ARTICLE IN PRESS

Abstracts 261

Figure 2 This image can be seen in colour on ScienceDirect. When viewed in black and white in the printed version the
displacement pattern mentioned in the caption is not clearly visible.

Disclosures
This study was funded by the NIH and NCCAM Research
Grant RO1 AT01121.

doi:10.1016/j.jbmt.2008.04.024

d
The spring-like function of the lumbar fascia in Institute of Optics, University of Technology, Berlin, Germany
e
human walking Institute of Solid State Physics, University of Technol-
ogy, Berlin, Germany
f
Adjo Zorna,c, Franz-Josef Schmittd, Society for the Advancement of Applied Computer
Kai Friedrich Hodecke, Robert Schleipa, Science, Berlin, Germany
Frank Weckendf, Werner Klinglerb

a
Department of Physiology, University of Ulm, Einstein- Introduction
Allee 11, D-89081 Ulm, Germany
b
Department of Anesthesiology, University of Ulm, The lumbodorsal fascia (LDF) spans the whole of the back
Einstein-Allee 11, D-89081 Ulm, Germany and provides a biomechanical link between the upper and
c
Rolf Institute, Boulder, CO, USA lower body. Nonetheless, the LDF has rarely been
 ARTICLE IN PRESS
262 Abstracts

considered as having an active function in human

locomotion.
The aim of the study was to explore the biomechanical
action of the LDF in the regular whole-body gait. It is our
hypothesis that the LDF acts as an elastic spring, which
resembles the elastic recoil observed in the Achilles
tendon when walking. We developed a model of a walking
human body, which included the legs, the pelvis, the
back, the shoulders and the arms (see Figure 1).
A crisscross arrangement of elastic springs models the
posterior layer of the lumbodorsal fascia (PLLF), which is
pretensioned by the isometrically opposed action of the
latissimus dorsi and glutaeus maximus muscles, thus
connecting diagonally the contralateral arm and leg
pendulums.
In this way, a mechanical system of interconnected
oscillators was realised which was handled by using
Lagrangian mechanics.
The results show that the PLLF, the latissimus dorsi and
the glutaeus maximus muscle together form a continuous
sling having an anterior–posterior orientation and acting
in a bowstring-like manner, which exerts a periodical
sagittal force. This force propels the mass of the trunk
forward.
This model provides an explanation for the peculiar Figure 1
orientation of the PLLF fibres, for the orientation of the
glutaeus maximus muscle fibres and for the strength of the LDF a pre-stretch as described by Fukunaga (2001) for
the latissimus dorsi muscle in humans, although they the Achilles tendon. The elastic stiffness of the PLF in
rarely use them to climb. Additionally it completes the vivo is unknown—instead we used Young’s modulus of
imperfect ‘‘inverted pendulum’’ model of the energy human tendons (Ker, 1999). This set of interconnected
saving human gait. oscillators in the gravity field was handled by formation
of the appropriate Euler–Lagrange differential equations
(Goldstein et al., 2002). The equations obtained were
Hypothesis solved using a C++ program, which included arbitrary-
precision arithmetic and was specifically designed for this
Although almost every person swings their arms and simulation. The time-dependent values of kinetic and
rotates their trunk while walking, the movement of arms potential energies during the cycle of movement were
and trunk in gait analysis are generally regarded as one examined (Figure 1).
inflexible passenger block serving no function in walking.
We introduce the hypothesis that the lumbodorsal fascia
acts as an elastic spring helping to propel the mass of the
trunk forward. Results

The lumbodorsal fascia, the latissimus dorsi and the

Methods
We developed a model of a walking human body, which
included the legs, the pelvis, the back, the shoulders and
the arms. We described the kinetics of this body using
accurate mathematical treatment of applied mechanics.
The legs are represented by inverted and suspended
pendulums. The pelvic and the shoulder girdle are
represented by torsion pendulums and the arms by
suspended pendulums. A crisscross arrangement of
elastic springs acts as a model for the posterior layer of
the lumbodorsal fascia (PLF) which is put under tension
by the latissimus dorsi and the glutaeus maximus
muscles, thus connecting diagonally the contralateral
arm and leg pendulums, based on the anatomical findings
from Vleeming et al. (1995). The PLF has an attachment
at the trunk (spine) in the lumbar region. Anthropometric
data were mainly taken from Zatsiorsky (2002). The two
muscles were assumed to work isometrically, thus giving
glutaeus maximus muscle together form a continuous
bowstring-like sling, being able to periodically exert a
sagittal force helping to propel the mass of the trunk
forward. Acting in this way, these two muscles (being the
largest of the human body) can also work in the normal
walking movement in an efficient isometric way, in addition
to the generally recognized leg muscles. The values of the
kinetic and potential energies during the stride cycle show
a shift from pendulum to spring loading and back again. As
such, the PLF acts as an active force transmitter.
Conclusion
In contrast to the traditional gait analysis, the pendulum
action of the arms and the spring-like action of the
lumbar fascia can have the potential to facilitate
energetic efficiency in walking.
 ARTICLE IN PRESS
Abstracts
References
Fukunaga, T., 2001. In vivo behaviour of human muscle tendon.
Proceedings of the Biological Science 268, 229–233.
Goldstein, H., et al., 2002. Classical Mechanics, third ed.
Addison-Wesley, Reading, MA.
doi:10.1016/j.jbmt.2008.04.023
Chronic low back pain may originate from sub-
failure injuries in lumbar fasciae
Robert Schleip, Ph.D.a, Werner Klingler, M.D.b
a
Department of Physiology, University of Ulm, Einstein-
Allee 11, D-89081 Ulm, Germany
b
Department of Anesthesiology, University of Ulm,
Einstein-Allee 11, D-89081 Ulm, Germany
Background
Recently Panjabi provided evidence for the hypothesis that
chronic back pain originates from ligament subfailure
injuries, which then send out corrupted transducer signals
to the neuromuscular control unit, and as a result,
corrupted muscle response patterns are generated which
lead to further injuries and inflammation (Panjabi, 2006).
Previously, this explanatory model excluded the role of
human lumbar fasciae, although this fascia is anatomically
equipped to serve an important role in tension transmission
and proprioception during spinal flexion. Given their
relative stiffness and distance from the axis of spinal
flexion, these fasciae could be at least as prone to
subfailure injuries as are spinal ligaments and could
therefore be a frequent facilitator of chronic low back pain.
Methods
Samples of the posterior layer of the lumbar fascia at the
level of L2, taken from twelve human donors (ages
19–76 yr), were analyzed immunohistochemically for the
presence of fiber bundles containing alpha smooth
muscle-actin, a differential marker of myofibroblasts,
i.e. cells associated with an increased local demand for
doi:10.1016/j.jbmt.2008.04.022
Functional fascial tapings for lower back pain:
A case report
Ron Alexander
Alphington Sports Medicine Clinic, Melbourne, Australia
Objective
To examine the effectiveness of functional fascial
tapings (FFTs) on a young female with chronic lower
263
Ker, R.F., 1999. The design of soft collagenous load-bearing
tissues. Journal of Experimental Biology 202, 3315–3324.
Vleeming, A., et al., 1995. The posterior layer of the
thoracolumbar fascia. Its function in load transfer from spine
to legs. Spine 20, 753–758.
Zatsiorsky, V.M., 2002. Kinetics of Human Motion. Human Kinetics
Europe Ltd (Chapter 4.3, Appendices 1 and 2).
tissue repair. Fifteen microscopic images from randomly
chosen locations within each tissue sample were digitally
quantified. Samples of the posterior layer of lumbar
fascia from rats were also analyzed for comparison.
Mann–Whitney Test (U-test) was used to test for
significant differences between samples from different
species. A significance level of po0.05 was applied.
Results
Median values in human tissues varied from 0 to 120151
parts per million (ppm), representing a 0 to E1.2%
proportion of positively stained areas. Large variations in
ppm values were apparent, not only among the 12 donors
(SD 5358 ppm), but also between the 15 different images
per sample. Most myofibroblasts were seen accumulated
in clustered groups. Density of myofibroblasts in the
lumbar fascia samples taken from rats was significantly
lower than in that of humans.
Conclusions
Our findings reveal that human lumbar fascia frequently
shows signs of regions with increased tissue repair
activity. This suggests that lumbar fasciae play a major
role in the facilitation of chronic low back pain, which
may be induced by subfailure injuries and subsequent
muscle control dysfunction, as suggested by Panjabi.
Reference
Panjabi, M.M., 2006. A hypothesis of chronic back pain: ligament
subfailure injuries lead to muscle control dysfunction.
European Spine Journal 15, 668–676.
back pain for 14 years. The patient had two procedures
18 months apart for decompression and discectomy
(L4 and L5) for back and leg pain, the second procedure
was 2 years prior. Despite these procedures she had
experienced persistent pain and restricted range of trunk
flexion 151, for 3 months prior to treatment. Other
treatments had not improved her symptoms.
Method
Patient screened to determine her suitability for FFT, as well
as any propensity to tape allergy. FFT was applied and