Hip-Abduction Torque and Muscle Activation in People With Low Back Pain

2015 ◽  
Vol 24 (1) ◽  
pp. 51-61 ◽  
Author(s):  
Mark A. Sutherlin ◽  
Joseph M. Hart

Context:Individuals with a history of low back pain (LBP) may present with decreased hip-abduction strength and increased trunk or gluteus maximus (GMax) fatigability. However, the effect of hip-abduction exercise on hip-muscle function has not been previously reported.Objective:To compare hip-abduction torque and muscle activation of the hip, thigh, and trunk between individuals with and without a history of LBP during repeated bouts of side-lying hip-abduction exercise.Design:Repeated measures.Setting:Clinical laboratory.Participants:12 individuals with a history of LBP and 12 controls.Intervention:Repeated 30-s hip-abduction contractions.Main Outcome Measures:Hip-abduction torque, normalized root-mean-squared (RMS) muscle activation, percent RMS muscle activation, and forward general linear regression.Results:Hip-abduction torque reduced in all participants as a result of exercise (1.57 ± 0.36 Nm/kg, 1.12 ± 0.36 Nm/kg; P < .001), but there were no group differences (F = 0.129, P = .723) or group-by-time interactions (F = 1.098, P = .358). All participants had increased GMax activation during the first bout of exercise (0.96 ± 1.00, 1.18 ± 1.03; P = .038). Individuals with a history of LBP had significantly greater GMax activation at multiple points during repeated exercise (P < .05) and a significantly lower percent of muscle activation for the GMax (P = .050) at the start of the third bout of exercise and for the biceps femoris (P = .039) at the end of exercise. The gluteal muscles best predicted hip-abduction torque in controls, while no consistent muscles were identified for individuals with a history of LBP.Conclusions:Hip-abduction torque decreased in all individuals after hip-abduction exercise, although individuals with a history of LBP had increased GMax activation during exercise. Gluteal muscle activity explained hip-abduction torque in healthy individuals but not in those with a history of LBP. Alterations in hip-muscle function may exist in individuals with a history of LBP.

Author(s):  
Beatriz Rodríguez-Romero ◽  
Michelle D Smith ◽  
Alejandro Quintela-del-Rio ◽  
Venerina Johnston

This study examines demographic, physical and psychosocial factors associated with an increase in low back pain (LBP) during a one-hour standing task. A cross-sectional survey with 40 office workers was conducted. The primary outcome was pain severity during a one-hour standing task recorded every 15 min using a 100 mm Visual Analogue Scale (VAS). Participants were defined as pain developers (PD), if they reported a change in pain of ≥10 mm from baseline, or non-pain developers (NPD). Physical outcomes included participant-rated and examiner-rated trunk and hip motor control and endurance. Self-report history of LBP, physical activity, psychosocial job characteristics, general health and pain catastrophising were collected. Fourteen participants were PD. Hip abduction, abdominal and spinal muscle endurance was lower for PD (p ≤ 0.05). PD had greater self-reported difficulty performing active hip abduction and active straight leg raise tests (p ≤ 0.04). Those reporting a lifetime, 12 month or 7-day history of LBP (p < 0.05) and lower self-reported physical function (p = 0.01) were more likely to develop LBP during the standing task. In conclusion, a history of LBP, reduced trunk and hip muscle endurance and deficits in lumbopelvic/hip motor control may be important to consider in office workers experiencing standing-induced LBP.


2011 ◽  
Vol 106 (5) ◽  
pp. 2506-2514 ◽  
Author(s):  
Jesse V. Jacobs ◽  
Sharon M. Henry ◽  
Stephanie L. Jones ◽  
Juvena R. Hitt ◽  
Janice Y. Bunn

People with a history of low back pain (LBP) exhibit altered responses to postural perturbations, and the central neural control underlying these changes in postural responses remains unclear. To characterize more thoroughly the change in muscle activation patterns of people with LBP in response to a perturbation of standing balance, and to gain insight into the influence of early- vs. late-phase postural responses (differentiated by estimates of voluntary reaction times), this study evaluated the intermuscular patterns of electromyographic (EMG) activations from 24 people with and 21 people without a history of chronic, recurrent LBP in response to 12 directions of support surface translations. Two-factor general linear models examined differences between the 2 subject groups and 12 recorded muscles of the trunk and lower leg in the percentage of trials with bursts of EMG activation as well as the amplitudes of integrated EMG activation for each perturbation direction. The subjects with LBP exhibited 1) higher baseline EMG amplitudes of the erector spinae muscles before perturbation onset, 2) fewer early-phase activations at the internal oblique and gastrocnemius muscles, 3) fewer late-phase activations at the erector spinae, internal and external oblique, rectus abdominae, and tibialis anterior muscles, and 4) higher EMG amplitudes of the gastrocnemius muscle following the perturbation. The results indicate that a history of LBP associates with higher baseline muscle activation and that EMG responses are modulated from this activated state, rather than exhibiting acute burst activity from a quiescent state, perhaps to circumvent trunk displacements.


Author(s):  
Michelle D. Smith ◽  
Chun Shing Johnson Kwan ◽  
Sally Zhang ◽  
Jason Wheeler ◽  
Tennille Sewell ◽  
...  

While many office workers experience low back pain (LBP), little is known about the effect of prolonged standing on LBP symptoms. This repeated-measures within-subjects study aimed to determine whether office workers with LBP are able to work at a standing workstation for one hour without exacerbating symptoms and whether using a footstool affects LBP severity. Sixteen office workers with LBP performed computer work at a standing workstation for one hour under the following two conditions, one week apart: with a footstool and without a footstool. The intensity of LBP was recorded at 10 min intervals. Maximal severity of LBP pain and change in LBP severity throughout the standing task were not different between the footstool and no footstool conditions (p > 0.26). There was a trend for more participants to have an increase in their pain between the start and end of the task when not using a footstool compared to using a footstool (p = 0.10). Most office workers with LBP are able to use a standing workstation without significant exacerbation of symptoms, but a proportion will experience a clinical meaningful increase in symptoms. Using a footstool does not change the severity of LBP experienced when using a standing workstation in individuals with a history of LBP.


2008 ◽  
Vol 33 (1) ◽  
pp. 52-60 ◽  
Author(s):  
Mark J. Pitcher ◽  
David G. Behm ◽  
Scott N. MacKinnon

Maximal voluntary isometric activations (MVIA) are frequently used as inputs for models attempting to predict muscle force and as normalization values in studies assessing muscle function. However, pain may adversely affect maximal muscle activation. The purpose of this study was to assess reliability of MVIA force and electromyographic (EMG) activity during prone isometric back extension in subjects with and without low back pain (LBP). A novel sub-maximal method using the percentages of the estimated mass of the head–arms–trunk (HAT) segment was also investigated. Repeated measures on 20 male volunteers divided into an LBP (n = 10) and a control group (n = 10) were made on 4 occasions. Force and EMG activity were recorded bilaterally from upper lumbar erector spinae (ULES), lower lumbar erector spinae (LLES), and biceps femoris (BF). Subjects exerted a maximal extension effort against a harness assembly that was attached to a force transducer. Submaximal exertions were also performed with an additional resistance of 100%, 110%, 120%, 130%, 140%, 150%, 160%, and 170% of HAT. Mean MVIA forces were significantly (p ≤ 0.05) lower in LBP vs. control. Intraclass correlation coefficients (ICC) for MVIA force, right and left ULES, and LLES EMG indicated high reliability in controls (R > 0.90), but were significantly less in LBP (R = 0.36–0.80). EMG of BF demonstrated excellent reliability across both groups (R > 0.90). The resistance at 100% HAT demonstrated the highest reliability for LBP patients, whereas higher percentages of HAT showed either similar or higher reliability for controls. Force output and back EMG activity are less reliable with LBP individuals and should be taken into consideration when testing.


2018 ◽  
Vol 53 (6) ◽  
pp. 553-559 ◽  
Author(s):  
Mark A. Sutherlin ◽  
Matthew Gage ◽  
L. Colby Mangum ◽  
Jay Hertel ◽  
Shawn Russell ◽  
...  

Context:  Injury-prediction models have identified trunk muscle function as an identifiable factor for future injury. A history of low back pain (HxLBP) may also place athletes at increased risk for future low back pain. Reduced muscle thickness of the lumbar multifidus (LM) and transversus abdominis (TrA) has been reported among populations with clinical low back pain via ultrasound imaging in multiple positions. However, the roles of the LM and TrA in a more functional cohort and for injury prediction are still unknown. Objectives:  To (1) assess the reliability of LM and TrA ultrasound measures, (2) compare changes in muscle thickness across positions between persons reporting or not reporting HxLBP, and (3) determine the ability to distinguish between groups. Design:  Cross-sectional study. Setting:  Research laboratory. Patients or Other Participants:  Participants were 34 people who did not report HxLBP (age = 22 ± 7 years, body mass index = 23.7 ± 2.7) and 25 people who reported HxLBP (age = 25 ± 10 years, body mass index = 24.0 ± 3.2). Main Outcome Measure(s):  Muscle thickness and changes in muscle thickness of the LM and TrA as shown on ultrasound imaging. Results:  Intraclass correlation coefficients ranged from 0.641 to 0.943 for all thickness measures and from 0 to 0.693 for all averaged thickness modulations bilaterally. Participants who reported HxLBP had voluntarily reduced TrA thickness modulations compared with those not reporting HxLBP (P = .03), and the testing position influenced TrA thickness modulations (P &lt; .01). No differences were observed for LM thickness modulations between groups or positions (P &gt; .05). A tabletop cutoff value of 1.32 had a sensitivity of 0.640 and a specificity of 0.706, whereas a seated cutoff value of 1.18 had a sensitivity of 0.600 and a specificity of 0.647. Conclusions:  In participants reporting HxLBP, TrA thickness modulations were lower and both tabletop and seated thickness modulations were able to distinguish reported HxLBP status. These findings suggest that TrA muscle function may be altered by HxLBP.


2010 ◽  
Vol 2010 ◽  
pp. 1-9 ◽  
Author(s):  
Erika Nelson-Wong ◽  
Jack P. Callaghan

A major research focus is optimization of interventions for low back pain (LBP). Predisposing factors for LBP development have been previously identified. To differentiate changes in these factors with intervention, factor stability over time must be determined. Twenty-three volunteers without LBP participated in a LBP-inducing standing protocol on two separate days. Outcome measures included visual analog scale (VAS) for LBP and trunk/hip muscle coactivation patterns. Intraclass correlation coefficients (ICCs) were used to examine repeatability. Between-day repeatability of outcome measures was excellent (ICCs>0.80). Individuals were consistent in subjective LBP, with 83% reporting similar day-to-day VAS levels. Muscle co-activation patterns and LBP reports are stable measures over time for this LBP-inducing protocol. Changes in these measures following intervention can be considered to be treatment effects and are not due to natural variability. This provides support for use of this protocol in studying interventions for standing-induced LBP.


2013 ◽  
Vol 22 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Rebecca J. Bedard ◽  
Kyung-Min Kim ◽  
Terry L. Grindstaff ◽  
Joseph M. Hart

Objective:To compare active hamstring stiffness in female subjects with and without a history of low back pain (LBP) after a standardized 20-min aerobic-exercise session.Design:Case control.Setting:Laboratory.Participants:12 women with a history of recurrent episodes of LBP (age = 22.4 ± 2.1 y, mass = 67.1 ± 11.8 kg, height = 167.9 ± 8 cm) and 12 matched healthy women (age = 21.7 ± 1.7 y, mass = 61.4 ± 8.8 kg, height = 165.6 ± 7.3 cm). LBP subjects reported an average 6.5 ± 4.7 on the Oswestry Disability Index.Interventions:Participants walked at a self-selected speed (minimum 3.0 miles/h) for 20 min. The treadmill incline was raised 1% grade per minute for the first 15 min. During the last 5 min, participants adjusted the incline of the treadmill so they would maintain a moderate level of perceived exertion through the end of the exercise protocol.Main Outcome Measures:During session 1, active hamstring stiffness, hamstring and quadriceps isometric strength, and concurrently collected electromyographic activity were recorded before and immediately after the exercise protocol. For session 2, subjects returned 48–72 h after exercise for repeat measure of active hamstring stiffness.Results:Hamstring active stiffness (Nm/rad) taken immediately postexercise was not significantly different between groups. However, individuals with a history of recurrent LBP episodes presented significantly increased hamstring stiffness 48–72 h postexercise compared with controls. For other outcomes, there was no group difference.Conclusions:Women with a history of recurrent LBP episodes presented greater active hamstring stiffness 48–72 h after aerobic exercise.


Work ◽  
2021 ◽  
pp. 1-8
Author(s):  
Fatemeh Khoshroo ◽  
Foad Seidi ◽  
Reza Rajabi ◽  
Abbey Thomas

BACKGROUND: Distinctive features of low back pain-developers (LBPDs) as pre-clinical low back pain (LBP) population have been evidenced in three areas of alignment, muscle activation, and movement patterns. To clarify whether the reported altered functional movement patterns in chronic LBP patients result from or result in LBP disorders, LBPDs’ functional movement patterns should be investigated. OBJECTIVES: This study aimed to compare female LBPDs’ functional movement patterns with non-pain developers’ (NPDs). METHODS: Sixty female LBPDs and NPDs were recruited based on the research requirements. The Functional Movement Screen (FMS) was used to investigate movement quality. Data were compared between groups via Mann-Whitney U tests and correlation analyses examined association between pain intensity and onset during prolonged standing and the FMS score. Receiver Operating Characteristic Curves and Chi Squares were conducted to find the best cutoff points. An alpha level of p≤0.05 was used to establish statistical significance. RESULTS: LBPDs scored significantly lower, or rather worse than NPDs in the FMS composite score (12.06±1.33 vs. 16.43±1.59, U = 3, P <  0.001). Moreover, the optimal cutoff scores of≤14 on the FMS, 2 on the push-up, and 1 on the deep squat discriminated between female LBPDs and NPDs. The FMS composite score was correlated negatively with LBP intensity (r (60) = –0.724, p <  0.001) and positively with LBP onset (r (60) = 0.277, p = 0.032) during prolonged standing. Finally, the results indicated that female LBPDs presented with at least one bilateral asymmetry on the FMS had 10 times (95%CI, 2.941–34.008) and with at least two bilateral asymmetries on the FMS had 15.5 times (95%CI, 3.814–63.359) higher odds of developing LBP during prolonged standing than NPDs. CONCLUSIONS: Female LBPDs, who are at higher risk for developing LBP in the future, have significantly lower quality of functional movement patterns compared to NPDs. Moreover, the FMS appears to show promise for predicting individuals who are at risk for LBP development during prolonged standing.


2021 ◽  
Vol 10 (2) ◽  
pp. e001068
Author(s):  
Shaun Wellburn ◽  
Cormac G Ryan ◽  
Andrew Coxon ◽  
Alastair J Dickson ◽  
D John Dickson ◽  
...  

ObjectivesEvaluate the outcomes and explore experiences of patients undergoing a residential combined physical and psychological programme (CPPP) for chronic low back pain.DesignA longitudinal observational cohort design, with a parallel qualitative design using semistructured interviews.SettingResidential, multimodal rehabilitation.Participants136 adults (62 male/74 female) referred to the CPPP, 100 (44 male/56 female) of whom completed the programme, during the term of the study. Ten (2 male/8 female) participated in the qualitative evaluation.InterventionA 3-week residential CPPP.Outcome measuresPrimary outcome measures were the STarT Back screening tool score; pain intensity—11-point Numerical Rating Scale; function—Oswestry Disability Index (ODI); health status/quality of life—EQ-5D-5L EuroQol five-Dimension-five level; anxiety—Generalised Anxiety Disorder-7; depression—Patient Health Questionnaire-9. Secondary outcome measures were the Global Subjective Outcome Scale; National Health Service Friends and Family Test;.ResultsAt discharge, 6 and 12 months follow ups, there were improvements from baseline that were greater than minimum clinically important differences in each of the outcomes (with the sole exception of ODI at discharge). At 12 months, the majority of people considered themselves a lot better (57%) and were extremely likely (86%) to recommend the programme to a friend. The qualitative data showed praise for the residential nature of the intervention and the opportunities for interaction with peers and peer support. There were testimonies of improvements in understanding of pain and how to manage it better. Some participants said they had reduced, or stopped, medication they had been taking to manage their pain.ConclusionsParticipants improved, and maintained long term, beyond minimum clinically important differences on a wide range of outcomes. Participants reported an enhanced ability to self-manage their back pain and support for the residential setting.


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