The abstract of my 20 minute presentation follows:
Title: An ancient perspective on deconditioning in low back pain.
Bio: James Steele BSc (Hons), Ph.D. Cand., is an Associate Lecturer at Southampton Solent University (United Kingdom). He has previously published peer reviewed articles on the area of resistance training. His current research, however, seeks to examine low back pain (LBP) as a multifactorial condition from an exercise physiology/biomechanics perspective. In particular he is examining the effects of specifically addressing lumbar extensor deconditioning in LBP with isolated lumbar extension resistance exercise, upon other associated physical symptoms of chronic LBP.
Abstract: LBP is a multifactorial issue with many associated symptoms and potential causes. Prevalence is high in westernised populations and also comparably high in rural and indigenous populations. Other diseases common in western populations, such as obesity, diabetes, heart disease, and cancer are almost absent in populations devoid of the western influence and who follow a traditional diet and lifestyle. It therefore seems counter-intuitive that LBP rates should also be high in traditional populations. The hypothesis that an evolutionarily determined factor might predispose these high rates across a wide range of Homo sapiens populations thus seems plausible to examine. Fossil data from the clade Anthropoidea suggest adaptations in predominant habitual locomotion styles from 1) arboreal quadruped, to 2) semi-terrestrial quadruped, to 3) biped over the past ~20 million years. These adaptations were accompanied and permitted by important anatomical evolutionary changes occurring in the lumbar spine and pelvis. These changes appear to have developed from 1) a long mobile lumbar vertebral column, laterally facing pelvis and large lumbar extensors to 2) a short lumbar vertebral column, posterior location of the transverse process, lengthening of the ilia, reduction of extensor musculature and increase in passive rigidity through entrapment and invagination and 3) to re-lengthening of the vertebral column, reduction in length and broadening of the ilia and sacrum. However, comparative musculature anatomy between old world monkeys and modern humans suggests the presence of a relatively smaller lumbar extensor musculature, and thus potentially weaker, in humans. In addition, hip/trunk extensor musculature of short backed primates is well developed. Anatomically modern humans therefore may bear the compromise of relatively strong hip/trunk extensors and relatively weak lumbar extensors in combination with a long flexible lumbar spine. This may contribute to disuse atrophy of the lumbar extensors which may explain the consistent association of their deconditioning in LBP, and also predispose modern humans to the high prevalence of LBP presently observed.
Learning Objectives:
Upon completion of this session, participants will be able,
1. Describe the prevalence of LBP across a range of populations.
2. Explain the role the lumbar extensor musculature plays in LBP and its multifactorial symptoms, and some of the key observations regarding this musculature.
3. Understand the hypothesis that anatomical evolutionary changes might be responsible for deconditioning of the lumbar extensor musculature and thus the high prevalence of LBP across a range of populations.
4. Recognise predictions of this hypothesis and suggested methods of testing them.
For those of you who have been wondering what ever happened to the next parts in my series of blog posts from way back covering this topic, well, I continued researching and putting the evidence together in preparation for this and for writing a paper on the topic. So AHS13 will see me present my full ideas on this topic alongside some proposals for future research to tests the predictions that stem from them.
I'm really looking forward to heading out to Atlanta and getting to meet with the people who's work I have been reading for some time now, and getting to be a part of what is a fascinating direction in research that has prompted and shaped many of my thought in my own research.
Hope to see you all there!
