{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T06:05:05Z","timestamp":1789365905338,"version":"build-2803163510"},"reference-count":29,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T00:00:00Z","timestamp":1789084800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Prospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare sit-to-stand (STS) movement patterns and characterize neuromuscular activation and compensatory strategies in patients with degenerative lumbar stenosis (DLS) before and after lumbar decompression, relative to healthy controls.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Thirty-five DLS patients undergoing central decompression and sixteen healthy controls were included in the study. Patients were evaluated one week preoperatively and three months postoperatively; controls were tested once. STS kinematics and muscle activation were quantified using three-dimensional motion capture and surface EMG across three trials without upper-extremity assistance. Outcomes were analyzed using linear mixed-effects regression models adjusted for age and body mass index, with subject-level random intercepts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At peak trunk forward lean, postoperative patients shifted toward a lower-extremity\u2013driven strategy, with greater knee flexion, reduced pelvic anterior tilt, and reduced thoracic flexion (25.9\u00b0 vs 30.4\u00b0,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). Neuromuscular coordination improved postoperatively. Normalized EMG findings reflect relative activation patterns and should not be interpreted as absolute muscle effort. Tibialis anterior activation occurred earlier (4.6% vs 10.1%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002) with lower mean activity, suggesting improved anticipatory ankle control. Gluteus maximus showed earlier onset (2.9% vs 9.0%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.018), longer activation duration (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.001), and lower mean amplitude (0.9 vs 1.8,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.002), reflecting more efficient hip extension. Erector spinae activation was delayed (9.3% vs 4.3%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.031) with reduced duration (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.003), indicating decreased reliance on protective trunk co-contraction. Patient-reported outcomes improved significantly, including disability (ODI: 24.8 vs 44.4), fear of movement (TSK: 36.2 vs 43.4), physical function (PROMIS PF: 42.3 vs 35.1), and pain interference (PROMIS PI: 57.3 vs 66.2) (all\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lumbar decompression was associated with measurable changes in functional transition biomechanics and neuromuscular coordination during sit-to-stand. Postoperatively, patients demonstrated reduced reliance on trunk-dominant compensatory strategies and protective extensor co-contraction, with greater lower-extremity contribution and improved anticipatory neuromuscular control. Importantly, these objective recovery signatures were detected despite minimal differences in task completion time, suggesting that conventional time-based assessments may underestimate meaningful postoperative functional recovery. Objective biomechanical assessment of activities of daily living may provide a sensitive measure of recovery following lumbar decompression and may help guide postoperative rehabilitation and functional optimization in patients with degenerative lumbar stenosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261489579","type":"journal-article","created":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T14:48:47Z","timestamp":1789138127000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lumbar Decompression is Associated With Changes in Functional Transition Biomechanics and Neuromuscular Control During Sit-to-Stand in Degenerative Lumbar Stenosis"],"prefix":"10.1177","author":[{"given":"Ye","family":"Shu","sequence":"first","affiliation":[{"name":"Department of Orthopaedics, University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prasanth","family":"Romiyo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Gansas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2576-3242","authenticated-orcid":false,"given":"Paul","family":"Rubery","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9900-4623","authenticated-orcid":false,"given":"Mark","family":"Lawlor","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Rogerson","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Megas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Varun","family":"Puvanesarajah","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1273-5499","authenticated-orcid":false,"given":"Ram","family":"Haddas","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics, University of Rochester Medical Center"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-020-06339-1"},{"issue":"4","key":"e_1_3_4_3_2","first-page":"350","article-title":"Lumbar Spinal Stenosis: Diagnosis and Management","volume":"109","author":"Webb CW","year":"2024","unstructured":"Webb CW, Aguirre K, Seidenberg PH. 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