Pain-Related Factors Contributing to Muscle Inhibition in Patients With Chronic Low Back Pain

OBJECTIVE: The main objective of this study was to identify general and military-related factors that are associated with the level of recovery in Dutch service members with chronic low back pain (CLBP) who followed a rehabilitation program. MATERIAL AND METHOD: One hundred five consecutive service members with CLBP were included in this study. The level of disability, was used to distinguish a recovered and non-recovered group. Level of pain and self-perceived recovery were used as secondary outcome measurements. Differences were evaluated within and between the groups using the Student’s t-test Bivariate logistic regression analyses were used for identifying the prognostic factors related to various outcomes of recovery RESULTS: After following the rehabilitation program, 64.8% of the service members recovered from CLBP. The recovered group, demonstrated significant effect sizes in disability and in pain The non-recovered group showed on disability a non-significant effect and in pain a significant effect. The self-perceived recovery in the recovered group was “much improved” and the non-recovered group “slightly improved”. The results of the bivariate regression analyses showed no significant independent prognostic factors related to recovery. CONCLUSIONS: In this study, no significant independent prognostic factors could be identified that were associated to the various outcomes of recovery in service members with CLBP who followed a rehabilitation program.

Download Full-text

Combined abnormal muscle activity and pain-related factors affect disability in patients with chronic low back pain: An association rule analysis

PLoS ONE ◽

10.1371/journal.pone.0244111 ◽

2020 ◽

Vol 15 (12) ◽

pp. e0244111

Author(s):

Hayato Shigetoh ◽

Yuki Nishi ◽

Michihiro Osumi ◽

Shu Morioka

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Muscle Activity ◽

Association Rule ◽

Low Back ◽

Related Factors ◽

Activity Distribution ◽

Rule Analysis ◽

Flexion Relaxation

Objectives In patients with chronic low back pain (CLBP), reduced lumbar flexion-relaxation and reduced variability of muscle activity distribution are reported as abnormal muscle activity. It is not known how abnormal muscle activity and pain-related factors are related to CLBP-based disability. Here, we performed an association rule analysis to investigated how CLBP disability, muscle activity, and pain-related factors in CLBP patients are related. Methods Surface electromyographic signals were recorded from over the bilateral lumbar erector spinae muscle with four-channel electrodes from 24 CLBP patients while they performed a trunk flexion re-extension task. We calculated the average value of muscle activities of all channels and then calculated the flexion relaxation ratio (FRR) and the spatial variability of muscle activities. We also assessed the pain-related factors and CLBP disability by a questionnaire method. A clustering association rules analysis was performed to determine the relationships among pain-related factors, the FRR, and the variability of muscle activity distribution. Results The association rules of severe CLBP disability were divisible into five classes, including ‘low FRR-related rules.’ The rules of the mild CLBP disability were divisible into four classes, including ‘high FRR-related rules’ and ‘high muscle variability-related rules.’ When we combined pain-related factors with the FRR and muscle variability, the relationship between abnormal FRR/muscle variability and CLBP disability became stronger. Discussion Our findings thus highlight the importance of focusing on not only the patients’ pain-related factors but also the abnormal motor control associated with CLBP, which causes CLBP disability.

Download Full-text