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

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.

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Trunk muscle activity during dynamic exercises on land and in water for participants with and without chronic low back pain

Physiotherapy ◽

10.1016/j.physio.2017.11.158 ◽

2017 ◽

Vol 103 ◽

pp. e6-e7

Author(s):

L. Linton ◽

S. Valentine ◽

S. Coleman ◽

K. Kaliarntas ◽

S. Psycharakis

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Muscle Activity ◽

Trunk Muscle ◽

Low Back

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Lumbar and abdominal muscle activity during walking in subjects with chronic low back pain: Support of the “guarding” hypothesis?

Journal of Electromyography and Kinesiology ◽

10.1016/j.jelekin.2009.03.009 ◽

2010 ◽

Vol 20 (1) ◽

pp. 31-38 ◽

Cited By ~ 62

Author(s):

Marije van der Hulst ◽

Miriam M. Vollenbroek-Hutten ◽

Johan S. Rietman ◽

Hermanus J. Hermens

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Muscle Activity ◽

Abdominal Muscle ◽

Low Back

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Immediate effect of thoracic mobilization on trunk motion, pain sensation and lumbar spine muscle activity in patients with chronic low back pain

http://isrctn.com/ ◽

10.1186/isrctn75190733 ◽

2021 ◽

Author(s):

Amornthep Jankaew

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Lumbar Spine ◽

Chronic Low Back Pain ◽

Muscle Activity ◽

Low Back ◽

Pain Sensation ◽

Trunk Motion

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O 086 - Relation between the flexion-relaxation phenomenon and back extensor endurance in non-specific chronic low back pain patients

Gait & Posture ◽

10.1016/j.gaitpost.2018.06.105 ◽

2018 ◽

Vol 65 ◽

pp. 176-177 ◽

Cited By ~ 2

Author(s):

K. Rose-Dulcina ◽

S. Genevay ◽

D.E. Dominguez ◽

S. Armand ◽

N. Vuillerme

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Relaxation Phenomenon ◽

Low Back ◽

Flexion Relaxation Phenomenon ◽

Flexion Relaxation ◽

Pain Patients ◽

Back Extensor

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Chronic low back pain and back muscle activity during functional tasks

Gait & Posture ◽

10.1016/j.gaitpost.2018.01.021 ◽

2018 ◽

Vol 61 ◽

pp. 250-256 ◽

Cited By ~ 12

Author(s):

Maicom Lima ◽

Arthur Sá Ferreira ◽

Felipe José Jandre Reis ◽

Vanessa Paes ◽

Ney Meziat-Filho

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Muscle Activity ◽

Low Back ◽

Back Muscle

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An Evaluation of an Innovative Exercise to Relieve Chronic Low Back Pain in Sedentary Workers

Human Factors The Journal of the Human Factors and Ergonomics Society ◽

10.1177/0018720820966082 ◽

2020 ◽

pp. 001872082096608

Author(s):

Pongsatorn Saiklang ◽

Rungthip Puntumetakul ◽

James Selfe ◽

Gillian Yeowell

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Pain Intensity ◽

Muscle Fatigue ◽

Chronic Low Back Pain ◽

Muscle Activity ◽

Trunk Muscle ◽

Low Back ◽

Prolonged Sitting ◽

Lumbar Extension

Objective The purpose of the study was to examine the effectiveness of a novel supported dynamic lumbar extension with the abdominal drawing-in maneuver (ADIM) technique on stature change, deep abdominal muscle activity, trunk muscle fatigue, and pain intensity during prolonged sitting in chronic low back pain (CLBP) participants. Background Prolonged sitting can cause trunk muscle fatigue from continuous contraction of deep trunk muscles in seated postures. Deficiency of activity of deep muscles can reduce muscular support of the spine, causing stress on spinal structures, which could result in pain. Method Thirty participants with CLBP were randomly allocated: (a) control—sitting without exercise, and (b) intervention—supported dynamic lumbar extension with the ADIM technique. Results Compared to the intervention condition, the control condition demonstrated significantly greater deterioration in stature change, increased levels of deep trunk muscle fatigue, and an increase in pain during prolonged sitting. Conclusion The supported dynamic lumbar extension with the ADIM technique appears to provide a protective effect on detrimental stature change and deep trunk muscle fatigue. In addition, it prevented an increase in pain intensity during prolonged sitting in people with CLBP. Application Sedentary behavior harms health, particularly affecting the lower back. Clinicians can use the intervention to induce dynamic lumbar movement, and this exercise can maintain deep trunk muscle activity during prolonged sitting, thereby helping to prevent low back pain (LBP) problems.

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Exploring Neuromuscular Electrical Stimulation Intensity Effects on Multifidus Muscle Activity in Adults With Chronic Low Back Pain: An Ultrasound Imaging–Informed Investigation

Clinical Medicine Insights Arthritis and Musculoskeletal Disorders ◽

10.1177/1179544119849570 ◽

2019 ◽

Vol 12 ◽

pp. 117954411984957 ◽

Cited By ~ 1

Author(s):

Jaclyn Megan Sions ◽

DeJ’a Chyanna Crippen ◽

Gregory Evan Hicks ◽

Abdulmohsen Meshari Alroumi ◽

Tara Jo Manal ◽

...

Keyword(s):

Electrical Stimulation ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Muscle Activity ◽

Neuromuscular Electrical Stimulation ◽

Low Back ◽

High Tolerance ◽

Multifidus Muscle ◽

Thickness Change

Study design: Cross-sectional study. Background: Neuromuscular electrical stimulation (NMES) is an effective tool for stimulating multifidus muscle contractions. Ultrasound imaging (USI) is valid and reliable for quantifying multifidus activity represented by percent thickness change from a resting to contracted state. Thus, USI may be used to help determine optimal NMES intensity. Objectives: To explore NMES intensity effects on multifidus thickening in adults with chronic low back pain (CLBP). Methods: Sixty patients with CLBP participated. L4/5 multifidus ultrasound images were obtained and percent thickness change from a resting to a contracted state was determined at baseline with a limb lift and during NMES application. During NMES, the examiner recorded the intensity, in milliampere, when the multifidus first started to thicken as observed with USI. The examiner also recorded the NMES intensity that resulted in no further multifidus thickening (ie, high-tolerance group) or, in cases where maximal thickening was not observed, the NMES intensity of the submaximal contraction (ie, low-tolerance group). Differences between participants with high versus low NMES tolerance were evaluated. Results: During NMES, the multifidus began thickening at a higher intensity for the high-tolerance group (n = 39), that is, 34 mA, compared with the low-tolerance group (n = 21), that is, 32 mA ( P = .001). A greater mean intensity in the high-tolerance group, that is, 62 mA, as compared to 45 mA in the low-tolerance group, resulted in a larger percent thickness change, that is, 30.89% compared to 20.60%, respectively ( P < .001). Conclusions: Results provide clinicians with NMES intensity targets to facilitate multifidus muscle thickening, which provides insight into muscle activity.

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