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Cholewicki, J., Panjabi, M. M. & Khachatryan, A. (1997). Stabilizing function of trunk flexor-extensor muscles around a neutral spine posture. Spine 22, 2207-2212.

Synergism (++ co-contraction also changes is reciprocal activation)

Ferrari R. A re-examination of the whiplash associated disorders (WAD) as a systemic illness Annals of the Rheumatic Diseases 2005;64:1337-1342

Nausea

Ferrari R. A re-examination of the whiplash associated disorders (WAD) as a systemic illness Annals of the Rheumatic Diseases 2005;64:1337-1342

General fatigue

Sense of weakness

Nederhand MJ. Predictive value of fear avoidance in developing chronic neck pain disability: consequences for clinical decision making. Achives of Physical Medicine and Rehabilitation. 200:85:3,p 496-501

Increased pain perception   & reduced tolerance to pain

Nikolai Bogduk. Psychology and low back pain. IJOM 9 (2006) 49-53

Fear of use & Pain avoidance (behavioural)

Psychological / psychomotor:

Suter E, Lindsay D. Back muscle fatigability is associated with knee extensor inhibition in subjects with low back pain. Spine. 2001 Aug 15;26(16):E361-6

Increased fatigability

Zedka M, Prochazka A, Knight B, Gillard D, Gauthier M Voluntary and reflex control of human back muscles during induced pain. J Physiol. 1999 Oct 15;520 Pt 2:591-604.

Reduce velocity

Shirado O, Ito T, Kaneda K, Strax TE 1995 Flexion-relaxation phenomenon in the back muscles. A comparative study between healthy subjects and patients with chronic low back pain. Am J Phys Med Rehabil 74(2):139-44

Reduced range

Shirado O, Ito T, Kaneda K, Strax TE 1995 Concentric and eccentric strength of trunk muscles: influence of test postures on strength and characteristics of patients with chronic low-back pain. Arch Phys Med Rehabil. 76(7):604-11

Force loss (with or without atrophy)

Huppe A, Brockow T, Raspe H. Chronic widespread pain and tender points in low back pain: a population-based study Z Rheumatol. 2004 Feb;63(1):76-83

Pain   / hyperalgesia                              Avoidance & hypersensitisation

Reflexive :

The injury response

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