scholarly journals Understanding regional activation of thoraco-lumbar muscles in chronic low back pain and its relationship to clinically relevant domains

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Francesca Serafino ◽  
Marco Trucco ◽  
Adele Occhionero ◽  
Giacinto Luigi Cerone ◽  
Alessandro Chiarotto ◽  
...  

Abstract Background Altered regional activation of the lumbar extensors has been previously observed in individuals with low back pain (LBP) performing high-effort and fatiguing tasks. It is currently unknown whether similar alterations can be observed during low-effort functional tasks. Similarly, previous studies did not investigate whether side differences in regional activation are present in individuals with LBP. Finally, there is limited evidence of whether the extent of the alteration of regional activation is associated with clinical factors. Therefore, the aim of this study was to investigate whether individuals with LBP exhibit asymmetric regional activation of the thoraco-lumbar extensor muscles during functional tasks, and if the extent of neuromuscular control alteration is associated with clinical and psychosocial outcome domains. Methods 21 participants with and 21 without LBP performed five functional tasks (gait, sit-to-stand, forward trunk flexion, shoulder flexion and anterior pelvic tilt). The spatial distribution of activation of the thoraco-lumbar extensor muscles was assessed bilaterally using high-density electromyography. For each side, the distribution of electromyographic (EMG) amplitude was characterized in terms of intensity, location and size. Indices of asymmetry were calculated from these features and comparisons between groups and tasks were performed using ANOVA. The features that significantly differed between groups were correlated with self-reported measures of pain intensity and other outcome domains. Results Indices of asymmetry did not differ between participants with and without LBP (p > 0.11). The cranio-caudal location of the activation differed between tasks (p < 0.05), but not between groups (p = 0.64). Participants with LBP showed reduced EMG amplitude during anterior pelvic tilt and loading response phase during gait (both p < 0.05). Pearson correlation revealed that greater pain intensity was associated with lower EMG amplitude for both tasks (R<-0.5, p < 0.05). Conclusions Despite clear differences between tasks, individuals with and without LBP exhibited similar distributions of EMG amplitude during low-effort functional activities, both within and between sides. However, individuals with LBP demonstrated lower activation of the thoraco-lumbar muscles during gait and anterior pelvic tilt, especially those reporting higher pain intensity. These results have implications in the development or refinement of assessment and intervention strategies focusing on motor control in patients with chronic LBP.

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Britta K. Krautwurst ◽  
Jürgen R. Paletta ◽  
Sylvia Mendoza ◽  
Adrian Skwara ◽  
Melvin Mohokum

Objective. Detection of a lateral shift (LS) in patients with diagnosed disc herniation compared to healthy controls. Summary of Background Data. A specific lateral shift (LS) pattern is observed in patients with disc herniation and low back pain, as shown in earlier studies. Methods. Rasterstereography (RS) was used to investigate the LS. Thirty-nine patients with lumbar disc herniation diagnosed by radiological assessment and low back pain and/or leg pain (mean age 48.2 years, mean BMI 28.5, 28 males and 11 females) and 36 healthy controls (mean age 47.4 years, mean BMI 25.7, 25 males and 11 females) were analysed. LS, pelvic tilt, pelvic inclination, lordotic angle, and trunk torsion were assessed. Results. The patient group showed a nonsignificant increase in LS, that is, 5.6 mm compared to the healthy controls with 5.0 mm (p = 0.693). However, significant differences were found between groups regarding pelvic tilt in degrees (patients 5.9°, healthy controls 2.0°; p = 0.016), trunk torsion (patients 7.5°, controls 4.5°; p = 0.017), and lordotic angle (patients 27.5°, healthy controls 32.7°; p = 0.022). The correlation between pain intensity and the FFbH-R amounted 0.804 (p = < 0.01), and that between pain intensity and the pain disability index was 0.785 (p < 0.01). Discussion. Although some studies have illustrated LS with disc herniation and low back pain, the present findings demonstrate no significant increase in LS in the patient group compared to healthy controls. Conclusion. The patients with lumbar disc herniation did not demonstrate an increased LS compared to healthy controls. Other parameters like pelvic tilt and inclination seemed to be more suitable to identify changes in posture measured by RS in patients with low back pain or disc herniation.


2020 ◽  
Vol 5 (2) ◽  
pp. 71-88
Author(s):  
Zahra Salsabila Hafid ◽  
Ummy Aisyah N ◽  
Parmono Dwi Putro

Background: Lower back pain still occurs in many cyclists. The sitting position is considered to be one of the factors causing complaints of low back pain. This study was conducted to determine the correlation between sitting position and complaints of low back pain in cyclists. Methods: This study employed the narrative review method by collecting ten research articles from the Google Scholar and PubMed databases, identifying keywords using the PEOs format, so that the keywords "Cyclist", "Sitting Position", "Lower Back Pain", and "All Study Design" were used. Results: All articles used were articles published starting in 2010. Seven articles stated that lower back pain occurred more frequently in a sitting position with large lumbar flexion. Six articles stated that the sitting position of a cyclist was affected by the position of the handlebars. Five articles stated that sitting with the lower handlebars resulted in greater lumbar flexion and anterior pelvic tilt. Five articles stated that prolonged lumbar flexion and anterior pelvic tilt resulted in a lower crossed syndrome. Four articles found that lower crossed syndrome contributes to lower back pain. Conclusion: There is a correlation between sitting position and complaints of low back pain in cyclists. However, there are limitations to the article which states that the statistical closeness of the correlation between sitting position and complaints of low back pain in cyclists.


Author(s):  
Devadhason Malarvizhi ◽  
Sai Kishore Varma ◽  
Sivakumar Vpr

OBJECTIVE: The objective of the study was to measure the anterior pelvic tilt for both males and females of low back pain patients.  STUDY DESIGN:  Observational type. PROCEDURE: 120 subjects were approached. In that 70 male and 50 females . Using i@handy application in mobile anterior pelvic tilt was calculated among low back pain patients.RESULTS: Anterior pelvic tilt was increased in low back pain patients . In that correlation between males and Visual analogue scale was not significant. But there was a significant correlation found in female anterior pelvic tilt and Visual analogue scale.CONCLUSION:  This study concluded that there was increase in anterior pelvic tilt among low back pain patients. Anterior pelvic tilt and Visual analogue scale was highly correlated in females not in males.KEYWORDS: i@handy, Anterior pelvic tilt, low back pain.


Author(s):  
Janny M. A. Tavares ◽  
André L. F. Rodacki ◽  
Francielle Hoflinger ◽  
Alexandre dos Santos Cabral ◽  
Anderson C. Paulo ◽  
...  

Background: Chronic low back pain (CLBP) is a serious problem in Military Police Officers (MPO), which accounts for up to 45% of the sick leave rates. It has been assumed that the strength and the endurance of trunk flexor and extensor muscles are CLPB key factors, but it is not known whether these attributes are related to pain intensity. It was aimed to determine whether the strength and endurance of trunk flexor and extensor muscles differ in MPO with no pain (CON; n = 24), moderate (MOD; n = 42), and severe (SEV; n = 37) nonspecific chronic low back pain (CLBP). Methods: The peak torque and endurance test of trunk flexor (PTF.BM−1) and extensor (PTE.BM−1) muscles were compared. A multiple regression analysis was used to identify pain intensity predictors in all groups (PAIN) and according to pain intensity (MOD and SEV). Results: The PTF.BM−1 was negatively related to pain and was a significant predictor, irrespective of pain intensity (PAIN). Conclusion: When pain intensity was considered the PTF.BM−1 and PTE.BM−1 explained the pain in the MOD, while the PTE.BM−1 and service time explained pain intensity in the SEV. Endurance of the flexor and extensor muscles was not related to pain intensity. These results indicated that training protocols must emphasize specific strengthening routines.


2013 ◽  
Vol 25 (1) ◽  
pp. 65-68 ◽  
Author(s):  
Hee Sung Lim ◽  
Su Yeon Roh ◽  
Suk Min Lee

2015 ◽  
Vol 28 (2) ◽  
pp. 319-326 ◽  
Author(s):  
Vanessa Patrícia Soares de Sousa ◽  
Silvia Oliveira Ribeiro ◽  
Carla Monique Ribeiro de Aquino ◽  
Elizabel de Souza Ramalho Viana

Introduction Pregnancy is characterized by several changes in her body. These changes contribute to the emergence of low back pain, which may influence the quality of sleep during pregnancy. Objective To compare the quality of sleep among pregnant women with and without low back pain during pregnancy, examining the relationship between two variables. Materials methods Thirty volunteers aged between 19 and 36 years, divided into control group (CG – n = 16) and Study Group (SG – n = 14), residents in the cities of Natal, were evaluated in the second trimester of pregnancy. To sleep evaluation were used to index the Pittsburgh Sleep Quality and the Epworth Sleepiness Scale. Low back pain was evaluated using the pressure algometer, Visual Analogue Scale (VAS) and Oswestry Disability Index. Statistical analysis used the Shapiro Wilk test, Student’s T test for independent samples and Pearson correlation test. Results The mean gestational and chronological ages were 28.2 ± 3.4 years and 19.9 ± 3.7 weeks, respectively. Sleep quality was lower in SG (8.21 ± 4.8) when compared to CG (5.94 ± 1.7) and was statistically significant (P = 0.021). Analyzing the relationship between sleep quality and pain intensity, it was observed that the variables have a positive correlation between them (r = 0.372, P = 0.043). Conclusion Our findings indicate that sleep quality is decreased in women with low back pain compared to those without pain.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takahiro Miki ◽  
Daisuke Higuchi ◽  
Tsuneo Takebayashi ◽  
Mina Samukawa

AbstractThis study aimed to explore factors associating with disability, which means physical impairment affecting a person’s mobility, capacity, stamina, or agility, of non-specific low back pain (NSLBP) of the acute and non-acute groups. Two hundred thirty-five patients with NSLBP of less than 8 weeks’ duration as acute groups (n = 124) and more than 8 weeks’ duration as non-acute group (n = 111) were recruited. It was collected data on pain intensity, disability and psychosocial factors, including pain catastrophising, fear of movement and pain self-efficacy. Disability was measured Roland Morris Disability Questionnaire. A hierarchical multiple regression analysis was performed to analyse factors associating with disability of the acute and non-acute groups. The Result was that explanatory power increased with each additional variable of the order of demographic characteristics, pain intensity and psychosocial factors for both groups. Pain intensity, pain catastrophising and pain self-efficacy had significant explanatory power, with pain self-efficacy having the most significant association on the acute group. Only pain self-efficacy having the most significant association on disability of the non-acute group. In conclusion, the factors associating with disability differed depending on the duration of the disease, and pain self-efficacy might be one of the factors associating with disability of patients with NSLBP.


Author(s):  
Jay Kumar Soni ◽  
Edrish Contractor

Aims: Non specific Low back pain is defined as pain without any known pathology which affects almost all the leading occupation where body's awkward posture, twisting and stress forces are commonly encountered across the globe and it is highly prevalent 60% to 70% in a year. Studies have shown various exercise regimen individual effect on the same but superiority of regimen out of these is not clear. Study Design: Comparative Study Place and Duration of Study: Ahmedabad Institute of Medical Sciences, Duration 2013-15 Objective: To assess and compare the effect of core stability exercise, back school program and Swiss ball exercise on Pain, core endurance and Functional disability. Methodology: A group of 24 patients having non-specific low back pain between age groups 18-40 were randomly selected and allocated in to two groups. Group A(n=12) received traditional exercise whereas Swiss ball exercise was given to Group B(n=12). The subjects were treated for two weeks. Baseline data for VAS, Core endurance and MODI were taken on day1 and at the end of two weeks Result: The results were analyzed by wilcoxon signed rank test within both groups. Both groups showed significant improvement in VAS, core endurance and MODI at the end of 2weeks.Comparison between both the Group A and Group B was done by Mann- whitney U test and statistically no significant difference was seen in VAS, core endurance and MODI between the groups Conclusion: The study concluded that both the exercises are equally effective in reducing pain intensity, improves core endurance and functional status in subjects with non specific low back pain


2020 ◽  
Vol 12 (4) ◽  
pp. 1037-1042
Author(s):  
M. Jamaluddin ◽  
Widiyaningsih Widiyaningsih ◽  
Dwi Kustriyanti

During pregnancy there are physiological and psychological changes that can cause discomfort such as leg cramps, difficulty breathing, back pain, depression, anxiety and sleep disorders. The prevalence of low back pain is around 60-80% which can lead to strain on the ligaments and fatigue in the abdominal muscles, as well as balance disorders. This will lead to disruption of activities during pregnancy, such as difficulty walking and sleep disturbances. To assess low back pain and sleep quality among pregnant women: cross sectional study. Cross-sectional data were collected by 37 pregnant women with inclusion criteria were third trimester pregnant women, willing to be a respondent, with normal blood pressure, and have not received any medication related sleep disorder. They completed the Pittsburgh Sleep Quality Index (PSQI) and Rolland-Morris Disability Questionaire (RDQ), statistical analysis was conducted using Pearson Correlation Product Moment. Research was conducted in Semarang and Kudus. Sleep quality among pregnant women demonstrated significanly poor overall sleep quality with PSQI score (mean 8.70 ± 3.511) and RDQ score (mean 8.97 ± 6.414). There was moderate correlation between low back pain with sleep quality (r correlation = 0.558). Low back pain have correlation to increase or decrease sleep quality among preganant women. 


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