Evaluation of the threshold of stability for the human spine.

The threshold of stability (ToS) is introduced as a new tool for evaluating spinal stability. Current methods have evaluated the magnitude of spinal kinematic variability, stability diffusion, or Lyapunov exponents. This present method differs by modifying task difficulty to obtain a critical value delineating regions of stability and instability. Conceptually, as task difficulty increases, kinematic variability of the system increases and the basin of stability decreases. When kinematic variability exceeds the basin of stability, stability cannot be maintained over time. This concept is first illustrated using a mathematical model, from which an effective potential function was calculated to show the relationships among kinematic variability, the basin of stability, and task difficulty. In addition, an experiment was performed to evaluate the sensitivity of the ToS to changes in postural control using visual feedback as a control variable. The ToS was found to be more sensitive than the Lyapunov exponent to removal of visual feedback, suggesting it may have use as a diagnostic indicator (e.g. for low back pain). Furthermore, this new method has an additional advantage in which minimal instrumentation is needed. Its simplicity, sensitivity, and low cost suggest that the ToS has potential as a diagnostic or prognostic tool in a clinical setting.