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PubMed2002

Lumbosacral interspinous ligament rupture associated with acute intrinsic spinal muscle degeneration.

The objective of this study was to demonstrate lumbosacral interspinous ligament rupture, with or without related acute intrinsic spinal muscle degeneration. This study consisted of a prospective imaging analysis of consecutive 100 MRI studies in adult patients (mean age 56 years) presenting with low back pain. Alterations from the normal in the inter- and perispinal structures of the spine and perispinal soft tissues (e.g., spinal ligaments, perispinal muscles) were sought based upon studies on young volunteers without low back pain ( n=10; mean age 23 years). Compared with the group without low back pain, many index cases ( n=71, 71%) demonstrated hyperintensity (i.e., sprain or frank ligamentous rupture) of the interspinous ligament(s) on T2-weighted, fat-suppressed MRI studies at one (20 of 71, 28%) or multiple (51 of 71, 72%) levels. Associated intrinsic spinal muscle (e.g., interspinalis, multifidus muscles) degeneration was observed in a minority of cases overall ( n=7, 7%), but was only seen in association with cases also demonstrating interspinous ligament degeneration/rupture (7 of 71, 10%). Lumbosacral interspinous ligament sprain or frank rupture, as well as related acute-subacute autotraumatic intrinsic spinal muscle rupture/degeneration, may be overlooked by many observers if fat-suppressed, T2-weighted MRI is not acquired. These musculoligamentous alterations are on occasion the only abnormalities recognized on MRI of the lumbosacral spine and may theoretically be sources of low back morbidity that potentially may respond to specific therapy. Because this study was an observational one, based solely upon medical imaging, future research must focus upon the correlation of the relevance of these findings with an age-matched asymptomatic control group and longitudinal clinicoradiologic therapeutic trials.

Humans↗
PubMed2000

Nonlinear time-course of lumbar muscle fatigue using recurrence quantifications.

Isometric skeletal muscle fatigue is usually assumed to be a linear process based upon the monotonic decrease in spectral frequency of the EMG. Since spectral analysis by fast Fourier transform (FFT) constitutes a linear transformation of the data, the present study was designed to reevaluate the time-course of muscle fatigue with a nonlinear tool, recurrence quantification analysis (RQA). Surface EMG recordings were obtained from the multifidus muscle of 17 human subjects during isometric posture-holding of the upper torso. The process of muscle fatigue was found to be linear for 59% of the subjects by FFT criteria, but nonlinear for 76% by RQA criteria. As a demonstrative control, both slow and fast transients occurring within a nonlinear mathematical process could be accurately depicted by RQA, but not by FFT. It is concluded that assessment of EMG patterns by nonlinear techniques can give insight into the time-course of fatiguing muscles attributed to the summation of several nonlinear and competing processes.

Adult↗
PubMed2002

Regional differences within the human supraspinous and interspinous ligaments: a sheet plastination study.

The extent to which neighboring muscles and the fascia contribute to the formation of the supraspinous and interspinous ligaments is not clear from the literature. The purpose of this investigation is to examine the midline attachments of tendons and the posterior layer of thoracolumbar fascia in order to determine their respective contributions to the formation of these ligaments throughout the thoracolumbar spine. Study of the dense connective tissue organization in the posterior ligamentous system was carried out on two cadavers serially sectioned into thin (2.5-mm) epoxy resin plastinated slices. Additional observations were taken from a gross anatomical study of the midline anatomy in two adult cadavers. The results show that the spinal attachments of trapezius, rhomboideus major and splenius cervicis combine with the deep fascia to form the supraspinous ligament in the upper thoracic spine. The posterior layer of the thoracolumbar fascia makes a major contribution to the supraspinous and interspinous ligaments in the lower thoracic spine. In addition to the posterior layer of thoracolumbar fascia, longissimus thoracis and multifidus combine to form the lumbar supraspinous and interspinous ligaments. Their spinal attachments produce a system of dense connective tissue with marked regional variation in fiber orientation and arrangement. The findings support the description of the supraspinous and interspinous ligaments as structures formed by both muscle tendons and aponeuroses along the length of the thoracic and lumbar spine, with regional differences in their connective tissue architecture.

Aged↗
PubMed2005

An investigation into the use of MR imaging to determine the functional cross sectional area of lumbar paraspinal muscles.

The purpose of this study was to investigate the use of magnetic resonance (MR) imaging and image processing software to determine the functional cross-sectional area (FCSA) (the area of muscle isolated from fat) of the lumbar paraspinal muscles. The measurement of the morphology of the lumbar paraspinal muscles has become the focus of several recent investigations into the aetiology of low back pain. However, the reliability and validity of determining the FCSA of the lumbar paraspinal muscles using MR imaging are yet to be reported. T2 axial MR scans at the L1-S1 spinal levels of six subjects were obtained using identical MR systems and scanning parameters. Lean paraspinal muscle, vertebral body bone and intermuscular fat were manually segmented using image analysis software to assign a grey scale range to the MR signal intensity emitted by each tissue type. The resultant grey scale range for muscle was used to determine FCSA measurements for each of the paraspinal muscles, psoas, quadratus lumborum, erector spinae and lumbar multifidus on each scan slice. As various biological, instrument and measurement factors can affect MR signal intensity, a sensitivity analysis was conducted to determine the error associated in calculating FCSA for paraspinal muscle using a discrete grey scale range. Cross-sectional area and FCSA measurements were repeated three times and reliability indices for the FCSA measurements were obtained, showing excellent reliability, intra class correlation coefficient (mean=0.97, range 0.90-0.99) and %SEM (mean=2.6%, range 0.7-4.8%). In addition, the error associated with miscalculation of the grey scale range for the MR signal intensity of muscle was calculated and found to be low with an error of 20 grey scale units at the upper end of the muscle's grey scale range resulting in a very small error in the measured muscle FCSA. The method presented in this paper has a variety of practical applications in areas such as evidence-based rehabilitation, biomechanical modelling and the determination of segmental inertial parameters.

Adult↗
PubMed2006

Muscular contributions to dynamic dorsoventral lumbar spine stiffness.

Spinal musculature plays a major role in spine stability, but its importance to spinal stiffness is poorly understood. We studied the effects of graded trunk muscle stimulation on the in vivo dynamic dorsoventral (DV) lumbar spine stiffness of 15 adolescent Merino sheep. Constant voltage supramaximal electrical stimulation was administered to the L3-L4 interspinous space of the multifidus muscles using four stimulation frequencies (2.5, 5, 10, and 20 Hz). Dynamic stiffness was quantified at rest and during muscle stimulation using a computer-controlled testing apparatus that applied variable frequency (0.46-19.7 Hz) oscillatory DV forces (13-N preload to 48-N peak) to the L3 spinous process of the prone-lying sheep. Five mechanical excitation trials were randomly performed, including four muscle stimulation trials and an unstimulated or resting trial. The secant stiffness (k (y) = DV force/L3 displacement, kN/m) and loss angle (phase angle, deg) were determined at 44 discrete mechanical excitation frequencies. Results indicated that the dynamic stiffness varied 3.7-fold over the range of mechanical excitation frequencies examined (minimum resting k (y) = 3.86 +/- 0.38 N/mm at 4.0 Hz; maximum k (y) = 14.1 +/- 9.95 N/mm at 19.7 Hz). Twenty hertz muscle stimulation resulted in a sustained supramaximal contraction that significantly (P < 0.05) increased k (y) up to twofold compared to rest (mechanical excitation at 3.6 Hz). Compared to rest, k (y) during the 20 Hz muscle stimulation was significantly increased for 34 of 44 mechanical excitation frequencies (mean increase = 55.1%, P < 0.05), but was most marked between 2.55 and 4.91 Hz (mean increase = 87.5%, P < 0.05). For lower frequency, sub-maximal muscle stimulation, there was a graded change in k (y), which was significantly increased for 32/44 mechanical excitation frequencies (mean increase = 40.4%, 10 Hz stimulus), 23/44 mechanical excitation frequencies (mean increase = 10.5%, 5 Hz stimulus), and 11/44 mechanical excitation frequencies (mean increase = 4.16%, 2.5 Hz stimulus) when compared to rest. These results indicate that the dynamic mechanical behavior of the ovine spine is modulated by muscle stimulation, and suggests that muscle contraction plays an important role in stabilizing the lumbar spine.

Animals↗
PubMed1984

Electromyographic study of lumbar back muscles during locomotion in acute high decerebrate and in low spinal cats.

The electromyographic (EMG) activity of the lumbar back muscles (multifidus, longissimus and iliocostalis) was investigated during treadmill locomotion in acute high decerebrate and in low spinal cats. During alternate stepping (0.7-2.0 m X s-1) in high decerebrate cats, the back muscles have two bursts of activity per step cycle. On the average these EMG bursts last about 170 ms and start some 25 ms before the onset of each vastus lateralis (VL). The two bursts in any one back muscle may have a different duration, the shortest burst on one side coinciding with the longest burst of the homologous contralateral muscle. There is often an overall asymmetry in the discharge wherein the bursts of activity in both ipsi- and contralateral muscles are longer at the onset of one of the VLs. Correlation analyses of several timing parameters of the bursts as a function of walking speeds were made. Different patterns of correlation were identified and it was found that, in most cases, the end of the bursts (with respect to the onset of VL activity) was best correlated with the speed of walking. During gallop, the back muscles activity is a single burst of about 200 ms duration which starts some 75 ms before the onset of VL. In low spinal cats walking after an injection of clonidine, the double burst pattern of EMG activation may be present if there is adequate weight support. However, when the animal steps with the hindlimbs extended and with insufficient weight support, these muscles have a tonic activity uncorrelated with the rhythmic activity of hindlimb muscles.

Animals↗
PubMed1988

Measurement of the trunk musculature of active males using CT scan radiography: implications for force and moment generating capacity about the L4/L5 joint.

The purpose of this study was to add to the growing database of cross-sectional areas and moment arm lengths of trunk musculature using the methods of computerized tomographic scanning. An attempt was also made to estimate muscle force and moment generating capacity under various reported values of muscle force per unit cross-sectional area. The data were obtained on 13 active men 40.5 +/- 11.9 years of age, 173.8 +/- 5.9 cm tall and 89.1 +/- 11.7 kg body mass. Transverse CT scans were taken at the level of the L4/L5 disc with the subjects supine. Muscle cross-sectional areas were measured from 35 mm slides of the scans using a planimeter and moment arm length in the transverse plane were taken from the centroid of the L4/L5 disc to the centroid of the muscle section. Prior to estimating force and moment generating capacity, areas were corrected, where necessary, for fibre pennation angle to produce a physiological cross-sectional area. The physiological cross-sectional areas (cm2) for one side of the body were (mean +/- S.D.): sacrospinalis (SS) 15.9 +/- 2.5; multifidus (Mu) 4.2 +/- 0.7; psoas (Ps) 17.6 +/- 4.0; rectus abdominis (RA) 7.9 +/- 2.5; external oblique (EO) 9.4 +/- 2.7; internal oblique (IO) 8.1 +/- 2.3; transverse abdominus (TA) 2.9 +/- 1.3. The anterior posterior moment arm lengths were: erector mass (SS and Mu combined) 5.90 +/- 0.52; Ps 0.58 +/- 0.40; R.A. 10.28 +/- 2.07; E.O. (anterior portion) 5.94 +/- 1.39; E.O. (posterior portion) 2.08 +/- 1.39; I.O. (anterior portion) 6.92 +/- 1.63; I.O. (posterior portion) 3.85 +/- 1.54. The corresponding lateral moment arm lengths were: 3.26 +/- 0.36; 4.88 +/- 0.36; 4.35 +/- 1.31; 12.86 +/- 1.93; 13.95 +/- 1.16; 10.77 +/- 2.02; 12.52 +/- 1.26. The maximum force per unit cross-section that human muscles are capable of generating is not well defined. However, assuming an intermediate value of 50 N cm-2 of physiological cross-section, the erector musculature observed at the L4/L5 level should be capable of generating an extensor moment of about 118 N.m. At a muscle stress of 30 or 90 N cm-2, values also reported on human muscle, the moment would be 71 and 213 Nm, respectively. It must be remembered, however, that muscles not observable at the L4/L5 level can create moments around that center of rotation.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1996

Influence of varying muscle forces on lumbar intradiscal pressure: an in vitro study.

The purposes of this study were to determine the effect of including muscle forces in the experimental loading of the spine on the intradiscal pressure and to determine whether this effect correlates with previously established in vivo data. We modeled the spine muscles as of five distinct groups and isolated the effect of each group on the intradiscal pressure (L4-L5). Seven human lumbosacral spines were tested in pure flexion/extension, right/left lateral bending, and left/right axial rotation moments. Stimulated muscle activity strongly influenced load-pressure characteristics, especially for the multifidus. Without muscle forces active, pressure increased proportionately with increasing moment. With five pairs of symmetrical constant muscle forces active (80 N per pair) the pressure increased more than 200% in neutral position and did not increase with increasing moment. The pressure without muscle forces and without axial preload was 0.12 MPa, which is about the same found by earlier in vivo studies of anesthetized subjects in prone position. With simulated muscle forces, the pressure was 0.39 MPa and in the range found for non-anesthetized subjects. We conclude that simulating muscle forces substantially affects intradiscal pressure.

Adult↗
PubMed1982

Effect of marine glycosides on adenosinetriphosphatase activity.

Marine glycosides from the sea cucumbers Actinopyga agassizi, Holothuria atra, Bohadschia argus, Cucumaria fraudatrix, Astichopus multifidus and Thelenota ananas inhibit both Na+-K+ ATPase and Mg2+-ATPase of rat brain in vitro. The glycoside-cholesterol complex of these compounds does not influence ATPase activity. Asterosaponins from starfishes Linckia guildingi and Linckia laevigata possess a slight inhibiting effect. The triterpene glycosides from sea cucumbers are more powerful inhibitors than steroidal glycosides from starfishes.

Adenosine Triphosphatases↗
PubMed1996

The function of the long back muscles during postural development in the rat.

The development of the EMG of the multifidus (MM) and longissimus lateralis (LL) muscles was studied in 16 rats between the 6th day (P6) and P45 and related to behavioural development. The EMG changes gradually from irregular and spiky towards a regular interference pattern and simultaneously, the general activity level increases. From P11, tonic background activity occurs with phasic activity superimposed. During locomotion, a relation between increasing activity in the long back muscles and the swing phase of both hind paws develops, but only from P15 the activity modulates consistently with the step cycle. From the end of the second week of life, the activity in the long back muscles precedes hind paw movements. The development of the EMG of the LL and MM is closely followed by the development of adult and fluent motor patterns. This suggests that the stabilisation of the trunk is essential for the development of these patterns.

Animals↗
PubMed1996

Body height changes with hyperextension.

OBJECTIVE: To automatize the lumbar physical examination with an acceptable rate of error. DESIGN: An external skin marker method for automatizing the physical examination was developed and its ability to discriminate between normal and abnormal subjects tested in a blind clinical trial. BACKGROUND: The low reproducibility of clinical findings, even among experienced doctors, has been well documented. This is of particular concern and may explain why there is such a wide variation in surgical rates across the USA (tenfold for disc herniation). Inconsistencies among physicians in the evaluation of benign low back conditions make standardization desirable. METHODS: A computerized physical examination was used to evaluate patients with low back pain and compare their results with a normative database obtained from a selection of healthy subjects. A high-resolution motion analysis system tracked the movement of skin markers placed on the midline and pelvis. Surface EMG electrodes placed above L(5) collected data from multifidus. From the kinematics of skin markers during flexion--extension with lifts up to 32 kg, and lateral bending with lifts up to 10 kg, the following parameters were estimated: lumbosacral angle and elongation, contribution of each lumbar segment to the lordosis reduction, relative pelvic/spine motion, and trunk velocity. First the average normal value for each estimated parameter was determined using 40 normal subjects. For each subject the difference between his parameter and the normal was processed by an expert system generating a normality index varying from zero (perfect abnormal) to one (perfect normal). To develop the expert system's rules, a preliminary group of 20 very abnormal subjects was used, such that the normality index separated them from the normals. For validation, a set of 29 back-sprain patients and another set of 42 discogram-positive patients were selected. Each subject was tested and his computerized normality index calculated without any clinician's input, then compared with the clinician's evaluation, which was taken to be the gold standard. The receiver operating characteristic technique was used to quantify the discrepancies. RESULTS: The expert system could detect clinically abnormal subjects with accuracy (sensitivity 83-91% and specificity > 90%) whele providing quantitative information on workers' functional capacities. CONCLUSIONS: Once a reference normative database is agreed upon, each patient can be compared with that reference according to the same rules, with the resulting machine classification being independent of the clinician. This eliminates the inter- and intra-clinician variability in patient follow-up. Because of the severity of the selection criteria, this study is based upon a relatively restricted number of subjects, as well as a limited normative database of 40 subjects. RELEVANCE: It is possible to automate the lumbar physical examination with an acceptable error rate. This technique permits the objective consistent assessment of lumbar function, and thus allows the comparison of different treatment regimes for lumbar dysfunction.

Journal Article↗
PubMed2006

Effects of lumbar stabilization using a pressure biofeedback unit on muscle activity and lateral pelvic tilt during hip abduction in sidelying.

OBJECTIVE: To assess the effects of lumbar spine stabilization using a pressure biofeedback unit on the electromyographic activity and angle of lateral pelvic tilt during hip abduction in a sidelying position. DESIGN: Comparative, repeated-measures study. SETTING: University research laboratory. PARTICIPANTS: Eighteen able-bodied volunteers (9 men, 9 women) with no history of pathology. INTERVENTION: Subjects were instructed to perform hip abduction in a sidelying position in both the preferred hip abduction (PHA) and hip abduction with lumbar stabilization (HALS). A pressure biofeedback unit was used for lumbar stabilization. MAIN OUTCOME MEASURES: Surface electromyography was recorded from the quadratus lumborum, gluteus medius, internal oblique, external oblique, rectus abdominis, and multifidus muscles. Kinematic data for lateral pelvic tilt angle were measured using a motion analysis system. Dependent variables were examined with 2 (PHA vs HALS) x 2 (men vs women) analysis of variance. RESULTS: Significantly decreased electromyographic activity in the quadratus lumborum (PHA, 60.39% +/- 15.62% of maximum voluntary isometric contraction [MVIC]; HALS, 27.90% +/- 13.03% of MVIC) and significantly increased electromyographic activity in the gluteus medius (PHA, 25.03% +/- 10.25% of MVIC; HALS, 46.06% +/- 21.20% of MVIC) and internal oblique (PHA, 24.25% +/- 18.10% of MVIC; HALS, 44.22% +/- 20.89% of MVIC) were found when the lumbar spine was stabilized. Lateral pelvic tilt angle (PHA, 13.86 degrees +/- 4.66 degrees; HALS, 5.55 degrees +/- 4.16 degrees) was decreased significantly when the lumbar spine was stabilized. In women the electromyographic activity (percentage of MVIC) in gluteus medius, external oblique, and rectus abdominis was significantly higher than that observed in men. CONCLUSIONS: With lumbar stabilization, the gluteus medius and internal oblique activity was increased significantly, and the quadratus lumborum activity was decreased significantly, causing reduced lateral pelvic tilt in a sidelying position. These results suggest that hip abduction with lumbar stabilization is useful in excluding substitution by the quadratus lumborum.

Adult↗
PubMed2006

The role of vertebral column muscles in level versus upslope treadmill walking-an electromyographic and kinematic study.

To gain insight into the neural mechanisms controlling vertebral column movement and its role in walking, we performed kinematic and electromyographic (EMG) studies on cats during level and upslope treadmill walking. Kinematic data of the limbs and vertebral column were obtained with a high-speed camera synchronized with EMG recordings from levels T10, L1, and L5 of m. longissimus dorsi (Long). During a single-step cycle at all upslope angles, vertebral movement in the lateral (left-right), cranial-caudal (forward-backward), and dorsal-ventral (upward-downward) directions was observed. Lateral movements were produced by forelimb take-off and hindlimb landing, and forward and upward movements were produced by hindlimb extension. During the single-step cycle, each of the three epaxial muscles, m. multifidus, m. iliocostalis, and Long, showed two bilateral EMG bursts. The onset of the EMG bursts coincided with the left-right movements, suggesting that epaxial muscle activity depresses lateral movement. The termination of the EMG bursts correlated with the forward and downward phase of the step cycle, suggesting that contraction of the epaxial muscles produces forward and downward movements. EMG bursts of the epaxial muscles increase the stiffness and produce inwardly movements to decrease the lateral movements of the vertebral column and the termination of EMG bursts control the movements into cranial and ventral direction of the vertebral column. The results suggest that the rhythmic EMG bursts in the epaxial muscles are produced by pattern generators, and the timing of EMG bursts among the different levels of the epaxial muscles are altered by walking condition input via peripheral afferents and descending pathways.

Action Potentials↗
PubMed2005

Supplementation of general endurance exercise with stabilisation training versus general exercise only. Physiological and functional outcomes of a randomised controlled trial of patients with recurrent low back pain.

BACKGROUND: Determination of the mode of action of new exercise techniques in different back pain populations is lacking. The effectiveness of supplementing an exercise programme with stabilisation exercises concerning physiological and functional parameters in non-specific back pain patients is unknown. METHODS: Randomised controlled trial, comparing a general trunk muscle endurance exercise approach enhanced with specific muscle stabilisation exercises (S&G group) with a general exercise approach only (G group). 55 patients with recurrent back pain were randomised in S&G group (n=29) and G group (n=26). Both groups received an 8-week exercise intervention and written advice. Paraspinal muscle strength and electromyographic fatigue of the erector spinae and multifidus were measured. Additionally, 3 functional speed tests were assessed. Outcomes were collected pre- and post-intervention. FINDINGS: No differences were detected for any of the paraspinal fatigue characteristics either within or between groups, apart from a significant decrease in normalised median frequency slope of the erector spinae for the G group. Paraspinal muscle strength and all functional tests have demonstrated significant within-group improvements for both groups, without any between-group differences. INTERPRETATION: An 8-week stabilisation exercise-enhanced approach presented equal benefits to a general endurance-based exercise programme for patients with recurrent non-specific back pain. A slightly steeper slope for the erector spinae in the G group was the only electromyographic fatigue alteration noted. Concomitant strength improvement probably reflects neural input changes rather than histochemical muscle changes. Physical exercise alone and not the exercise type was the key determinant for improvement in this patient group.

Back↗
PubMed2005

Spinal manipulation force and duration affect vertebral movement and neuromuscular responses.

BACKGROUND: Previous study in human subjects has documented biomechanical and neurophysiological responses to impulsive spinal manipulative thrusts, but very little is known about the neuromechanical effects of varying thrust force-time profiles. METHODS: Ten adolescent Merino sheep were anesthetized and posteroanterior mechanical thrusts were applied to the L3 spinous process using a computer-controlled, mechanical testing apparatus. Three variable pulse durations (10, 100, 200 ms, force = 80 N) and three variable force amplitudes (20, 40, 60 N, pulse duration = 100 ms) were examined for their effect on lumbar motion response (L3 displacement, L1, L2 acceleration) and normalized multifidus electromyographic response (L3, L4) using a repeated measures analysis of variance. FINDINGS: Increasing L3 posteroanterior force amplitude resulted in a fourfold linear increase in L3 posteroanterior vertebral displacement (p < 0.001) and adjacent segment (L1, L2) posteroanterior acceleration response (p < 0.001). L3 displacement was linearly correlated (p < 0.001) to the acceleration response over the 20-80 N force range (100 ms). At constant force, 10 ms thrusts resulted in nearly fivefold lower L3 displacements and significantly increased segmental (L2) acceleration responses compared to the 100 ms (19%, p = 0.005) and 200 ms (16%, p = 0.023) thrusts. Normalized electromyographic responses increased linearly with increasing force amplitude at higher amplitudes and were appreciably affected by mechanical excitation pulse duration. INTERPRETATION: Changes in the biomechanical and neuromuscular response of the ovine lumbar spine were observed in response to changes in the force-time characteristics of the spinal manipulative thrusts and may be an underlying mechanism in related clinical outcomes.

Animals↗
PubMed2006

Gender influence on fatigability of back muscles during intermittent isometric contractions: a study of neuromuscular activation patterns.

BACKGROUND: Gender difference in the fatigability of muscles can be attributed to muscle mass (or strength) and associated level of vascular occlusion, substrate utilization, muscle composition, and neuromuscular activation patterns. The purpose of this study was to assess the role of neuromuscular activation patterns to explain gender differences in back muscle fatigability during intermittent isometric tasks. METHODS: Sixteen males and 15 females performed maximal voluntary contractions (Strength) and a fatigue test to exhaustion (fatigue criterion=time to exhaustion), while standing in a static dynamometer measuring L5/S1 extension moment. The fatigue test consisted of repetitions of an 8-s cycle (1.5 s ramp to reach 40% of maximal voluntary contraction +5s plateau at 40% of maximal voluntary contraction +1.5s rest). Surface electromyography signals were collected bilaterally from 4 back muscles (multifidus at the L5 level, iliocostalis lumborum at L3, and longissimus at L1 and T10). FINDINGS: Males were stronger (P<0.05) than females (316, SD 82>196, SD 25 Nm) but showed significantly shorter time-to-exhaustion values (7.1, SD 5.2<13.0, SD 6.1 min.), the latter result being corroborated by electromyographic indices of fatigue. However, the gender effect on time to exhaustion disappeared when accounting for Strength, thus supporting the muscle mass hypothesis. Among the various electromyographic indices computed to assess neuromuscular activation patterns, the amount of alternating activity between homolateral and between contralateral muscles showed a gender effect (females>males). INTERPRETATION: These results support the muscle mass hypothesis as well as the neuromuscular activation hypothesis to explain gender differences in back muscle fatigability.

Adult↗
PubMed2004

Frequency-dependent changes in neuromuscular responses to cyclic lumbar flexion.

Repetitive lifting in the workplace has been identified to be a cause of low back disorders. Epidemiologic data further supports an hypothesis that higher repetition rate (i.e. frequency) is an added risk factor. The objective of this study was to provide experimental data testing the above hypothesis. An in vivo feline model was subjected to 20-min of cyclic lumbar loading at frequencies of 0.1 Hz and 0.5 Hz while monitoring the EMG from the L-3/4-L-5/6 multifidus muscles and the creep at the L-4/5 level. Seven hours of rest were allowed after the cyclic flexion/extension was terminated. During this rest period, a single test cycle was performed every hour to assess recovery of EMG and lumbar creep. The results demonstrate that cyclic lumbar flexion elicits a transient neuromuscular disorder consisting of EMG spasms during the cyclic loading and initial and delayed muscular hyperexcitabilities during the rest period. Cyclic loading at 0.5 Hz resulted in significant (p<0.05) increase in the hyperexcitability magnitude and duration during the recovery period. It was concluded that repetitive lumbar loading at fast rates is indeed a risk factor as it induces larger creep in the lumbar viscoelastic tissues which in turn intensify the resulting neuromuscular disorder.

Animals↗
PubMed2004

Influence of knee angle and individual flexibility on the flexion-relaxation response of the low back musculature.

In many occupational settings (e.g. agriculture and construction) workers are asked to maintain static flexed postures of the low back for extended periods of time. Recent research indicates that the resulting strain in the viscoelastic, ligamentous tissues may have a deleterious effect on the stability of the spine and the normal reflex response of spinal tissues. The purpose of this study was to evaluate the previously described flexion-relaxation response in terms of the interactive effect of trunk flexion angle (30 degrees, 50 degrees, 70 degrees, 90 degrees ), knee flexion angle (0 degrees (straight knees), 20 degrees, 40 degrees ) and individual flexibiliteky (low, medium, and high). These conditions were tested under two levels of loading: no load (just supporting the weight of the torso) and trunk extension moment equal to 50% of the subject's posture-specific maximum voluntary trunk extension capacity. Surface electromyographic (EMG) data were collected from the multifidus, the longissimus, the iliocostalis, the vastus medialis, the rectus femoris, the vastus lateralis, the biceps femoris, and the gastrocnemius-soleus group from a sample of eight male participants as they performed isometric weight holding tasks in the postures defined by the combinations of trunk angle and knee angle. The results of this study showed that knee angle did have a significant effect on the lumbar extensor muscle activity but only consistently at the 90 degrees trunk angle. Participant flexibility showed a consistent trend of decreasing lumbar extensor muscle activity with decreased flexibility across all trunk angle values. Most interesting was the interactive response of flexibility and knee angle, wherein the flexibility of the participant influenced the trunk angles at which the knee flexion angle affected the flexion-relaxation response. Highly flexible subjects showed an effect of knee angle on the flexion-relaxation response only at the 90 degrees trunk angle; subjects in the medium flexibility category showed a similar response in both the 70 degrees and 90 degrees trunk angles; subject in the low flexibility group showed no knee angle effect on the flexion-relaxation response. Overall the results confirm previous results with regard to the contribution of the passive tissues to the overall trunk extension moment but also show that the tension in the bi-articular biceps femoris, which was influenced by knee flexion angle and flexibility, affects the ratio of active extensor moment contributions of the lumbar extensor musculature to passive extensor moment contributions from the muscular and ligamentous tissues. The results of this study provide empirical data describing this complicated, interactive response.

Adult↗