm and IAP control, (control of center of mass/movement and neutral zones) and proprioception and kinesthesia. The relationship to static is not a strong as dynamic posture.

I have a 70 page .doc file that might be of interest and possibly lead you to desired directions.

Best regards and good hunting

Dr. Keith A. Zenker
Santa Cruz, CA
Please respond to zball@pacbell.net


I came across this article that might be of assistance. I haven't read
the article, but the abstract seems to be along the track that you are


Eur Spine J 2002 Dec;11(6):519-26
Muscle force evaluation and the role of posture in human lumbar spine
under compression.
Shirazi-Adl A, Sadouk S, Parnianpour M, Pop D, El-Rich M.

Good luck with your research,


Dear Kim,

Recently, I submitted a paper to Spine about a new sitting concept and I
addressed the LBP associated with the sitting posture. One of the reasons
for the LBP has been claimed to be backward or posterior inclination of the
pelvic. In this paper, I compared the results of the pelvic inclination,
segmental and total lordosis to the data available in the literature. Some
of these studies are measurements from LBP patients. Let me know if you are
interesting of this paper!

M. Makhsous

Mohsen Makhsous, Ph.D.
Research Scientist / Assistant Professor
Northwestern University, PMR
Sensory Motor Performance Program
Rehabilitation Institute of Chicago, Room 1406
345 E. Superior St.
Chicago, IL 60611

TEL: 312-908-7953 (312-238-4824 lab)
FAX: 312-238-2208
E-mail: m-makhsous2@nwu.edu


I'm not personally familiar with it, but I am aware of a body of work by G
Dumas relating to low back pain and pregnancy.

Paul Ostic
MSc Candidate
Queen's University
Kingston Canada

I'm not sure you want to read this.

I'm an orthopedic surgeon specialized In non-surgical Rx of back pain.
Instability is in the eye of the beholder. Panjabi is theorizing with no
clinical evidence. Exercises may work but they may not be for the reasons
given. Muscles cannot withstand the calculated shearing forces. Quadrupeds
have an even tougher problem. The model is wrong.

Levin, S. M. 1994. A new model for pelvic mechanics. Pages 10085-1088 in J.
Vossoughi, ed. Biomedical Engineering - Recent Developments: 13th Southern
Biomedical Engineering Conference. Engineering research Center, U of D.C.
,, Washington, D.C.