Long-term electromyographic activity in upper trapezius and low back muscles of women with moderate physical activity.

The habitual activity patterns of trapezius and postural back muscles (multifidus, iliocostalis, longissimus) of 23 female subjects with moderate physical activity were studied. Bilateral surface electromyographic (sEMG) recordings from start of work until bedtime were analyzed. The activity level was calibrated as percentage of root mean square-detected muscle activity at maximal voluntary contraction (EMG(max)). Sixty-six previous trapezius recordings of women with moderate physical activity were included in some analyses to pursue the full range of variation in trapezius activity. Twenty-six of these were recorded twice, separated by 16-28 mo. Median activity level and duration of periods with sEMG activity of <0.5% EMG(max) ("rest time"; only trapezius) and exceeding 2 ("burst time"), 10, 30, and 50% EMG(max) was determined. The trapezius median activity level ranged from 0.6 to 8.8% EMG(max), burst time from 9 to 84%, and rest time from 2 to 84%. The activity patterns of the back muscles showed similar large interindividual variation. Repeated trapezius recordings of the same subject showed high consistency; intraclass correlation coefficients ranged from 0.62 to 0.79 for different sEMG variables. Periods with high sEMG amplitude were of short duration; 7% of the trapezius recordings did not present time intervals (0.2-s duration) above 50% EMG(max). The activity patterns of the postural muscles, despite large interindividual variability, were distinctly different from activity patterns of upper and lower limb muscles reported by others (e.g., mean burst time 40-50 vs. 10-20%). We conclude that postural trunk muscles show idiosyncratic activity patterns with large interindividual variation. High-threshold motor units are activated to a very minor extent.     

Kinematic analyses of trunk stability in one leg standing for individuals with recurrent low back pain

This prospective study examined normalized stability differences based on dominance side and visual feedback. Subjects with low back pain (LBP) (n = 26; 9 men, 17 women) and without LBP (n = 28; 11 men, 17 women) participated in this study. All subjects were asked to maintain single leg standing balance with the contralateral hip flexed 90° for 25 s. The outcome measures included normalized holding duration and stability. The combined rotation (R_xyz) was also calculated to compare the upper and lower thorax and lumbar axes relative to the core spine axis. The holding duration was significantly different between groups (T = ?2.21, p = 0.03). The subjects without recurrent LBP (control group) demonstrated longer hold duration times (24.60 ± 4.2 s) than the subjects with recurrent LBP (21.2 ± 7.1 s). For the normalized hold duration, there was a significant difference between groups based on visual input (F = 7.13, p = 0.009). There was also a significant difference in standing stability based on visual input (F = 93.93, p = 0.0001) and trunk area (F = 101.51, p = 0.0001). In addition, the normalized stability was significantly different based on dominance and visual input (F = 11.28, p = 0.002). Therefore, trunk stability could prompt an uncoordinated bracing effect with poor proprioception from injury to passive structures or due to interference of pain during central processing of information in subjects with recurrent LBP.     

Low-level activity of the trunk extensor muscles causes electromyographic manifestations of fatigue in absence of decreased oxygenation

This study was designed to determine whether trunk extensor fatigue occurs during low-level activity and whether this is associated with a drop in muscle tissue oxygenation. Electromyography (EMG) feedback was used to impose constant activity in a part of the trunk extensor muscles. We hypothesized that electromyographic manifestations of fatigue and decreased oxygenation would be observed at the feedback site and that EMG activity at other sites would be more variable without fatigue manifestations. Twelve volunteers performed 30-min contractions at 2% and 5% of the maximum EMG amplitude (EMGmax) at the feedback site. EMG was recorded from six sites over the lumbar extensor muscles and near-infrared spectroscopy was used to measure changes in oxygenation at the feedback site (left L3 level, 3 cm paravertebral). In both conditions, mean EMG activity was not significantly different between electrode sites, whereas the coefficient of variation was lower at the feedback site compared to other recording sites. The EMG mean power frequency (MPF) decreased consistently at the feedback site only. At 5% EMGmax, the decrease in MPF was significant at the group level at all sites ipsilateral to the feedback site. These results suggest that the limited variability of muscle activity at the EMG feedback site and at ipsilateral locations enhances fatigue development. No decreases in tissue oxygenation were detected. In conclusion, even at mean activity levels as low as 2% EMGmax, fatigue manifestations were found in the trunk extensors. These occured in absence of changes in oxygenation of the muscle tissue.     

The role of trunk muscles in sitting balance control in people with low back pain

The purpose of this study was to examine the muscular activities and kinetics of the trunk during unstable sitting in healthy and LBP subjects. Thirty-one healthy subjects and twenty-three LBP subjects were recruited. They were sat on a custom-made chair mounted on a force plate. Each subject was asked to regain balance after the chair was tilted backward at 20°, and then released. The motions of the trunk and trunk muscle activity were examined. The internal muscle moment and power at the hip and lumbar spine joints were calculated using the force plate and motion data. No significant differences were found in muscle moment and power between healthy and LBP subjects (p > 0.05). The duration of contraction of various trunk muscles and co-contraction were significantly longer in the LBP subjects (p < 0.05) when compared to healthy subjects, and the reaction times of the muscles were also significantly reduced in LBP subjects (p < 0.05). LBP subjects altered their muscle strategies to maintain balance during unstable sitting, but these active mechanisms appear to be effective as trunk balance was not compromised and the internal moment pattern remained similar. The changes in muscle strategies may be the causes of LBP or the result of LBP with an attempt to protect the spine.     

Changes in the mechanical properties of the trunk in low back pain may be associated with recurrence

Exercise is one of the few effective treatments for LBP. Although exercise is often based on the premise of reduced spinal stiffness, trunk muscle adaptation may increase stiffness. This study developed and validated a method to assess trunk stiffness and damping, and tested these parameters in 14 people with recurring LBP and 17 pain-free individuals. Effective trunk stiffness, mass and damping were estimated with the trunk modeled as a linear second-order system following trunk perturbation. Equal weights (12–15% body weight) were attached to the front and back of the trunk via pulleys such that the trunk could move freely and no muscle activity was required to hold the weights. The trunk was perturbed by the unexpected release of one of the weights. Trunk kinematics and cable force were used to estimate system properties. Reliability was assessed in 10 subjects. Trunk stiffness was greater in recurrent LBP patients (forward perturbation only), but damping was lower (both directions) than healthy controls. Estimates were reliable and validated by accurately estimated mass. Contrary to clinical belief, trunk stiffness was increased, not reduced, in recurrent LBP, most likely due to augmented trunk muscle activity and changes in reflex control of trunk muscles. Although increased stiffness may aid in the protection of spinal structures, this may have long-term consequences for spinal health and LBP recurrence due to compromised trunk dynamics (decreased damping).     

A differential suction electrode for recording electromyographic activity from the pelvic floor muscles: Crosstalk evaluation

The purpose of this study was to determine whether a differential suction electrode (DSE) probe is less prone to recording crosstalk from the hip adductors or external rotators than the Femiscan? probe when recording electromyography (EMG) data from the pelvic floor muscles (PFMs). Twenty nulliparous, continent women performed hip adduction and hip external rotation contractions at 25%, 50% and 100% of maximal voluntary effort both while keeping their PFMs relaxed and while contracting their PFMs as strongly as possible. All tasks were performed while DSEs were adhered to the vaginal wall at the level of the pubococcygeus group bilaterally, and also with the Femiscan? probe in situ. The order of the probes was randomized. For each task, the peak smoothed PFM EMG amplitude was compared between hip forces and probes using a two-way repeated measures analysis of variance (ANOVA) including the interaction between contraction level and probe (α = 0.05). There was a significant contraction level by probe interaction for each task. In most cases the Femiscan? probe recorded significantly higher PFM EMG activity during hip adduction and external rotation tasks at 25% and 50% MVC compared to what it recorded when the hip musculature remained relaxed, whereas the DSE probe did not. As such, the DSE probe appears to be less susceptible to crosstalk from the hip adductors and external rotators than the Femiscan? probe at these hip muscle contraction levels. Both probes recorded significantly higher EMG activity when maximal contractions of the hip adductors and external rotators were performed therefore, no conclusion can be made regarding whether the activity recorded from the PFMs during maximal hip adduction and external rotation is the result of crosstalk or co-activation.     

Assessment of neuromuscular and haemodynamic activity in individuals with and without chronic low back pain

Background

Biering-Sørenson (1984) found that individuals with less lumbar extensor muscle endurance had an increased occurrence of first episode low back pain. As a result, back endurance tests have been recommended for inclusion in health assessment protocols. However, different studies have reported markedly different values for endurance times, leading some researchers to believe that the back is receiving support from the biceps femoris and gluteus maximus. Therefore, this study was designed to examine the haemodynamic and neuromuscular activity of the erector spinae, biceps femoris, and gluteus maximus musculature during the Biering-Sørenson Muscular Endurance Test (BSME).

Methods

Seventeen healthy individuals and 46 individuals with chronic low back pain performed the Biering-Sørenson Muscular Endurance Test while surface electromyography was used to quantify neuromuscular activity. Disposable silver-silver-chloride electrodes were placed in a bipolar arrangement over the right or left biceps femoris, gluteus maximus, and the lumbosacral paraspinal muscles at the level of L₃. Near Infrared Spectroscopy was used simultaneously to measure tissue oxygenation and blood volume changes of the erector spinae and biceps femoris.

Results

The healthy group displayed a significantly longer time to fatigue (Healthy: 168.5s, LBP: 111.1s; p ≤ 0.05). Significant differences were shown in the median frequency slope of the erector spinae between the two groups at 90–100% of the time to fatigue while no significant differences were noted in the haemodynamic data for the two groups.

Conclusion

Although the BSME has been recognized as a test for back endurance, individuals with chronic LBP appear to incorporate a strategy that may help support the back musculature by utilizing the biceps femoris and gluteus maximus to a greater degree than their healthy counterparts.

     

Effect of experimental low back pain on neuromuscular control of the trunk in healthy volunteers and patients with chronic low back pain

Studies of electromyographic (EMG) activity and lumbopelvic rhythm have led to a better understanding of neuromuscular alterations in chronic low back pain (cLBP) patients. Whether these changes reflect adaptations to chronic pain or are induced by acute pain is still unclear. This work aimed to assess the effects of experimental LBP on lumbar erector spinae (LES) EMG activity and lumbopelvic kinematics during a trunk flexion–extension task in healthy volunteers and LBP patients. The contribution of disability to these effects was also examined. Twelve healthy participants and 14 cLBP patients performed flexion–extension tasks in three conditions; control, innocuous heat and noxious heat, applied on the skin over L5 or T7. The results indicated that noxious heat at L5 evoked specific increases in LES activity during static full trunk flexion and extension, irrespective of participants’ group. Kinematic data suggested that LBP patients adopted a different movement strategy than controls when noxious heat was applied at the L5 level. Besides, high disability was associated with less kinematic changes when approaching and leaving full flexion. These results indicate that experimental pain can induce neuromechanical alterations in cLBP patients and healthy volunteers, and that higher disability in patients is associated with decreased movement pattern changes.     

Offering proper feedback to control for out-of-plane lumbar moments influences the activity of trunk muscles during unidirectional isometric trunk exertions

The assessment of trunk muscle activation and coordination using dynamometric measurements made in one anatomical plane has hardly minimized the production of out-of-plane coupled moments (CMs). This absence of control may add much variability in moment component partition as well as in recorded muscle activation. The aim of the study was to assess whether providing these CMs as visual feedback efficiently reduces them and whether this feedback influences trunk muscle activation. Twenty men performed five 5-s static ramp submaximal contractions, ranging from 0% to 55% of the maximal voluntary contraction (MVC), in six different directions while standing in a static dynamometer measuring L5/S1 moments. For each direction, four feedback conditions were offered, ranging from simple 1D-feedback in the primary plane of exertion, to full 3D-feedback. Surface electromyographic signals were collected for eight back and six abdominal muscles. Muscle activation amplitudes and CMs were extracted at each 10% force level from 10% to 50% maximum voluntary contraction (MVC). Providing 3D-feedback significantly reduced the CMs, at 50% MVC, by about 1–6%, 1–8% and 2–10% MVC in the sagittal, frontal and transverse planes, respectively. Providing 3D-feedback produced relatively small systematic effects (2–7%) on trunk muscle activation. However, the subjects responded differently to adequately control the coupled moments, leading in some cases to relatively high inter-individual differences in muscle activation. Interestingly, the statistical differences, and size of the effects, were mainly observed when the primary exertions were performed in the frontal and transverse planes. The implications of these findings are discussed.     

Differences between two subgroups of low back pain patients in lumbopelvic rotation and symmetry in the erector spinae and hamstring muscles during trunk flexion when standing

The present study was performed to examine lumbopelvic rotation and to identify asymmetry of the erector spinae and hamstring muscles in people with and without low back pain (LBP). The control group included 16 healthy subjects, the lumbar-flexion–rotation syndrome LBP group included 17 subjects, and the lumbar-extension–rotation syndrome LBP group included 14 subjects. Kinematic parameters were recorded using a 3D motion-capture system, and electromyography parameters were measured using a Noraxon TeleMyo 2400T. The two LBP subgroups showed significantly more lumbopelvic rotation during trunk flexion in standing than did the control group. The muscle activity and flexion–relaxation ratio asymmetries of the erector spinae muscles in the lumbar-flexion–rotation syndrome LBP group were significantly greater than those in the control group, and the muscle activity and flexion–relaxation ratio asymmetry of the hamstring muscles in the lumbar-extension–rotation syndrome LBP group were significantly greater than those in the control group. Imbalance or asymmetry of passive tissue could lead to asymmetry of muscular activation. Muscle imbalance can cause asymmetrical alignment or movements such as unexpected rotation. The results showed a greater increase in lumbopelvic rotation during trunk flexion in standing among the lumbar-flexion–rotation syndrome and lumbar-extension–rotation syndrome LBP groups compared with the control group. The differences between the two LBP subgroups may be a result of imbalance and asymmetry in erector spinae and hamstring muscle properties.     

Activation imbalances in lumbar spine muscles in the presence of chronic low back pain.

Paraspinal electromyographic (EMG) activity was recorded bilaterally from three lumbar levels during 30-s isometric trunk extensions [40 and 80% of maximum voluntary contraction (MVC)] in 20 healthy men and 14 chronic low back pain patients in pain. EMG parameters indicating neuromuscular fatigue and contralateral imbalances in EMG root-mean-square amplitude and median frequency were analyzed. Patients in pain showed less fatigue than controls at both contraction levels and produced only 55% of their MVC. Patients in pain likely did not produce a "true" maximum effort. A low MVC estimate would mean lower absolute contraction levels and less neuromuscular fatigue, thus explaining lower scores in the patients. Contralateral root-mean-square amplitude imbalances were present in both categories of subjects although such imbalances, when averaged across lumbar levels, were significantly larger in patients. Median frequency imbalances were significantly larger in the patients, at segmental as well as across lumbar levels. These results suggest that the presence of pain in these patients caused a redistribution of the activation behavior between synergistic muscles of the lumbar back.     

The eccentric,concentric strength relationship of the hamstring muscles in chronic low back pain

ObjectiveThe objective of this study was to measure hamstring muscle eccentric and concentric strength in individuals with and without low back pain (LBP). Two composite scores for the relative balance of eccentric to concentric strength at the different movement velocities were calculated (the DEC and SEC), to determine whether or not self perceived pain, disability, or fear avoidance measures were associated with hamstring strength characteristics.DesignCross-sectional repeated measures design.SettingUniversity laboratory.ParticipantsFifteen individuals with chronic LBP and 15 matched controls.Main outcome measuresIsokinetic eccentric and concentric strength at 30° s^?1 and 120° s^?1_. Composite scores (DEC and SEC) based on peak torque were calculated to evaluate the relationship between the different muscle actions across the test velocities. Self report measures included the Oswestry disability index, general health and well being, fear avoidance, and pain.ResultsEccentric/concentric strength ratio at 30° s^?1 was higher for the LBP group (F(1,58) = 4.81, p = 0.032). The SEC was also higher for the LBP (F(1,58) = 5.97, p = 0.018). Fear avoidance beliefs and mental well-being were significantly associated with the SEC only in the LBP group (adjusted r² = 0.26, (F(2,27) = 5.8, p = .008). For the control group both the DEC and SEC were associated with self report measures. Matched differences between groups’ for the SEC were best explained by fear avoidance beliefs about work (adjusted r² = 0.12, F(1,28) = 5.1, p = 0.03).ConclusionReduced concentric relative to eccentric strength is best identified by the SEC. The SEC was significantly associated with impaired self report measures of fear avoidance and mental well being in individuals with LBP. Differences between groups for the SEC were best explained by fear avoidance beliefs about work.     

An application of pattern recognition for the comparison of trunk muscles EMG waveforms between subjects with and without chronic low back pain during flexion-extension and lateral bending tasks.

The purpose of the study was twofold: (1) to evaluate the reliability of distance measures computed from a principal component analysis (PCA) of electromyographic (EMG) waveforms of trunk muscles recorded during standardized trunk movements and (2) to evaluate their sensitivity to the load lifted, the trunk range of motion (ROM) and to low back status. Thirty-three male subjects (18 normals, 15 suffering from non specific CLBP) aged between 35-45 years participated. The EMG signals from 12 trunk muscles and the kinematics of trunk segments were recorded during 12 tasks. The subjects performed flexion-extension and lateral bending (left and right) tasks (three complete cycles) with and without a 12 kg load and at different trunk ROM (maximal or at defined submaximal angles). Distance measures locating each subject relative to a reference PCA model were computed for each muscle and task. The reliability of these distance measures was evaluated for 10 subjects (five normals and five CLBP) who performed two tasks on three different days. The reliability of distance measures was acceptable for agonist muscles only. The distance measures were sensitive to the load lifted and to the trunk ROM for different muscles and tasks but poorly sensitive to low back status. Several reasons that could explain the low sensitivity of these measures to low back status are discussed and potential solutions are proposed. A procedure based on a reliability analysis is proposed to select the number of principal components to include in the reference PCA model. It is expected that the refinement of the method used in this study could provide an effective clinical tool to assess EMG waveforms of trunk muscles during dynamic tasks.     

Changes in electromyographic activity after botulinum toxin injection of the rectus femoris in patients with hemiparesis walking with a stiff-knee gait

PurposeThis study was designed to evaluate the effects of botulinum toxin type-A (BoNTA) injection of the rectus femoris (RF) muscle on the electromyographic activity of the knee flexor and extensor and on knee and hip kinematics during gait in patients with hemiparesis exhibiting a stiff-knee gait.MethodTwo gait analyses were performed on fourteen patients: before and four weeks after BoNTA injection. Spatiotemporal, kinematic and electromyographic parameters were quantified for the paretic limb.ResultsBoNTA treatment improved gait velocity, stride length and cadence with an increase of knee angular velocity at toe-off and maximal knee flexion in the swing phase. Amplitude and activation time of the RF and co-activation duration between the RF and biceps femoris were significantly decreased. The instantaneous mean frequency of RF was predominantly lower in the pre-swing phase.ConclusionsThe results clearly show that BoNTA modified the EMG amplitude and frequency of the injected muscle (RF) but not of the synergist and antagonist muscles. The reduction in RF activation frequency could be related to increased activity of slow fibers. The frequency analysis of EMG signals during gait appears to be a relevant method for the evaluation of the effects of BoNTA in the injected muscle.     

Changes in template activity and structure of nuclei from WI-38 cells in the prereplicative phase.

Quiescent confluent monolayers of WI-38 fibroblasts were stimulated to proliferate by either adding 10% fetal calf serum or by trypsinization and replating at lower density. The length of the prereplicative phase was 12 hr after serum stimulation and 18 hr after trypsinization and replating at lower density. Nuclei were isolated from WI-38 cells at different time intervals after either type of stimulation and their template activity, circular dichroism spectra, and ability to bind ethidium bromide were investigated. All these parameters were similarly increased after either type of stimulation. However, these changes, like the onset of DNA synthesis, were delayed 6 hr in cells trypsinized and replated at lower density. While there were no detectable changes in nuclear protein content after serum stimulation, at least 40% of nuclear protein, mostly nonhistone chromosomal proteins, were lost after trypsinization. The amount of nuclear proteins returned to prestimulation levels only 6-8 hr after replating. These data seem to suggest that nonhistone chromosomal proteins lost by trypsinization are essential for the entrance of WI-38 cells into the "prereplicative phase".     

Comparison of surface electromyographic (sEMG) activity of submental muscles between the head lift and tongue press exercises as a therapeutic exercise for pharyngeal dysphagia

Objective: The present study compared surface electromyographic (sEMG) activity obtained from the submental muscle group for a tongue press and a head lift exercise as potential therapeutic exercises for dysphagic elderly. Materials and methods: Fifty‐three healthy volunteers with a mean age of 35.3 participated in this study. Subjects were required to perform an isometric task, pressing their tongue against the hard palate, and an isotonic task requiring sustained lingual force against the hard palate. Pressure sensors were used to measure the amount of lingual pressure against the hard palate. Submental sEMG data from these tasks were compared with those obtained from the isometric and isotonic aspects of a head lift exercise. Results: No sEMG differences were identified between the isometric tongue press task and head lift exercise. Isotonic tongue press exercises resulted in significantly higher maximum and mean sEMG values compared with the isotonic head lift exercise (p < 0.05). The submental sEMG activity from the tongue press exercise was equal (isometric) to, or greater (isotonic) than comparable muscle activation obtained during the head lift exercise. Conclusions: The tongue press exercise may be less strenuous than the head lift exercise while achieving the same therapeutic effect.