Pain and Lumbar Muscle Activation before and after Functional Task in Nonspecific Chronic Low Back Pain

Individuals with non-specific chronic low back pain may present altered movement patterns during functional activities. However, muscle behavior before and after performing a functional task with different load conditions is not yet fully understood. The aim of this study is to analyze lumbar muscle activity before and after performing the functional task of picking up and placing an object on the ground (with and without load) in individuals with nonspecific chronic low back pain. 20 subjects with nonspecific chronic low back pain and 20 healthy subjects participated in this study. A surface electromyography was performed in the ilio-costal, longissimus and multifidus muscles to evaluate lumbar muscle activity before and after performing the functional task of picking up and placing an object on the ground, with and without load. The symptomatic participants had greater lumbar muscle activation compared to the asymptomatic group, more evident in performing the task without load, with statistically significant difference (p = 0,033) between groups for the right multifidus muscle. This study showed that individuals with nonspecific chronic low back pain have higher muscle activation before and after performing a functional task compared to healthy participants.

• Lídia E. O. Cruz
• Adriano P. C. Calvo
• Renato J. Soares
• Regiane A. Carvalho

• Chronic low back pain
• functional task
• lumbar muscles
• muscle activity.

[1] B.T. Saragiotto, C.G. Maher, T.P. Yamato, L.O.P. Costa, L.C. Menezes Costa, R.W.J.G. Ostelo, L.G. Macedo, Motor control exercise for chronic non-specific low-back pain, Cochrane Database Syst. Rev. (2016). https://doi.org/10.1002/14651858.CD012004.
[2] R.A. Laird, P. Kent, J.L. Keating, Modifying patterns of movement in people with low back pain -does it help? A systematic review, BMC Musculoskelet. Disord. (2012) 169. https://doi.org/10.1186/1471-2474-13-169.
[3] R. D’hooge, P. Hodges, H. Tsao, L. Hall, D. MacDonald, L. Danneels, Altered trunk muscle coordination during rapid trunk flexion in people in remission of recurrent low back pain, J. Electromyogr. Kinesiol. 23 (2013) 173–181. https://doi.org/10.1016/j.jelekin.2012.09.003.
[4] S.L. Jones, S.M. Henry, C.C. Raasch, J.R. Hitt, J.Y. Bunn, Individuals with non-specific low back pain use a trunk stiffening strategy to maintain upright posture, J. Electromyogr. Kinesiol. 22 (2012) 13–20. https://doi.org/10.1016/j.jelekin.2011.10.006.
[5] O. Airaksinen, J.I. Brox, C. Cedraschi, J. Hildebrandt, J. Klaber-Moffett, F. Kovacs, A.F. Mannion, S. Reis, J.B. Staal, H. Ursin, G. Zanoli, Chapter 4: European guidelines for the management of chronic nonspecific low back pain, Eur. Spine J. (2006) 192–300. https://doi.org/10.1007/s00586-006-1072-1.
[6] N. Henschke, C.G. Maher, K.M. Refshauge, R.D. Herbert, R.G. Cumming, J. Bleasel, J. York, A. Das, J.H. McAuley, Prevalence of and screening for serious spinal pathology in patients presenting to primary care settings with acute low back pain, Arthritis Rheum. 60 (2009) 3072–3080. https://doi.org/10.1002/art.24853.
[7] H.J. Hermens, B. Freriks, C. Disselhorst-Klug, G. Rau, Development of recommendations for SEMG sensors and sensor placement procedures, J. Electromyogr. Kinesiol. 10 (2000) 361–374. https://doi.org/10.1016/S1050-6411(00)00027-4.
[8] S. Swaney, Measurement of Joint Motion: A guide to goniometry, Physiotherapy. (1996). https://doi.org/10.1016/s0031-9406(05)66908-8.
[9] H.J. Martin, V. Yule, H.E. Syddall, E.M. Dennison, C. Cooper, A. Aihie Sayer, Is hand-held dynamometry useful for the measurement of quadriceps strength in older people? A comparison with the gold standard biodex dynamometry, Gerontology. 52 (2006) 154–159. https://doi.org/10.1159/000091824.
[10] P.O.P. Lima, R.R. Oliveira, A.G. Moura Filho, M.C.F. Raposo, L.O.P. Costa, G.E.C. Laurentino, Concurrent validity of the pressure biofeedback unit and surface electromyography in measuring transversus abdominis muscle activity in patients with chronic nonspecific low back pain, Brazilian J. Phys. Ther. 16 (2012) 389–395. https://doi.org/10.1590/s1413-35552012005000038.
[11] L.O.P. Costa, C.G. Maher, J. Latimer, P.H. Ferreira, M.L. Ferreira, G.C. Pozzi, L.M.A. Freitas, Clinimetric testing of three self-report outcome measures for low back pain patients in Brazil: Which one is the best?, Spine (Phila. Pa. 1976). 33 (2008) 2459 – 2463. https://doi.org/10.1097/BRS.0b013e3181849dbe.
[12] A. Wenngren, B.M. Stålnacke, Computerized assessment of pain drawing area: A pilot study, Neuropsychiatr. Dis. Treat. 5 (2009) 451–456.
[13] T. Suehiro, H. Ishida, K. Kobara, H. Osaka, S. Watanabe, Altered trunk muscle recruitment patterns during lifting in individuals in remission from recurrent low back pain, J. Electromyogr. Kinesiol. 39 (2018) 128–133. https://doi.org/10.1016/j.jelekin.2018.02.008.
[14] M. Lima, A.S. Ferreira, F.J.J. Reis, V. Paes, N. Meziat-Filho, Chronic low back pain and back muscle activity during functional tasks, Gait Posture. 61 (2018) 250–256. https://doi.org/10.1016/j.gaitpost.2018.01.021.
[15] M. Pakzad, J. Fung, R. Preuss, Pain catastrophizing and trunk muscle activation during walking in patients with chronic low back pain, Gait Posture. 49 (2016) 73–77. https://doi.org/10.1016/j.gaitpost.2016.06.025.
[16] H.S.J. Picavet, J.W.S. Vlaeyen, J.S.A.G. Schouten, Pain catastrophizing and kinesiophobia: Predictors of chronic low back pain, Am. J. Epidemiol. 156 (2002) 1028–1034. https://doi.org/10.1093/aje/kwf136.
[17] S.M.H. Tsang, G.P.Y. Szeto, L.M.K. Li, D.C.M. Wong, M.M.P. Yip, R.Y.W. Lee, The effects of bending speed on the lumbo-pelvic kinematics and movement pattern during forward bending in people with and without low back pain, BMC Musculoskelet. Disord. 18 (2017) 157. https://doi.org/10.1186/s12891-017-1515-3.