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A surface electromyographic study to assess the effect of spinal segmental stabilization [multifidus] exercise program in chronic mechanical low back pain patients

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European Orthopaedics and Traumatology

Abstract

Background

In the literature and in clinical practice, reduced activity of the back muscles [multifidus] has been associated with low back pain. Multifidus exercise can reduce low back pain intensity and improve back muscle activity. In the past decade, several researchers assessed the effect of multifidus on back pain by assessing the pain and functional outcome. There are limited studies which assessed the muscle activity by electromyography [EMG].

Objective

This study aimed to quantify the efficacy of the spinal segmental stabilization [multifidus] exercise program in chronic low back pain and also to determine its efficacy to improve the muscle activity and reduction of pain.

Methods and main outcome

This was a pretest/posttest, single group experimental study with purposive sampling. Thirty patients (18 males and 12 females) with chronic (>3 months) low back pain were included for the study. All the subjects were screened with modified Hendler 10-min questionnaire for chronic back pain to rule out psychological pain and were assessed for instability with the multifidus test and segmental instability test, and those who showed positive results were selected for the study. The mechanical low back pain was quantified with surface EMG [maximal voluntary isometric contraction] and visual analogue scale [pain]. All the subjects were given spinal segmental stabilization [multifidus] exercises, twice a day for 6 weeks. They were reassessed with the same tools at the end of the study after 6 weeks of exercises. The statistical analysis was done by paired “t” test.

Results

The calculated t values (P < 0.05) for maximal voluntary isometric contraction of right and left multifidus muscles and pain perception in visual analogue scale were 45.69, 33.7, and 27.05, respectively. This shows that the calculated t value was higher than the table value of 2.045, and hence, the alternate hypothesis is accepted. Thus, the statistical analysis shows significant results in the reduction of mechanical low back pain by spinal segmental stabilization [multifidus] exercise program.

Conclusion

This study shows that exercise plays a vital role in alleviating low back pain—in particular the mechanical back pain due to spinal instability, which is in a great need of spinal segmental stabilization [multifidus] exercise program. The improvement in muscle activity and reduction of pain proven by the multifidus exercise program administered in this current study can be added for the management of mechanical low back pain in computer professionals.

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Acknowledgments

Our sincere thanks to the Chairman, Director of Medical Education, Dr. Arun Vijay, principal, staffs, colleagues, and students especially Mr. Venkatesh, Mr. Sathish, and Mr. Saravanan of the KG College of Physiotherapy, Coimbatore. We also express our heartful gratitude to Mr. Shayam Sundar, KGiSL, and Ms. Jaseena, EMG Technician, KG Hospitals, Coimbatore.

Ethical approval

This study was approved by the ethical committee and the research department of the KG Institute of Health Sciences, KG Hospitals, and PG Research Institute, Coimbatore, India.

Conflict of interest

There is no conflict of interest and funding source for this research study.

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Authors and Affiliations

  1. Maharashtra Institute of Physiotherapy, MIMSR Medical College Campus, Ambajogai Road, Latur, 413531, Maharashtra State, India

    A. S. Leo Rathinaraj

  2. MIMSR Medical College, Latur, India

    M. T. Sreeja

  3. K.G. College of Physiotherapy, Coimbatore, India

    B. Arun

  4. KMCH College of Physiotherapy, Coimbatore, India

    K. Shayam Sundar

  5. Masterskill University of Health Sciences, Kota Bharu, Malaysia

    R. Premlal

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  1. A. S. Leo Rathinaraj
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Correspondence to A. S. Leo Rathinaraj.

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Leo Rathinaraj, A.S., Sreeja, M.T., Arun, B. et al. A surface electromyographic study to assess the effect of spinal segmental stabilization [multifidus] exercise program in chronic mechanical low back pain patients. Eur Orthop Traumatol 3, 161–168 (2012). https://doi.org/10.1007/s12570-012-0113-y

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