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Lumbar vertebral angles and back muscle loading with belts.

The study examined belt effects on the change of lumbosacral angle (LSA) and back muscle activity in postures of standing, erect sitting, and slump sitting. We thought that the resulting changes of LSA and back muscle activity when wearing belts with different mechanical characteristics should be different. Eighteen healthy male subjects participated in this study. Though we failed to identify a significant belt effect on the back muscle EMG, the radiographic data revealed an interactive effect of postures and belts on the change of LSA. In standing, the belts increased LSA by increasing almost every lumbar vertebral angle. In erect sitting, the lumbar belt had no effect but the pelvic belt decreased LSA through a decrease in the L1/L3. While sitting slump with a trunk flexion of 15 degrees, both belts increased LSA by restricting the movement of the pelvis. Belt effect on LSA was accompanied with a change of pelvic angle. Significant correlation was found between the backward rotation angles of the pelvis and the angles of LSA (r = 0.692, p < 0.0001), also between the decrease of pelvic angles and the increase of back muscle EMG (r = -0.4, p = 0.017). A change in LSA and pelvic angle after wearing a belt along with posture change seems lead to an increase of the myoelectric activities on the back.

Adult↗

Intra-operator and inter-operator reliability of surface electromyography in the clinical evaluation of back muscles.

As a prerequisite to the use of a test battery based on electromyographic (EMG) analysis of the paraspinal muscles for identifying and remedying back muscle dysfunction, the intra- and inter-operator reliability was assessed. Fifteen volunteers underwent EMG tests on three occasions. The test subjects were asked to perform 22 exercises, subdivided into four categories: coordination, stabilization, balance and strength exercises. The time interval between the tests was one week. The myoelectric signals of the multifidus (MF) and iliocostalis lumborum pars thoracis (ICLT) were analysed with regard to amplitude (averaged EMG) and frequency (zero cross rate). The results indicated that the reliability was better for the MF than for the ICLT, and also for exercises at higher loads (strength exercises). In the intra-operator condition, the reproducibility of the averaged EMG was good (ICC>0.75), except for the balance exercises (ICC = 0.40-0.74). In general, the averaged EMG in the inter-operator condition and the zero cross rate in both the intra- and inter-operator conditions are less or poorly reliable. These results demonstrate that when back muscle function is evaluated during coordination, stabilization and strength exercises, only the averaged EMG parameter has acceptable reproducibility over time when assessed by the same operator.

Adult↗

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↗

Lumbar back muscle activity during locomotion: effects of voluntary modifications of normal trunk movements.

The mechanisms of adaptation of the trunk to changed mechanical conditions were studied during locomotion in man. The myoelectrical (EMG) activity in lumbar back muscles and the movements of the trunk were recorded in nine healthy subjects during walking and running on a motor-driven treadmill. Two different types of voluntary modifications of the movement pattern were used: (1) The trunk was kept in an extreme forward or backward tilted position. In both these situations the basic EMG pattern with two periods of activity per stride cycle was maintained during walking, whereas a major shift relative to the stride cycle (25% of the stride cycle duration) occurred in running with the trunk tilted backwards. The synchrony of the back muscle activation at both sides increased when locomotion was performed with the trunk tilted forwards. The relative duration of the EMG bursts was similar to normal locomotion and corresponded to 15-26% of the stride cycle duration in walking and 23-37% in running. (2) In the other type of modification the subjects were instructed to exaggerate the angular trunk movements either in the sagittal or in the frontal plane. The basic EMG pattern and phase relationships remained in most cases unchanged. One exception was running with exaggerated lateral movements, in which only one period of back muscle activity per stride cycle was observed. The relative duration of the bursts was longer in trials with exaggerated trunk movements as compared to normal locomotion. In walking and running with the trunk tilted forwards or backwards the lumbar back muscles were not always involved as prime movers of the trunk. This was in contrast to the more dynamic situations, in which the back muscle activity appeared to be directly involved in braking and reversing the exaggerated trunk movements.

Adaptation, Physiological↗

Back muscle contraction patterns of patients with low back pain before and after rehabilitation treatment: an electromyographic evaluation.

The aims of this study were to conduct a comparative investigation of muscle function between patients with low back pain (LBP) and healthy persons, and to determine whether intensive rehabilitation can change back muscle contraction synergy. Twenty healthy persons and 20 patients with chronic LBP were asked to perform symmetrical and asymmetric tasks. The patients with LBP were tested in the weeks immediately before and after 12 weeks of LBP rehabilitation. Tasks include "carrying" weights up and down and with a 45 degrees left rotation. Eight-channel surface electromyographic electrodes were placed on the surface of paraspinal muscles over the lumbar region. Correlations between the right and left corresponding muscles and between values before and after treatment were determined. Lifting capacity for patients with LBP were also measured before and after treatment. Results from electromyographic profiles showed that the muscle activity strategies varied between healthy persons and patients with LBP. The correlation coefficients for spinal muscles have shown very reproducible intrasubject muscle contraction synergies. Unbalanced electromyographic patterns found in patients with LBP given symmetrical tasks were not affected by rehabilitation treatment.

Adult↗

Back muscle injury after posterior lumbar spine surgery. Part 1: Histologic and histochemical analyses in rats.

STUDY DESIGN: Back muscle injury caused by retractor application during posterior spine surgery in rats was examined histologically and histochemically according to the postoperative time with reference to the retraction time-pressure relationship. OBJECTIVES: The results were correlated to provide the risk factors for back muscle injury during posterior spine surgery. SUMMARY OF BACKGROUND DATA: Back muscles were examined histologically and histochemically after application of quantitative pressure and retraction time. No previous study has assessed this relationship. METHODS: Five groups were studied: Group 1, 1-hour low-pressure load group; Group 2, 1-hour high-pressure load group; Group 3, 3-hour low-pressure load group; Group 4, 3-hour high-pressure load group; and sham group. In each group, the multifidus muscle was evaluated 3 hours, 48 hours, 1 week, 3 weeks, and 6 weeks after surgery. RESULTS: In all groups except the sham group, degeneration of the muscle and neuromuscular junction was found at a very early postoperative time, but regeneration began at 1 week, and recovery was attained by 6 weeks. The extent of muscle fiber necrosis and the severity of degeneration of the neuromuscular junctions showed a parallelism with the magnitude of the pressure load and retraction time. As the duration and pressure load increased, the time required for regeneration also increased. The fiber type grouping in group 3 and 4 was consistent with the severity of degeneration of neuromuscular junctions. CONCLUSIONS: The muscular degeneration and the regeneration was largely dependent on the retraction pressure-time product. These results suggest that denervation muscle injuries are likely secondary responses to muscle retraction injury in any case of posterior spine surgery.

Animals↗

Surface electromyography assessment of back muscle intrinsic properties.

The purpose of this study was to assess (1) the reliability and (2) the sensitivity to low back pain status and gender of different EMG indices developed for the assessment of back muscle weakness, muscle fiber composition and fatigability. Healthy subjects (men and women) and chronic low back pain patients (men only) performed, in a static dynamometer, maximal and submaximal static trunk extension tasks (short and long duration) to assess weakness, fiber composition and fatigue. Surface EMG signals were recorded from four (bilateral) pairs of back muscles and three pairs of abdominal muscles. To assess reliability of the different EMG parameters, 40 male volunteers (20 controls and 20 chronic low back pain patients) were assessed on three occasions. Reliable EMG indices were achieved for both healthy and chronic low back pain subjects when specific measurement strategies were applied. The EMG parameters used to quantify weakness and fiber composition were insensitive to low back status and gender. The EMG fatigue parameters did not detect differences between genders but unexpectedly, healthy men showed higher fatigability than back pain patients. This result was attributed to the smaller absolute load that was attributed to the patients, a load that was defined relative to their maximal strength, a problematic measure with this population. An attempt was made to predict maximal back strength from anthropometric measurements but this prediction was prone to errors. The main difficulties and some potential solutions related to the assessment of back muscle intrinsic properties were discussed.

Abdominal Wall↗

The association of trunk muscle cross-sectional area and magnetic resonance image parameters with isokinetic and psychophysical lifting strength and static back muscle endurance in men.

The relationship between trunk muscle morphology as measured on transverse magnetic resonance images and isokinetic lifting, psychophysical lifting, and static back muscle endurance testing was examined in 110 men, ages 35-67 years (mean, 48 years), who had been chosen based on their exposure to a wide variety of occupational and leisure-time physical activities. The computed T2-relaxation times and the T2-weighted and proton density-weighted signal intensities of the erector spinae, quadratus lumborum, and psoas major muscles had almost no association with any of the strength tests. The cross-sectional areas of the muscles had good correlations with isokinetic lifting strength (r = 0.46-0.53). They did not correlate well with psychophysical lifting and static back muscle endurance. Other characteristics or neurological or psychological factors may have more influence on those tests.

Adult↗

Examination of the myoelectric activity of back muscles during random vibration--methodical approach and first results.

OBJECTIVE: To elaborate methods for an elimination of artefacts and the analysis of the relationship between random whole-body vibration and electromyographic responses of back muscles. DESIGN: A procedure involving wavelets and digital filtering has been used for the removal of artefacts from the electromyogram during whole-body vibration. BACKGROUND: Back muscle forces contribute essentially to the whole-body vibration-induced spinal load. The electromyogram can help to estimate these forces during whole-body vibration. METHODS: 38 subjects were exposed to identical random low-frequency whole-body vibration. Artefacts caused by the electrocardiogram in the electromyogram were identified by appropriate wavelets and eliminated in the time-domain. After averaging the individual high-pass filtered and rectified undistorted electromyograms across subjects, the transfer function from seat acceleration to the average electromyogram was determined and used for the prediction of the electromyogram. RESULTS: A sufficient procedure involving wavelets and digital filtering has been elaborated for the removal of artefacts from the electromyogram of back muscles during whole-body vibration. A systematic relationship between random vibration and back muscle-response was obtained and described. The transfer function suggests two different reflex-mechanisms - one elicited below, the other above 4 Hz. CONCLUSIONS: The approach of analysing and predicting the muscle-response to random vibration by using the transfer function seems to be promising and could be a valuable tool for the future calculation of muscle forces as an input to active models. RELEVANCE: The knowledge of the extent and timing of the back muscle-response to random whole-body vibration is relevant for an improved evaluation of whole-body vibration with respect to health.

Adult↗

Back muscle necrosis of pigs.

The clinical signs and pathological features of back muscle necrosis (BMN) in four pigs from three English pig herds were similar to those recorded in pigs from mainland Europe. The observations made support the view that BMN is a special manifestation of the porcine stress syndrome. Diagnosis of acute BMN can be made clinically supported by the analysis of plasma creatine phosphokinase activity and can be confirmed post mortem by macroscopic and microscopic observation on the back muscles.

Adenosine Triphosphatases↗

Cross-sectional area of the lumbar back muscles as a function of torso flexion.

OBJECTIVE: Quantification of the maximum anatomical cross-sectional area of the lumbar back muscles as a function of torso flexion angle and development of prediction equations as a function of torso flexion and anthropometric measures. BACKGROUND: Cross-sectional areas of the lumbar back muscles used as inputs into biomechanical models have traditionally been derived from subjects lying in the neutral supine posture. However, it is known that the cross-sectional area of muscle is altered as the torso angle changes. DESIGN: Experimental design consisted of a two-factor multivariate analysis of variance on the cross-sectional area of the lumbar torso muscle across the lumbar levels, as a function of gender and torso angle. Hierarchical linear regression was utilized to assess the association between cross-sectional area and individual and torso posture characteristics. METHOD: Axial MRI scans, through and parallel to each of the lumbar intervertebral discs at four torso flexion positions were obtained from subjects in a lateral recumbent posture. Cross-sectional areas were quantified and converted into anatomical cross-sectional areas utilizing known fascicle orientations. RESULTS: The maximum anatomical cross-sectional area was located between the L(3)/L(4) and L(4)/L(5) level in the neutral posture. The anatomical cross-sectional areas at the L(4)/L(5) and L(5)/S(1) decreased during torso flexion, however, the percent change varied as a function of the individual level. The majority of the anatomical cross-sectional area variability was explained by gender and body mass. Lumbar curvature explained a larger proportion of the anatomical cross-sectional area variability at the lower lumbar levels than at the higher lumbar levels. CONCLUSIONS: The maximum anatomical cross-sectional area of the lumbar back muscles occur at the neutral torso posture and did not decrease as a function of torso flexion. When using maximum anatomical cross-sectional area or specific lumbar level anatomical cross-sectional areas, it appears necessary to account for gender and body mass. At the lower lumbar levels, knowledge of spinal curvature plays an increasing role in the estimation of the size of the lumbar torso muscle cross-sectional area. RELEVANCE: This research indicates the lower lumbar level trunk muscle anatomical cross-sectional area decrease as torso flexion increases, however, the maximum lumbar trunk muscle anatomical cross-sectional area does not vary as a function of torso flexion. Accounting for gender, body mass, torso characteristics and lumbar curvature may help increase accuracy of anatomical cross-sectional area prediction, as well as muscle force predictions from biomechanical models.

Adult↗

Assessment of low back muscle fatigue by surface EMG signal analysis: methodological aspects.

This paper focuses on methodological issues related to surface electromyographic (EMG) signal detection from the low back muscles. In particular, we analysed (1) the characteristics (in terms of propagating components) of the signals detected from these muscles; (2) the effect of electrode location on the variables extracted from surface EMG; (3) the effect of the inter-electrode distance (IED) on the same variables; (4) the possibility of assessing fatigue during high and very low force level contractions. To address these issues, we detected single differential surface EMG signals by arrays of eight electrodes from six locations on the two sides of the spine, at the levels of the first (L1), the second (L2), and the fifth (L5) lumbar vertebra. In total, 42 surface EMG channels were acquired at the same time during both high and low force, short and long duration contractions. The main results were: (1) signal quality is poor with predominance of non-travelling components; (2) as a consequence of point (1), in the majority of the cases it is not possible to reliably estimate muscle fiber conduction velocity; (3) despite the poor signal quality, it was possible to distinguish the fatigue properties of the investigated muscles and the fatigability at different contraction levels; (4) IED affects the sensitivity of surface EMG variables to electrode location and large IEDs are suggested when spectral and amplitude analysis is performed; (5) the sensitivity of surface EMG variables to changes in electrode location is on average larger than for other muscles with less complex architecture; (6) IED influences amplitude initial values and slopes, and spectral variable initial values; (7) normalized slopes for both amplitude and spectral variables are not affected by IED and, thus, are suggested for fatigue analysis at different postures or during movement, when IED may change in different conditions (in case of separated electrodes); (8) the surface EMG technique at the global level of amplitude and spectral analysis cannot be used to characterize fatigue properties of low back muscles during very low level, long duration contractions since in these cases the non-stable MU pool has a major influence on the EMG variables. These considerations clarify issues only partially investigated in past studies. The limitations indicated above are important and should be carefully discussed when presenting surface EMG results as a means for low back muscle assessment in clinical practice.

Adult↗

Active therapy for chronic low back pain part 1. Effects on back muscle activation, fatigability, and strength.

DESIGN: Randomized prospective study of the effects of three types of active therapy on back muscle function in chronic low back pain patients. OBJECTIVES: To quantify the effects of 3 months active therapy on strength, endurance, activation, and fatigability of the back entensor muscles. SUMMARY OF BACKGROUND DATA: Many studies have documented an association between chronic low back pain and diminished muscular performance capacity. Few studies have quantified the changes in these measures following interventions using objective measurement techniques or related them to changes in clinical outcome. METHODS: A total of 148 individuals (57% women) with chronic low back pain (age, 45.0 +/- 10.0 years; duration of low back pain, 10.9 +/- 9.5 years) were randomized to a treatment that they attended for 3 months: active physiotherapy, muscle reconditioning on devices, or low-impact aerobics. Before and after therapy, assessments were made of the following: trunk muscle strength (in flexion, extension, lateral bending, and axial rotation), erector spinae activation (maximal, and during forward bending movements), back extensor endurance (Biering-Sørensen test), and erector spinae fatigability (determined from changes in the median frequency of the surface electromyographic signal) during isometric and dynamic tests. RESULTS: A total of 132 of 148 patients (89%) completed the therapy. Isometric strength in each movement direction increased in all groups post-therapy (P < 0.0008), most notably in the devices group. Activation of the erector spinae during the extension tests also increased significantly in all groups and showed a weak, but significant, relationship with increased maximal strength (P = 0.01). Pretherapy 55% of the subjects showed no relaxation of the back muscles at L5 when in the fully flexed position; no changes were observed in any group post-therapy. Endurance time during the Biering-Sørensen test increased significantly post-therapy in all groups (P = 0.0001), but there were no significant changes in EMG-determined fatigability. Fatigability of the lumbar muscles at L5 (EMG median frequency changes) during the dynamic test increased post-therapy (P = 0.0001) without group differences. CONCLUSION: Significant changes in muscle performance were observed in all three active therapy groups post-therapy, which appeared to be mainly due to changes in neural activation of the lumbar muscles and psychological changes concerning, for example, motivation or pain tolerance.

Adult↗

Voluntary and reflex control of human back muscles during induced pain.

1. Back pain is known to change motor patterns of the trunk. The purpose of this study was to examine the motor output of the erector spinae (ES) muscles during pain in the lumbar region. First, their voluntary activation was assessed during flexion and re-extension of the trunk. Second, effects of cutaneous and muscle pain on the ES stretch reflex were measured, since increased stretch reflex gain has been suggested to underlie increased muscle tone in painful muscles. 2. The trunk movement and electromyographical (EMG) signals from the right and left ES during pain were compared with values before pain. Controlled muscle pain was induced by infusion of 5 % saline into the right lumbar ES. Cutaneous pain was elicited by mechanical or electrical stimulation of the dorsal lumbar skin. The stretch reflex was evoked by rapidly indenting the right lumbar ES with a servo-motor prodder. 3. The results from the voluntary task show that muscle pain decreased the modulation depth of ES EMG activity. This pattern was associated with a decreased range and velocity of motion of the painful body segment, which would normally serve to avoid further injury. Interestingly, when subjects overcame this guarding tendency and made exactly the same movements during pain as before pain, the EMG modulation depth was still reduced. The results seem to reconcile the controversy of previous studies, in which both hyper- and hypoactivity of back muscles in pain have been reported. 4. In the tapped muscle, the EMG response consisted of two peaks (latency 19.3 +/- 2.1 and 44.6 +/- 2.5 ms, respectively) followed by a trough. On the contralateral side the first response was a trough (26.2 +/- 3.2 ms) while the second (46.4 +/- 4.3 ms) was a peak, similar to the second peak on the tapped side. Cutaneous pain had no effect on the short-latency response but significantly increased the second response on the tapped side. Surprisingly, deep muscle pain had no effect on the stretch reflex. A short-latency reciprocal inhibition exists between the right and left human ES. 5. It is concluded that deep back pain does not influence the stretch reflexes in the back muscles but modulates the voluntary activation of these muscles.

Adult↗

Quantitative studies of the flexion-relaxation phenomenon in the back muscles.

In quiet standing positions involving substantial trunk flexion, myoelectric activity in the back muscles diminishes to low levels. Aspects of that "flexion-relaxation" phenomenon were explored through measurements of myoelectric activities in 11 young men during performance of 19 isometric tasks in flexed positions. Biomechanical model analyses were used to predict the internal loads imposed on the lumbar trunk structures during those performances. Flexion-relaxation consistently occurred in quiet flexed standing, but marked increases in myoelectric activity were found on imposition of external loads in flexed positions. Increases in myoelectric activity per unit increase in back muscle contraction force increase were nearly the same as those found in upright postures. Whether or not flexion-relaxation occurs, large trunk flexions load the spine heavily.

Adult↗

Determinants of isokinetic and psychophysical lifting strength and static back muscle endurance: a study of male monozygotic twins.

STUDY DESIGN: Retrospective cohort. OBJECTIVES: To determine the relative contributions of anthropometric factors, physical activity, back and neck pain, overall health, and familial aggregation (the combined effects of genetics and childhood environment) to different measurements of adult back muscle function. SUMMARY OF BACKGROUND DATA: Many methods of muscle testing are employed in the attempt to predict, prevent, treat, and rehabilitate low back pain. Poor correlations between the test results suggest that they are measuring different attributes and have different determinants. METHODS: Muscle function tests, magnetic resonance images, and a detailed interview were obtained in 65 pairs of monozygotic male twins. RESULTS: Familial aggregation was the strongest determinant of isokinetic and psychophysical lifting and static back endurance, explaining 56%, 32%, and 15% of the variances, respectively, beyond that which age alone predicted. Back pain and physical loading in work and leisure explained 2%, 0%, and 23% of the variances. CONCLUSIONS: The combined effects of genetics and childhood environment play a dominant role in determining adult back muscle function. Physical loading at work and leisure, back and neck pain history, overall health, and anthropometric factors had a comparatively minor role, suggesting that the potential of interventions to increase and sustain back muscle function in healthy adults, measured through these tests, may be limited. The relative contributions of constitutional, behavioral, and environmental factors differ substantially in the three tests, and provide insights into what these commonly used tests actually reflect or measure. This knowledge can be used to guide more appropriate selection and interpretation of results of back muscle function tests.

Adult↗

Back muscle function during bipedal walking in chimpanzee and gibbon: implications for the evolution of human locomotion.

The evolution of erect posture and locomotion continues to be a major focus of interest among paleoanthropologists and functional morphologists. To date, virtually all of our knowledge about the functional role of the back muscles in the evolution of bipedalism is based on human experimental data. In order to broaden our evolutionary perspective on the vertebral region, we have undertaken an electromyographic (EMG) analysis of three deep back muscles (multifidus, longissimus thoracis, iliocostalis lumborum) in the chimpanzee (Pan troglodytes) and gibbon (Hylobates lar) during bipedal walking. The recruitment patterns of these three muscles seen in the chimpanzee closely parallel those observed in the gibbon. The activity patterns of multifidus and longissimus are more similar to each other than either is to iliocostalis. Iliocostalis recruitment is clearly related to contact by the contralateral limb during bipedal walking in both species. It is suggested that in both the chimpanzee and gibbon, multifidus controls trunk movement primarily in the sagittal plane, iliocostalis responds to and adjusts movement in the frontal plane, while longissimus contributes to both of these functions. In many respects, the activity patterns shared by the chimpanzee and gibbon are quite consistent with recent human experimental data. This suggests a basic similarity in the mechanical constraints placed on the back during bipedalism among these three hominoids. Thus, the acquisition of habitual bipedalism in humans probably involved not so much a major change in back muscle action or function, but rather an improvement in the mechanical advantages and architecture of these muscles.

Animals↗