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The effect of sex and chronic low back pain on back muscle reflex responses

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Abstract

Different back muscle reflex assessment protocols have shown abnormally longer reflex latency responses of back muscles in chronic low back pain (CLBP). However, many confounding variables are difficult to control, such as the load magnitude and the preactivation of trunk muscles. The aims of this study were to evaluate, in 30 subjects with CLBP and 30 healthy controls, the activation levels of back muscles during pre-loading and their reflex responses to sudden loading. After subjected to six practice perturbations, 20 sudden and unexpected forward perturbations of the trunk were applied in 30 CLBP subjects (14 women) and 31 controls (17 women), while attempting to minimize the confounding effect of preactivation level and perturbation amplitude. Reflex latency and amplitudes were computed from the surface EMG signals of four back muscles (bilaterally at L5, L3, L1, T10 vertebral levels). EMG was also collected from abdominal muscles. Subjects with CLBP significantly increased the preactivation of back muscles (abdominal preactivation the same) relative to controls while no sex effect was observed. While adjusting statistically for these differences, reflex amplitude was significantly higher in subjects with CLBP and men, compared to healthy controls and women, respectively. Interestingly, contrary to most of the literature available, no between-group effects were detected for reflex latency, which could potentially be explained by an appropriate control of confounding variables, but this remains to be clarified in future research.

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Abbreviations

AGLR:

Approximated generalized likelihood-ratio

ANOVA:

Analysis of variance

ANCOVA:

Analysis of covariance

Ang150ms:

Trunk angle 150 ms after the beginning of trunk movement

CLBP:

Chronic low back pain

EMG:

Electromyography

EMGref:

EMG RMS signal corresponding to submaximal reference contractions

EMGmax:

Maximal EMG RMS signal collected during the MVCs

EO:

External oblique

LatencySD:

Reflex latency using the computer-based SD method to detect EMG onsets

LatencyAGLR:

Reflex latency using the computer-based AGLR method to detect EMG onsets

MVC:

Maximal voluntary contraction

NRMSref:

Muscle preactivation in RMS values normalized using EMGref

NRMSmax:

Muscle preactivation in RMS values normalized using EMGmax

PCS:

Pain catastrophizing scale

RA:

Rectus abdominis

RatioPeak:

Reflex amplitude corresponding to the ratio between RawPeak and the EMG signal amplitude (250 ms) prior to trunk movement

RawPeak:

Reflex amplitude corresponding to the peak reflex amplitude (in μV)

RDQ:

Rolland–Morris disability questionnaire

RMS:

Root mean square

SD:

Standard deviation

TSK:

Tampa scale of kinesiophobia

VAS:

Visual analog scale

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Acknowledgments

The present research project was funded by the Occupational Health and Safety Research Institute Robert-Sauvé (IRSST) and the “Réseau provincial de recherche en adaptation-réadaptation (REPAR)” of Quebec (Canada). Special thanks to Flavia Dell’Oso and Marielle Trottier for data collection and to David McFadden, Jean-François Pilon and Hakim Mecheri for technical (engineering) assistance.

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Authors and Affiliations

  1. Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505, boul. De Maisonneuve Ouest, Montreal, QC, H3A 3C2, Canada

    Christian Larivière

  2. School of Rehabilitation, Université de Montreal, C.P. 6128, Succursale Centre-Ville, Montreal, QC, H3C 3J7, Canada

    Robert Forget

  3. School of Rehabilitation Sciences, Élisabeth Bruyère Research Institute, University of Ottawa, 451 Smyth, Ottawa, ON, K1H 8M5, Canada

    Martin Bilodeau

  4. Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Canada

    Christian Larivière, Robert Forget, Roger Vadeboncoeur & Hakim Mecheri

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  1. Christian Larivière
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  2. Robert Forget
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  3. Roger Vadeboncoeur
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  4. Martin Bilodeau
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Correspondence to Christian Larivière.

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Communicated by Fausto Baldissera.

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Larivière, C., Forget, R., Vadeboncoeur, R. et al. The effect of sex and chronic low back pain on back muscle reflex responses. Eur J Appl Physiol 109, 577–590 (2010). https://doi.org/10.1007/s00421-010-1389-7

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