Physiology and pathophysiology of trunk control mechanisms

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The overall aim of this series of experiments is to understand how the spine is controlled and how this changes in disease. Altered control has been identified in people with low back pain, yet we still know very little about the normal mechanisms for protection and support of the spine. Back pain is a common affliction that affects about 5% of Australians each year and is the most common and expensive work-related injury in western society. An understanding of normal control and the mechanism of dysfunction is critical for identification of risk factors and development of strategies for rehabilitation and prevention. The experiments are divided into two series. The first series addresses normal spinal control. The questions to be asked deal with how the brain copes with the challenge of using trunk muscles for breathing and spinal control at the same time, how the activity of the trunk muscles is affected by input from sensory receptors in the joints, ligaments and muscles of the spine, and whether intra-abdominal pressure can support the trunk. The second series deals with clinical populations. The first aim is to identify whether people with respiratory diseases use trunk muscles for spinal control and breathing at the same time. If they cannot, we predict that they will be more prone to low back pain. We will test this in a large study of incidence of low back pain in people with and without respiratory disease. The second study will investigate the pelvic floor muscles which are important for continence and assist with spinal control. We will investigate whether people with incontinence have poor spinal control and whether this leads to back pain. The final experiment will identify whether people with low back pain interpret sensory information from the spine differently. By answering these questions we hope to intervene in the enormous personal, social and economic consequences of LBP which affects between 60-90% of the population at some stage in their life.