Characterizing Local Dynamic Stability of Lumbar Spine Sub-regions During Repetitive Trunk Flexion-Extension Movements.

Using a technique of tracking intersegmental spine kinematics via skin surface markers, this study aimed to estimate local dynamic spine stability across smaller sub-regions (or segments) of the lumbar spine while also considering the impact of an external pelvic constraint during repetitive movements. Sixteen participants (10 males) performed two trials [Free Motion (FM), Pelvis Constrained (PC)] each consisting of 65 repetitive trunk flexion-extension movements to assess dynamic spine stability using maximum Lyapunov exponents (LyE). First, results indicated that LyE obtained from analysis of 30 repetitive flexion-extension movements did not differ from those obtained from analysis of greater numbers of repetitive movements, which aligns with results from a previous study for the whole lumbar spine. Next, for both males and females, and FM and PC trials, the most caudal region of the lumbar spine behaved the most dynamically stable, while upper lumbar regions behaved the most dynamically unstable. Finally, females demonstrated greater lumbar and intersegmental stability (lower LyE) during PC trials compared to FM, while males demonstrated slightly decreased lumbar and intersegmental stability (higher LyE) during PC trials compared to FM; this resulted in PC trials, but not FM trials, being different between sexes. Altogether, these data show that dynamic stability of lumbar spine sub-regions may be related to the proximity of the motion segment to rigid skeletal structures, and that consideration is needed when deciding whether to constrain the pelvis during analyses of dynamic spine stability.