Trunk muscle activation in low-back pain patients, an analysis of the literature (original) (raw)
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Trunk muscle recruitment patterns in specific chronic low back pain populations
Clinical Biomechanics, 2005
Background. It is hypothesized that injury or degeneration of osteoligamentous spinal structures would require compensation by trunk musculature and alterations in motor control to maintain spine stability. While, biomechanical modeling has supported this hypothesis, studies of muscle recruitment patterns in chronic low back pain patients both with and without significant osteoligamentous damage have been limited. This study utilized a non-randomized case-control design to investigate trunk muscle recruitment patterns around the neutral spine position between subgroups of patients with chronic mechanical low back pain and asymptomatic controls.
Journal of Electromyography and Kinesiology, 2011
Studies of electromyographic (EMG) activity and lumbopelvic rhythm have led to a better understanding of neuromuscular alterations in chronic low back pain (cLBP) patients. Whether these changes reflect adaptations to chronic pain or are induced by acute pain is still unclear. This work aimed to assess the effects of experimental LBP on lumbar erector spinae (LES) EMG activity and lumbopelvic kinematics during a trunk flexion-extension task in healthy volunteers and LBP patients. The contribution of disability to these effects was also examined. Twelve healthy participants and 14 cLBP patients performed flexionextension tasks in three conditions; control, innocuous heat and noxious heat, applied on the skin over L5 or T7. The results indicated that noxious heat at L5 evoked specific increases in LES activity during static full trunk flexion and extension, irrespective of participants' group. Kinematic data suggested that LBP patients adopted a different movement strategy than controls when noxious heat was applied at the L5 level. Besides, high disability was associated with less kinematic changes when approaching and leaving full flexion. These results indicate that experimental pain can induce neuromechanical alterations in cLBP patients and healthy volunteers, and that higher disability in patients is associated with decreased movement pattern changes.
Trunk muscle co-ordination during gait: Relationship between muscle function and acute low back pain
Pathophysiology, 2005
Low back pain costs billions of Euros annually in all industrialized countries. Often radiological diagnosis fails to give evidence of the pathogenesis of low back pain. Although psychophysiological characteristics have an influence, it seems that insufficient muscular spinal stabilization may play the major role in the development of low back pain. Assessment of trunk muscle stabilization activity during everyday activities is rare. Therefore, in this study healthy persons were investigated during walking on a treadmill at a speed of 4 km/h. Women (n = 16) with no history of back pain were investigated before and after a static loading situation of the spine, i.e. while wearing a waistcoat. After this loading situation four women developed pain (pain subjects). Surface EMG (SEMG) was taken from five trunk muscles of both sides. Grand averaged amplitude curves over stride, amplitude normalized curves and variation between all included strides were calculated for all muscles and subjects, respectively. The normal range of all calculated parameters was defined within the span between the 5th and the 95th percentiles of all pain free subjects. Data were evaluated according to deviations from the normal range.
Background: While some patients with low back pain demonstrate increased spinal stiffness that decreases as pain subsides, this observation is inconsistent. Currently, the relation between spinal stiffness and low back pain remains unclear. This study aimed to investigate the effects of experimental low back pain on temporal changes in posteroanterior spinal stiffness and concurrent trunk muscle activity. Method: In separate sessions five days apart, nine asymptomatic participants received equal volume injections of hypertonic or isotonic saline in random order into the L3-L5 interspinous ligaments. Pain intensity, spinal stiffness (global and terminal stiffness) at the L3 level, and the surface electromyographic activity of six trunk muscles were measured before, immediately after, and 25-minute after injections. These outcome measures under different saline conditions were compared by generalized estimating equations. Findings: Compared to isotonic saline injections, hypertonic saline injections evoked significantly higher pain intensity (mean difference: 5.7/10), higher global (mean difference: 0.73N/mm) and terminal stiffness (mean difference: 0.58N/mm), and increased activity of four trunk muscles during indentation (p < 0.05). Both spinal stiffness and trunk muscle activity returned to baseline levels as pain subsided. Interpretation: While previous clinical research reported inconsistent findings regarding the association between spinal stiffness and low back pain, our study revealed that experimental pain caused temporary increases in spinal stiffness and concurrent trunk muscle co-contraction during indentation, which helps explain the temporal relation between spinal stiffness and low back pain observed in some clinical studies. Our results substantiate the role of spinal stiffness assessments in monitoring back pain progression.
BMC Musculoskeletal Disorders
Background Trunk muscle dysfunction is often regarded as a key feature of non-specific chronic low back pain (NSCLBP) despite being poorly understood and variable with increases, decreases and no change in muscle activity reported. Differences in thoraco-lumbar kinematics have been observed in motor control impairment NSCLBP subgroups (Flexion Pattern, Active Extension Pattern) during static postures and dynamic activities. However, potential differences in muscle activity during functional tasks has not been established in these subgroups to date. Methods A case-control study design recruited 50 NSCLBP subjects (27 Flexion Pattern, 23 Active Extension Pattern) and 28 healthy individuals. Surface electromyography determined muscle activity during functional tasks: reaching upwards, step-down, step-up, lifting and replacing a box, stand-to-sit, sit-to-stand, bending to retrieve (and returning from retrieving) a pen from the floor. Normalised (% sub-maximal voluntary contraction) mean...
Physiotherapy Quarterly, 2021
The purpose of this study was to determine normal and abnormal patterns of activation of gluteus maximus (GM), hamstring (HAM), contralateral erector spinae (CES), and ipsilateral erector spinae (iES) muscles during a prone hip extension test in healthy or asymptomatic subjects and those with non-specific chronic low back pain through a systematic review. Studies were recognized by searching electronic databases (Embase, MEdLiNE/PubMed, Cochrane Library, PEdro [Physiotherapy Evidence database], and CiNAHL) and scanning articles reference lists from the beginning until July 2018. Limits involved studies in the English language and performed among humans. of 2112 citations and reference lists scanned, 15 articles were determined to be relevant to this review. From these studies, 4 investigated 157 subjects (88 asymptomatic and 69 with low back pain), and 11 investigated 257 healthy subjects. The results of the moderate and weak quality studies indicate that the HAM and ES muscles are activated early and almost simultaneously, but GM is consistently delayed in relation to leg movement and the other 3 muscles in healthy individuals. in low back pain subjects, CES are delayed and GM is significantly delayed in individuals who showed abnormal lumbar motions when compared with healthy ones.
Altered muscle recruitment during extension from trunk flexion in low back pain developers
Background: A functionally induced, transient low back pain model consisting of exposure to prolonged standing has been used to elucidate baseline neuromuscular differences between previously asymptomatic individuals classified as pain developers and non-pain developers based on their pain response during a standing exposure. Previous findings have included differences in frontal plane lumbopelvic control and altered movement strategies that are present prior to pain development. Control strategies during sagittal plane movement have not been previously investigated in this sample. The purpose of this research was to investigate neuromuscular control differences during the extension phase from trunk flexion between pain developers and non-pain developers. Methods: Continuous electromyography and kinematic data were collected during standing trunk flexion and extension on 43 participants (22 male) with an age range of 18–33 years, prior to entering into the prolonged standing exposure. Participants were classified as pain developer/non-pain developer by their pain response (≥10 mm increase on a 100 mm visual analog scale) during standing. Relative timing and sequencing data between muscle pairs were calculated through cross-correlation analyses, and evaluated by group and gender. Findings: Pain developers demonstrated a 'top-down' muscle recruitment strategy with lumbar extensors activated prior to gluteus maximus, while non-pain developers demonstrated a typical 'bottom-up' muscle recruitment strategy with gluteus maximus activated prior to lumbar extensors. Interpretation: Individuals predisposed to low back pain development during standing exhibited altered neuro-muscular strategies prior to pain development. These findings may help to characterize biomechanical movement profiles that could be important for early identification of people at risk for low back pain.
Medical journal of the Islamic Republic of Iran, 2015
Alterations in the neuromuscular control of the spine were found in patients with chronic low back pain (CLBP). Sudden loading of the spine is assumed to be the cause of approximately 12% of lower back injuries. However, some aspects of this problem, such as alterations in the sensory-motor control of the spine, remain questionable. This study investigated postural and neuro- motor changes in trunk muscles during sudden upper limb loading in patients with CLBP. Electromyography of the erector spinae (ES) and transverses abdominis/internal oblique (TrA/IO) and external oblique (EOA) muscles were recorded in 20 patients with CLBP and 20 asymptomatic individuals with eyes open (EO) and eyes closed (EC) conditions. Moreover, measurements of the center of pressure (COP) and vertical ground reaction force (GRF) or Fz were recorded using a force plate. Data were analyzed using paired t-test and independent t-test at the significance level of 0.05. In patients with CLBP, decreased electrica...