Manual Therapy, Posturology & Rehabilitation Journal
http://www.mtprehab.periodikos.com.br/article/doi/10.17784/mtprehabjournal.2017.15.493
Manual Therapy, Posturology & Rehabilitation Journal
Research Article

The trunk muscles behavior in women with low back pain in the test of flexion and extension of the trunk

Guilherme Thomaz de Aquino Nava; Beatriz Mendes Tozim; Mary Hellen Morcelli; Marcelo Tavella Naveg

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Abstract

INTRODUCTION: Chronic low back pain has a direct repercussion on the activities of daily living and the alteration of motor control is its main cause. This change leads to instability of the trunk stabilizer systems that control movements. Trunk flexion and extension movements associated with external disturbances may increase the potential for motor control error, resulting in injury and pain. OBJECTIVE: To evaluate and compare the recruitment of the trunk stabilizer muscles, with and without load, in the flexion and extension movements of the trunk. METHODS: Thirty - four sedentary women were evaluated, aged between 30 and 59 years, divided into: low back pain group (LBPG n = 19) and control group (CG n = 15). The protocol consisted of clinical evaluation, pain evaluation, strength test of extensor trunk muscles and trunk flexion and extension tests (TFET). Muscle electromyography in internal oblique (IO), lumbar multifidus (LM), rectus abdominis (RA), external oblique (EO) and lumbar iliacus (LI) were performed simultaneously. Multivariate analysis of variance was used with two-way repeated measurements. RESULTS: LBPG presented a trend of greater recruitment in all muscles and loads evaluated, with muscle activation up to 47% higher when compared to CG. In the intergroup comparison, the global muscles demonstrated a tendency for greater activation in LBPG, with values up to 53% higher when compared to CG, and predominantly high effect size d> 0.80. In the intragroup comparison, the IO, EO, LI and LM muscles of the LBPG presented ascending muscle recruitment with increased load the opposite was seen in the CG, which showed increased activation only in the LI and LM muscles. CONCLUSION: Women with low back pain need more muscle recruitment to remain stable and, in challenging situations, use inefficient strategies.

Keywords

Lumbar Pain. Postural Balance. Electromyography. Applied Kinesiology

References

1. Rossi DM, Morcelli MH, Marques NR, Hallal CZ, Gonçalves M, LaRoche DP, et al. Antagonist coactivation of trunk stabilizer muscles during Pilates exercises. J Bodyw Mov Ther [Internet]. 2014;18(1):34–41.

2. Mostagi FQRC, Dias JM, Pereira LM, Obara K, Mazuquin BF, Silva MF, et al. Pilates versus general exercise effectiveness on pain and functionality in non-specific chronic low back pain subjects. J Bodyw Mov Ther. 2015;19(4):636–45.

3. Cho KH, Beom JW, Lee TS, Lim JH, Lee TH, Yuk JH. Trunk muscles strength as a risk factor for nonspecific low back pain: A pilot study. Ann Rehabil Med. 2014;38(2):234–40.

4. Luiz A, Teixeira S, Fernandes N, Meneses E. Evaluation of functional disability and pain in patients with chronic low back pain submitted to physiotherapy. MTP&RehabJournal. 2016;14.

5. Tsao H, Galea MP, Hodges PW. Driving plasticity in the motor cortex in recurrent low back pain. Eur J Pain. 2010;14(8):832–9.

6. Butler HL, Hubley-Kozey CL, Kozey JW. Changes in electromyographic activity of trunk muscles within the sub-acute phase for individuals deemed recovered from a low back injury. J Electromyogr Kinesiol. 2013;23:369–77.

7. Sánchez-Zuriaga D, López-Pascual J, Garrido-Jaén D, García-Mas MA. A Comparison of Lumbopelvic Motion Patterns and Erector Spinae Behavior Between Asymptomatic Subjects and Patients With Recurrent Low Back Pain During Pain-Free Periods. J Manipulative Physiol Ther. 2015;38(2):130–7.

8. Hodges PW, Moseley GL, Gabrielsson A, Gandevia SC. Experimental muscle pain changes feedforward postural responses of the trunk muscles. Exp brain Res. 2003;151(2):262–71.

9. D’hooge R, Hodges P, Tsao H, Hall L, MacDonald D, Danneels L. Altered trunk muscle coordination during rapid trunk flexion in people in remission of recurrent low back pain. J Electromyogr Kinesiol. 2013;23(1):173–81.

10. Panjabi M. The Stabilizing System of the Spine Part I. Journal of Spinal Disorders. 1992;5:383–9.

11. Bergmark A. Stability of the lumbar spine: a study in mechanical engineering. Acta Orthop. 1989;230:1-54.

12. Larivière C, Gagnon D, Loisel P. The effect of load on the coordination of the trunk for subjects with and without chronic low back pain during flexionextension and lateral bending tasks. Clin Biomech. 2000;15(6):407–16.

13. Sánchez-Zuriaga D, Artacho-Pérez C, Biviá-Roig G. Lumbopelvic flexibility modulates neuromuscular responses during trunk flexion–extension. J Electromyogr Kinesiol 2016;28:152–7.

14. Kienbacher T, Paul B, Habenicht R, Starek C, Wolf M, Kollmitzer J, et al. Age and gender related neuromuscular changes in trunk flexion-extension. J Neuroeng Rehabil. 2015;12(1):1–10.

15. Vera-Garcia FJ, Moreside JM, McGill SM. MVC techniques to normalize trunk muscle EMG in healthy women. J Electromyogr Kinesiol. 2010;20(1):10–6.

16. Hoffman M, Schrader J, Applegate T, Koceja D. Unilateral Postural Control of the Functionally Dominant and Nondominant Extremities of Healthy Subjects. 1998;33(4):319–22.

17. Morcelli MH, Faganello FR, Navega MT. Avaliação da flexibilidade e dor de idosos físicamente ativos e sedentários. MTP&RehabJournal. 2010;8:298–304.

18. Schinkel-Ivy A, Nairn BC, Drake JDM. Investigation of trunk muscle cocontraction and its association with low back pain development during prolonged sitting. J Electromyogr Kinesiol. 2013;23(4):778–86.

19. Gruther W, Wick F, Paul B, Leitner C, Posch M, Matzner M, et al. Diagnostic accuracy and reliability of muscle strength and endurance measurements in patients with chronic low back pain. J Rehabil Med. 2009;41(8):613–9.

20. Marshall P, Murphy B. The validity and reliability of surface EMG to assess the neuromuscular response of the abdominal muscles to rapid limb movement. J Electromyogr Kinesiol. 2003;13(5):477–89.

21. Marques NR, Hallal CZ, Gonçalves M. Padrão de co-ativação dos músculos do tronco durante exercícios com haste oscilatória. Motriz Rev Educ Fis. 2012;18(2):245–52.

22. Graham RB, Oikawa LY, Ross GB. Comparing the local dynamic stability of trunk movements between varsity athletes with and without non-specific low back pain. J Biomech. 2014;47(6):1459–64.

23. Luoto S, Heliijvaara M, Hurri H, Alaranta H. Static back endurance low-back pain and the risk of. 1995;10(6):323–4.

24. Nelson-Wong E, Alex B, Csepe D, Lancaster D, Callaghan JP. Altered muscle recruitment during extension from trunk flexion in low back pain developers. Clin Biomech. 2012;27(10):994–8.

25. Beck T ravis W. The importance of a priori sample size estimation in strength and conditioning research. 2013;27(8):2323–37.

26. Espírito-Santo H, Daniel F. Calcular e apresentar tamanhos do efeito em trabalhos científicos: As limitações do p < 0,05 na análise de diferenças de médias de dois grupos. Rev Port Investig Comport e Soc. 2015;1(1):3–16.

27. Lee PJ, Granata KP, Moorhouse KM. Active trunk stiffness during voluntary isometric flexion and extension exertions. Hum Factors. 2007;49(1):100–9.

28. IAF Stokes, MG Gardner-Morse SH. Abdominal muscle activation increase lumbar spinal stability: analysis of contributions of different muscle groups. Clin Biomech. 2012;26(8):797–803.

29. Dubois J-D, Piché M, Cantin V, Descarreaux M. Effect of experimental low back pain on neuromuscular control of the trunk in healthy volunteers and patients with chronic low back pain. J Electromyogr Kinesiol. 2011;21(5):774–81.

30. Lund JP, Donga R, Widmer CG, Stohler CS. The pain-adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activity. Can J Physiol Pharmacol. 1991;69(5):683–94.

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