Role of Intrinsic and Reflexive Dynamics in the Control of Spinal Stability

Spinal stability describes the ability of the neuromuscular system to maintain equilibrium in the presence of kinematic and control variability, and may play an important role in the etiology of low-back disorders (LBDs). The primary mechanism for the neuromuscular control of spinal stability is the recruitment and control of active paraspinal muscle stiffness (i.e., trunk stiffness). The two major components of active muscle stiffness include the immediate stiffness contribution provided by the intrinsic stiffness of actively contracted muscles, and the delayed stiffness contribution provided by the reflex response. The combined behavior of these two components of active muscle stiffness is often referred to as “effective stiffness”. In order to understand the neuromuscular control of spinal stability, stochastic system identification methods were utilized and nonparametric impulse response functions (IRFs) calculated in three separate studies in an effort to: 1) Quantify the effective dynamics (stiffness, damping, mass) of the trunk Nonparametric IRFs were implemented to estimate the dynamics of the trunk during active voluntary trunk extension exertions. IRFs were determined from the movement following pseudo-random stochastic force disturbances applied to the trunk. Results demonstrated a significant increase in effective stiffness and damping with voluntary exertion forces. 2) Quantify the reflex dynamics of the trunk Nonparametric IRFs were computed from the muscle electromyographic (EMG) reflex response following a similar pseudo-random force disturbance protocol. Reflexes were observed with a mean response delay of 67 msec. Reflex gain was estimated from the peak of the IRF and increased significantly with exertion effort. 3) Separate the intrinsic and reflexive components of the effective dynamics and determine the relative role of each in the control of spinal stability. Both intrinsic muscle and reflexive components of activation contribute to the effective trunk stiffness. To evaluate the relative role of these components, a nonlinear parallelcascade system identification procedure was used to separate the intrinsic and reflexive dynamics. Results revealed that the intrinsic dynamics of the trunk alone can be insufficient to counteract the destabilizing effects of gravity. This illustrates the extreme importance of reflexive feedback in the maintenance of spinal stability and warrants the inclusion of reflexes in any comprehensive trunk model.