Tolerability and Muscle Activity of Core Muscle Exercises in Chronic Low-back Pain

Most of the studies evaluating core muscle activity during exercises have been conducted with healthy participants. The objective of this study was to compare core muscle activity and tolerability of a variety of dynamic and isometric exercises in patients with non-specific low back pain (NSLBP). 13 outpatients (average age 52 years; all with standing or walking work in their current or latest job) performed 3 consecutive repetitions at 15-repetition maximum during different exercises in random order. Surface electromyography was recorded for the rectus abdominis; external oblique and lumbar erector spinae. Patients rated tolerability of each exercise on a 5-point scale. The front plank with brace; front plank and modified curl-up can be considered the most effective exercises in activating the rectus abdominis; with a median normalized EMG (nEMG) value of 48% (34–61%), 46% (26–61%) and 50% (28–65%), respectively. The front plank with brace can be considered the most effective exercise in activating the external oblique; with a nEMG of 77% (60–97%). The squat and bird-dog exercises are especially effective in activing the lumbar erector spinae; with nEMG of 40% (24–87%) and 29% (27–46%), respectively. All the exercises were well tolerated; except for the lateral plank that was mostly non-tolerated. In conclusion; the present study provides a variety of dynamic and isometric exercises; where muscle activity values and tolerability can be used as guide to design evidence-based exercise programs for outpatients with NSCLBP.

Download Full-text

Effects of Whole Body Vibration exercise on Lumbar-Abdominal Muscles Activation for patients with chronic low back pain

10.21203/rs.3.rs-54803/v1 ◽

2020 ◽

Author(s):

yulin dong ◽

huifang wang ◽

Yan Zhu ◽

Binlin Chen ◽

Yili Zheng ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Muscle Activity ◽

Whole Body Vibration ◽

Abdominal Muscle ◽

Erector Spinae ◽

Whole Body ◽

Low Back ◽

Body Vibration

Abstract BackgroundWhole body vibration (WBV) training as an intervention method can cure chronic low back pain (CLBP). Different WBV parameters exert different effects on lumbar-abdominal muscle performance. Currently, there is a lack of study researched the influence of WBV training on patients with CLBP by lumbar–abdominal muscle activity. Therefore, this study aimed to investigate how WBV and exercise and their interactions influence lumbar-abdominal muscle activity in patients with CLBP.Methodsa group of ambulatory patients with chronic low back pain. Muscle activities of the multifidus, erector spinae, abdominal oblique externus muscle and the rectus abdominis muscle were measured by surface electromyography, whereas participants performed 4 different exercises during three whole body vibration conditions and a no-vibration condition in a single experimental session.ResultsCompared with the same exercises without whole body vibration, muscle activity increased when whole body vibration was added to the exercises. The frequency and exercise presented significant effects on the root mean square of multifidus, whereas exercise and frequency also resulted in significant interaction effects.ConclusionAdding whole body vibration to exercise could increase muscle activation of lumbar–abdominal muscle in patients with CLBP. The optimum frequency for lumbar–abdominal muscles is 15 Hz. The best exercises include plank for multifidus and erector spinae, V crunch for rectus abdominis and single bridge for abdominal oblique externus.Trial registration:ChiCTR-TRC-13003708. Registered 19 October 2013, http://www.chictr.org.cn/showproj.aspx?proj=5852

Download Full-text

Association between lumbopelvic motion and muscle activation in patients with non-specific low back pain during forward bending task: A cross-sectional study

Hong Kong Physiotherapy Journal ◽

10.1142/s1013702520500043 ◽

2019 ◽

Vol 40 (01) ◽

pp. 29-37

Author(s):

Peemongkon Wattananon ◽

Komsak Sinsurin ◽

Sirikarn Somprasong

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Muscle Activity ◽

Muscle Activation ◽

Erector Spinae ◽

Low Back ◽

Activation Patterns ◽

Muscle Activation Patterns ◽

Forward Bending ◽

Lumbar Motion

Background: Evidence suggests patients with non-specific low back pain (NSLBP) have altered lumbar and pelvic movement patterns. These changes could be associated with altered patterns of muscle activation. Objective: The study aimed to determine: (1) differences in the relative contributions and velocity of lumbar and pelvic movements between people with and without NSLBP, (2) the differences in lumbopelvic muscle activation patterns between people with and without NSLBP, and (3) the association between lumbar and pelvic movements and lumbopelvic muscle activation patterns. Methods: Subjects (8 healthy individuals and 8 patients with NSLBP) performed 2 sets of 3 repetitions of active forward bending, while motion and muscle activity data were collected simultaneously. Data derived were lumbar and pelvic ranges of motion and velocity, and ipsilateral and contralateral lumbopelvic muscle activities (internal oblique[Formula: see text]transverse abdominis (IO[Formula: see text]TA), lumbar multifidus (LM), erector spinae (ES) and gluteus maximus (GM) muscles). Results: Lumbar and pelvic motions showed trends, but exceeded 95% confidence minimal detectable difference (MDD[Formula: see text]), for greater pelvic motion [Formula: see text], less lumbar motion [Formula: see text] among patients with NSLBP. Significantly less activity was observed in the GM muscles bilaterally [Formula: see text] in the NSLBP group. A significant association [Formula: see text], [Formula: see text] was found between ipsilateral ES muscle activity and lumbar motion, while moderate, but statistically non-significant associations, were found between GM muscle activity bilaterally and lumbar velocity [Formula: see text]ipsilateral: [Formula: see text], [Formula: see text]; contralateral: [Formula: see text], [Formula: see text] in the NSLBP group. Conclusion: Findings indicated patients had greater pelvic contribution, but less lumbar contribution which was associated with less activation of the GM bilaterally.

Download Full-text

Spatial distribution of lumbar erector spinae muscle activity in individuals with and without chronic low back pain during a dynamic isokinetic fatiguing task

Clinical Biomechanics ◽

10.1016/j.clinbiomech.2020.105214 ◽

2020 ◽

pp. 105214

Author(s):

Michail Arvanitidis ◽

Nikolaos Bikinis ◽

Stylianos Petrakis ◽

Afroditi Gkioka ◽

Dimitrios Tsimpolis ◽

...

Keyword(s):

Spatial Distribution ◽

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Muscle Activity ◽

Erector Spinae ◽

Low Back ◽

Erector Spinae Muscle

Download Full-text

Effect of Modified Bridge Exercise on Muscle Activity of Erector Spinae, Gluteus Maximus and Biceps Femoris Muscle in Patients with Chronic Low Back Pain

The Asian Journal of Kinesiology ◽

10.15758/ajk.2018.20.1.64 ◽

2018 ◽

Vol 20 (1) ◽

pp. 64-70

Author(s):

Sung-Jin Moon ◽

Jaesoon Chung

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Chronic Low Back Pain ◽

Muscle Activity ◽

Gluteus Maximus ◽

Biceps Femoris ◽

Erector Spinae ◽

Low Back ◽

Biceps Femoris Muscle ◽

Femoris Muscle

Download Full-text

EMG-pressure Response in the Transverse Abdominis and Multifidus Muscles among Individuals With and Without Chronic Low Back Pain

10.21203/rs.2.20052/v1 ◽

2020 ◽

Author(s):

Chu huai Wang ◽

Xin Li ◽

Wai Leung Ambrose Lo ◽

Song wei Lu ◽

Howe Liu ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Muscle Activity ◽

Low Cost ◽

Random Order ◽

Trunk Muscles ◽

Control Group ◽

Low Back ◽

Maximal Voluntary Isometric Contraction ◽

Pressure Biofeedback

Abstract Background: Pressure biofeedback unit (PBU) is a non-invasive, low-cost, and widely used device for monitoring, evaluating and training transverse abdominals (TA) and multifidus (MF) muscles of patients with low back pain (LBP). There has been little research on quantifying muscle activity under different pressures. The primary aim of this preliminary study was to explore the response between deep local trunk muscles (TA and MF) and different target pressures of PBU in seated positions. Methods: Twenty-two patients with chronic LBP (cLBP) and 24 age matched healthy individuals were recruited. Electromyography (EMG) signals were recorded from the TA and MF muscles while individuals contract the TA and MF muscles in seated position to achieve PBU pressure value of 50, 60 and 70mmHg in random order. The t-test was used to compare between-group and within-subjects’ effects to examine the effect of different pressure values. Spearman’s correlation analysis was performed in the cLBP group to determine potential correlations. Results: The %MVIC of the TA and MF in the cLBP group were statistically higher than the control group at each pressure value (P＜0.05). The slope of the cLBP subjects was significantly steeper than the healthy control subjects (TA: P=0.01, MF: P＜0.001). During maximal voluntary isometric contraction (MVIC) of TA and MF, compared with pain-free group, cLBP patients showed a significant decrease (P≤0.001). MF MVIC was significantly and moderately negatively correlated with visual analog scale (VAS) (r = -0.48, P=0.024) and Oswestry Disability Index (ODI) (r = -0.59, P=0.004). Conclusions: The study demonstrates the feasibility of using PBU to assess muscle contraction that corresponds with changes of muscle activity as measured by EMG. The use of EMG to quantify the extent of how much the PBU activates muscles may provide important information to clinicians and researchers for patients with LBP.

Download Full-text

Spatial Distribution and Asymmetry of Surface Electromyography on Lumbar Muscles of Soldiers with Chronic Low Back Pain

Pain Research and Management ◽

10.1155/2020/6946294 ◽

2020 ◽

Vol 2020 ◽

pp. 1-8

Author(s):

Zengming Hao ◽

Lin Xie ◽

Jian Wang ◽

Zhenhai Hou

Keyword(s):

Spatial Distribution ◽

Low Back Pain ◽

Back Pain ◽

Muscle Fatigue ◽

Chronic Low Back Pain ◽

Muscle Activity ◽

Surface Electromyography ◽

Erector Spinae ◽

Low Back ◽

Sustained Contraction

This study investigated spatial distribution and asymmetry of surface electromyography on lumbar muscles during a sustained contraction in soldiers with and without chronic low back pain. Twenty healthy soldiers and twenty chronic low back pain (CLBP) soldiers had performed the Sorensen test with a duration of 60 seconds. The corresponding muscle fatigue, spatial distribution, and the asymmetry of muscle activity over bilateral paraspinal lumbar regions were measured by the high-density surface electromyography (HDsEMG). The paired and independent samples t-tests were performed to compare the degree of muscle fatigue and asymmetry. The repeated-measures analyses of variance (ANOVA) were used to compare spatial distribution between groups and muscle fatigue. The baseline characteristics of soldiers between groups were comparable. CLBP soldiers had significantly less muscle fatigue on both sides of erector spinae compared to healthy ones. The spatial distribution was significantly associated with the group factor but independent of muscle fatigue. In addition, the asymmetry of erector spinae activity in the CLBP soldiers was significantly higher than the healthy one. In conclusion, uneven spatial distribution and asymmetry of lumbar muscle activity play significant roles in CLBP patients. The HDsEMG could be used as an objective method in distinguishing the function of the erector spinae between healthy individuals and CLBP patients during 1 min sustained contraction.

Download Full-text

Differences in myoelectric activity of the lumbar muscles between recurrent and chronic low back pain: a cross-sectional study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04623-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Balasch-Bernat Mercè ◽

Willems Tine ◽

Danneels Lieven ◽

Meeus Mira ◽

Goubert Dorien

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Muscle Activity ◽

Healthy Subjects ◽

Erector Spinae ◽

Emg Activity ◽

Myoelectric Activity ◽

Healthy Controls ◽

Low Back ◽

Trunk Extension

Abstract Background Altered lower back muscle activity is proposed as a contributing factor to the reoccurrence and chronicity of low back pain (LBP). This study compared lumbar muscle activity during trunk extension in patients with continuous chronic LBP (CLBP), non-continuous CLBP, recurrent LBP (RLBP) and healthy subjects. Methods In 75 subjects (16 continuous CLBP, 15 non-continuous CLBP, 23 RLBP, 21 healthy controls), surface electromyographic (EMG) activity of the lumbar erector spinae (ES), multifidus (MF), latissimus dorsi (LD) and gluteus maximus (GM) was recorded during the concentric, holding and eccentric phase of a modified Biering Sorenson exercise. Results Continuous CLBP patients showed higher EMG activity in the ES and MF muscles compared to healthy controls in the concentric (p = 0.011; p = 0.009 respectively) and the holding phase (p = 0.015; p = 0.013). Higher EMG activity was observed in continuous CLBP compared to RLBP in the ES and MF muscles in the holding phase (p = 0.035; p = 0.037), and in the MF in the concentric phase (p = 0.046), but not in the ES (p = 0.062). No differences in muscle activity were established in either the concentric, holding, and eccentric phase for the LD and GM muscles. No differences were found between non-continuous CLBP and the other groups. Conclusions An enhanced muscle activity of the lumbar muscles during the concentric and holding phase was observed during trunk extension in patients with continuous CLBP compared to patients with RLBP and healthy subjects. No differences between groups are present in the GM and LD muscles during concentric and holding phases and for any muscle in the eccentric phase.

Download Full-text

The effect of experimental low back pain on lumbar muscle activity in people with a history of clinical low back pain: a muscle functional MRI study

Journal of Neurophysiology ◽

10.1152/jn.00192.2015 ◽

2016 ◽

Vol 115 (2) ◽

pp. 851-857 ◽

Cited By ~ 10

Author(s):

Lieven Danneels ◽

Barbara Cagnie ◽

Roseline D'hooge ◽

Yves De Deene ◽

Geert Crombez ◽

...

Keyword(s):

Low Back Pain ◽

Back Pain ◽

Functional Mri ◽

Muscle Activity ◽

Experimental Pain ◽

Erector Spinae ◽

Low Back ◽

Lumbar Muscle ◽

History Of ◽

Trunk Extension

In people with a history of low back pain (LBP), structural and functional alterations have been observed at several peripheral and central levels of the sensorimotor pathway. These existing alterations might interact with the way the sensorimotor system responds to pain. We examined this assumption by evaluating the lumbar motor responses to experimental nociceptive input of 15 participants during remission of unilateral recurrent LBP. Quantitative T2 images (muscle functional MRI) were taken bilaterally of multifidus, erector spinae, and psoas at several segmental levels (L3 upper and L4 upper and lower endplate) and during several conditions: 1) at rest, 2) upon trunk-extension exercise without pain, and 3) upon trunk-extension exercise with experimental induced pain at the clinical pain-side (1.5-ml intramuscular hypertonic saline injections in erector spinae). Following experimental pain induction, muscle activity levels similarly reduced for all three muscles, on both painful and nonpainful sides, and at multiple segmental levels ( P = 0.038). Pain intensity and localization from experimental LBP were similar as during recalled clinical LBP episodes. In conclusion, unilateral and unisegmental experimental LBP exerts a generalized and widespread decrease in lumbar muscle activity during remission of recurrent LBP. This muscle response is consistent with previous observed patterns in healthy people subjected to the same experimental pain paradigm. It is striking that similar inhibitory patterns in response to pain could be observed, despite the presence of preexisting alterations in the lumbar musculature during remission of recurrent LBP. These results suggest that motor output can modify along the course of recurrent LBP.

Download Full-text