Abstract

BackgroundAltered 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.MethodsIn 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.ResultsContinuous 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.ConclusionsAn 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.

Highlights

  • Altered lower back muscle activity is proposed as a contributing factor to the reoccurrence and chronicity of low back pain (LBP)

  • Demographics Seventy-five subjects participated in this study of which 16 had continuous chronic LBP (CLBP), 15 non-continuous CLBP, 23 recurrent LBP (RLBP) and 21 healthy controls

  • Post-hoc comparisons showed that patients with continuous CLBP were significantly older compared to patients with RLBP (p = 0.002) while there was no difference between the other groups

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Summary

Introduction

Altered lower back muscle activity is proposed as a contributing factor to the reoccurrence and chronicity of low back pain (LBP). Altered back muscle activity has been proposed as a factor contributing to LBP. Several lumbar muscles such as erector spinae (ES), multifidus (MF), latissimus dorsi (LD) and gluteus maximus (GM) play an important role in the stabilization and dynamic control of the lumbar spine [2, 3]. Enhanced activity of the superficial back muscles has been reported in people with chronic LBP (CLBP) compared to healthy controls [4,5,6] as a compensatory strategy to increase spinal stability, leading to fatigability of the spinal muscles [7, 8]. In recurrent LBP (RLBP) in remission previous research observed reduced muscle activity compared to healthy subjects [9, 10], whereas others found the opposite [11]

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