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PubMed2003

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↗
PubMed1997

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↗
PubMed2001

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↗
PubMed1979

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↗
PubMed2003

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↗
PubMed2003

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↗
PubMed2001

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↗
PubMed1999

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↗
PubMed1985

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↗
PubMed1997

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↗
PubMed1988

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↗
PubMed2001

Assessment of lower-back muscle fatigue using electromyography, mechanomyography, and near-infrared spectroscopy.

We have investigated the etiology of lower-back muscle fatigue using simultaneous recordings of electromyography (EMG), mechanomyography (MMG), and near-infrared spectroscopy (NIRS) in an attempt to shed some light on the electrophysiological, mechanical, and metabolic characteristics, respectively. Eight male subjects performed isometric back extensions at an angle of 15 degrees with reference to the horizontal plane, for a period of 60 s. Surface EMG, MMG and NIRS signals were recorded simultaneously from the center of the erector spinae at the level of L3. NIRS was measured to determine the level of muscle blood volume (BV) and oxygenation (Oxy-Hb). The root mean square amplitude value (RMS) of the EMG signal was significantly increased at the initial phase of contraction and then fell significantly, while mean power frequency (MPF) of the EMG signal decreased significantly and progressively as a function of time. There were also significant initial increases in RMS-MMG that were followed by progressive decreases at the end of fatiguing contractions. MPF-MMG remained unchanged. Muscle BV and Oxy-Hb decreased dramatically at the onset of the contraction and then remained almost constant throughout the rest of the contraction. These results, obtained by simultaneous recordings of EMG, MMG, and NIRS, demonstrate that the restriction of blood flow due to high intramuscular mechanical pressure is one of the most important factors in muscle fatigue in the lower-back muscles. In addition, the simultaneous recording system described here can be used to obtain more reliable information regarding the mechanism(s) of lower-back muscle fatigue.

Adult↗
PubMed1982

Lumbar back muscle activity in relation to trunk movements during locomotion in man.

The function of lumbar back muscles was studied by relating their activity patterns to trunk movements in 7 healthy adult males during normal walking (1.0-2.5 m/s) and running (2.0-7.0 m/s) on a treadmill. The movements of the trunk in the sagittal and frontal planes were recorded with a Selspot optoelectronic system using infrared light emitting diodes as markers. The electromyographic (EMG) activity from the two main portions of the lumbar erector spinae muscles (Multifidus and Longissimus) was recorded bilaterally with intramuscular wire electrodes. The angular displacements of the trunk showed regular oscillations, but their shape, magnitude and relation to the step cycle were different in the two planes (sagittal and frontal) and varied with speed and mode of progression. The EMG pattern in both muscles showed a bilateral cocontraction with two main bursts of activity per step cycle starting just before each foot was placed on the ground. Relating the EMG to the movements of the trunk indicated that the main function of the lumbar erector spinae muscles is to restrict excessive trunk movements. During walking this restricting action is most evident for movements in the frontal plane, whereas in running the lumbar back muscles mainly control the movements in the sagittal plane.

Adaptation, Physiological↗
PubMed1998

Spectral electromyographic fatigue analysis of back muscles in healthy adult women compared with men.

OBJECTIVE AND DESIGN: To investigate the difference in back muscle endurance between normal adult women and men using surface electromyographic (EMG) power spectral analyses. METHODS: Forty-five healthy subjects (22 men and 23 women) were studied during an unsupported trunk holding test for 120 seconds. Recording surface electrodes were placed over each erector spinae muscle at L1 level. OUTCOME MEASURES: Median frequency (MF), mean power frequency (MPF), and zero crossing rate (ZCR) were evaluated using the ME3000P Fast Fourier Transform spectrum analysis program. The rate of change was determined for each parameter during the test, and correlation was examined by Pearson's correlation. RESULTS: The negative slopes of all indices of back muscle fatigue were significantly steeper in men than in women. CONCLUSION: Our results indicated that the trunk holding test combined with EMG power spectral analysis of lumbosacral muscles is useful for the evaluation of fatigue performance of these muscles. Our results also showed a higher muscle endurance in healthy adult women than in men.

Adult↗
PubMed1993

Intensive, dynamic back-muscle exercises, conventional physiotherapy, or placebo-control treatment of low-back pain. A randomized, observer-blind trial.

In a randomized, observer-blind trial, 150 men and women, aged 21-64 years, with chronic/subchronic low-back pain, followed one of these three treatment regimens: 1) intensive, dynamic back-muscle exercises; 2) conventional physiotherapy, including isometric exercises for the trunk and leg muscles; and 3) placebo-control treatment involving semihot packs and light traction. Eight treatment sessions were given during the course of 4 weeks, each session lasting 1 hour. The short-term effect was evaluated at the end of the treatment period and 1 month later, and the long-term effect at 6 and 12 months. The evaluations included recording of changes in pain level and assessment of overall treatment effect, which were indicated on visual interval scales. Subgroups of patients could be identified according to their treatment responses: physiotherapy was the superior treatment for the male participants, whereas the intensive back exercises appeared to be most efficient for the female participants. Patients with moderate or hard physical occupations tended toward a better response with physiotherapy, whereas intensive back exercises seemed most effective for those with sedentary/light job functions.

Adult↗
PubMed1980

Crosses and uncrossed synaptic actions on motoneurones of back muscles in the cat.

Intracellular recording from motoneurones of back muscles was used to analyze their synaptic input. The sample included motoneurones located in Th13--L2 spinal segments, identified by their antidromic invasion following stimulation of medial, intermediate and lateral branches of the dorsal rami. The motoneurones were monosynaptically excited from lowest threshold ipsilateral afferents and from ipsilateral descending spinal tracts. Polysynaptic EPSPs and/or IPSPs were evoked in them from higher threshold ipsilateral and contralateral afferents and from descending spinal tracts, and recurrent inhibition was evoked from ipsilateral motor axon collaterals. There was no evidence of crossed disynaptic inhibition from group I afferents, or crossed recurrent inhibition of these neurones. Supplementary records from another group of neurones in Th13--L2 segments, unidentified but likely to innervate other back or abdominal muscles, showed monosynaptic and polysynaptic PSPs of the same origin, and in addition disynaptic IPSPs and disynaptic EPSPs from contralateral ventral roots. The crossed IPSPs had features of the crossed recurrent IPSPs, while the crossed EPSPs appeared to be more likely evoked by some afferents passing via the ventral roots. Generally, the input to the investigated neurones showed greatest similarities to the input to motoneurones of neck muscles and differed from that reported for tail motoneurones.

Afferent Pathways↗
PubMed1998

The influence of muscle fiber size and type distribution on electromyographic measures of back muscle fatigability.

STUDY DESIGN: This was a cross-sectional study carried out on a group of 31 healthy, consenting volunteers with no history of low back pain (17 men, 14 women). OBJECTIVES: To evaluate the relationship between electromyographic measures of erector spinae fatigability and the muscle's fiber type characteristics. SUMMARY OF BACKGROUND DATA: Using electromyographic techniques, a pronounced fatigability of the muscles of patients with low back pain has been identified. It has been postulated that this is the result of an unfavorable back muscle fiber type distribution, although an association between electromyographic measures of fatigue and the muscle's fiber type characteristics has never been established. METHODS: Two tests of back extensor fatigability were performed (on separate days), each to the limit of endurance: 1) maintenance of 60% total maximum voluntary contraction of the back extensors, and 2) performance of the Biering-Sørensen test. Pairs of surface electrodes were attached to the skin overlying the belly of the erector spinae, bilaterally, at T10 and L3. The median frequency was computed from the electromyographic power spectrum, and fatigability was given by the slope of the linear regression of median frequency on time (MFgrad; %.s-1). One week later, two percutaneous erector spinae muscle biopsy samples were obtained from the same sites described for electromyography (left side only). Samples were prepared for histochemistry for the identification of muscle fiber types. Fiber sizes (cross-sectional areas) were quantified using computerized image analysis. RESULTS: The mean fiber size at each erector spinae region showed a significant correlation with maximum back extensor strength. In the thoracic region, the relative area of the muscle occupied by Type I fibers (which accounts for the relative size and distribution of the fiber types) showed a significant relationship with MFgrad recorded during each fatigue test. A similar relationship was observed for the lumbar region, but for the Biering-Sørensen test only. CONCLUSIONS: The electromyographic changes recorded in back muscles during fatigue appear to be related to the underlying muscle fiber type area distribution. This confirms the usefulness of electromyography in reflecting such muscle characteristics in a noninvasive manner, when monitoring changes in function consequent to the development of, or rehabilitation from, low back pain.

Adult↗