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European Spine Journal

, Volume 15, Issue 5, pp 658–667 | Cite as

Trunk muscular activation patterns and responses to transient force perturbation in persons with self-reported low back pain

  • Ian A. F. StokesEmail author
  • James R. Fox
  • Sharon M. Henry
Original Article

Abstract

Trunk stability requires muscle stiffness associated with appropriate timing and magnitude of activation of muscles. Abnormality of muscle function has been implicated as possible cause or consequence of back pain. This experimental study compared trunk muscle activation and responses to transient force perturbations in persons with and without self-reported history of low back pain. The objective was to determine whether or not history of back pain was associated with (1) altered anticipatory preactivation of trunk muscles or altered likelihood of muscular response to a transient force perturbation and (2) altered muscle activation patterns during a ramped effort. Twenty-one subjects who reported having back pain (LBP group) and twenty-three reporting no recent back pain (NLBP group) were tested while each subject stood in an apparatus with the pelvis immobilized. They performed ‘ramped-effort’ tests (to a voluntary maximum effort), and force perturbation tests. Resistance was provided by a horizontal cable from the thorax to one of five anchorage points on a wall track to the subject’s right at angles of 0°, 45°, 90°, 135° and 180° to the forward direction. In the perturbation tests, subjects first pulled against the cable to generate an effort nominally 15% or 30% of their maximum extension effort. The effort and the EMG activity of five right/left pairs of trunk muscles were recorded, and muscle responses were detected. In the ramped-effort tests the gradient of the EMG–effort relationship provided a measure of each muscle’s activation. On average, the LBP group subjects activated their dorsal muscles more than the NLBP group subjects in a maximum effort task when the EMG values were normalized for the maximum EMG, but this finding may have resulted from lesser maximum effort generated by LBP subjects. Greater muscle preactivation was recorded in the LBP group than the NLBP group just prior to the perturbation. The likelihood of muscle responses to perturbations was not significantly different between the two groups. The findings were consistent with the hypothesis that LBP subjects employed muscle activation in a quasi-static task and preactivation prior to a perturbation in an attempt to stiffen and stabilize the trunk. However, interpretation of the findings was complicated by the fact that LBP subjects generated lesser efforts, and it was not known whether this resulted from anatomical differences (e.g., muscle atrophy) or reduced motivation (e.g., pain avoidance).

Keywords

Muscle activation Perturbation Back pain Electromyography Trunk stability 

Notes

Acknowledgements

This work was supported by NIH grants R01 AR 44119 and K01 HD 01194. Richard M. Single performed some of the statistical analyses. The work was done after review and approval of human subject procedures by the Institutional Committee on Human Research, and experiments were in compliance with USA law.

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Ian A. F. Stokes
    • 1
    Email author
  • James R. Fox
    • 1
  • Sharon M. Henry
    • 2
  1. 1.Department of Orthopaedics and RehabilitationUniversity of VermontBurlingtonUSA
  2. 2.Department of Physical TherapyUniversity of VermontBurlingtonUSA

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