A Comparison of Lumbopelvic Motion Patterns and Erector Spinae Behavior Between Asymptomatic Subjects and Patients With Recurrent Low Back Pain During Pain-Free Periods

Sánchez‐Zuriaga, Daniel; López-Pascual, Juan; Garrido-Jaén, David; García-Mas, Maria Amparo

doi:10.1016/j.jmpt.2014.11.002

Cited by 40 publications

(35 citation statements)

References 32 publications

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“…Mellin et al [24] also reported that extension strength was weaker than exion strength, with further reduction of extension moments, in patients with severe back pain. Conversely, normal spinal range of motion was regained after pain reduction in patients with chronic LBP [18]. Previous studies discussed the relationship of spinal motion with pain level, utilising the spine curvature measurement or gravity goniometer [19][20][21].…”

Section: Discussionmentioning

confidence: 99%

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The radiographic effects of ketorolac on patients with spondylolisthesis

Chou¹,

Lu²,

Lin³

et al. 2020

Preprint

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Background: Low back pain may inhibit patients’ spinal range of motion during radiography. Little is known about the dynamic changes of measurement variables and diagnosis of unstable segments in flexion/extension radiographs before and after analgesic injections. We hypothesise that pain control with intramuscular (IM) ketorolac could reveal more radiographic instability segments currently masked by low back pain. Methods: One hundred patients with symptomatic spondylolisthesis from outpatient clinics were recruited. Standing flexion-extension radiographs before and after analgesic injections (IM ketorolac 30 mg) were examined. The visual analog scale (VAS) score and the parameters of segmental instability, including dynamic lumbar lordosis (º; DL), dynamic segmental angulation (º; DA), dynamic segmental translation (mm; DT), and slip percentage (dynamic translation divided with vertebral body width; SP) (%), before and after ketorolac injection were measured. In addition, newly diagnosed unstable segments by different instability criteria were recorded. Pre-post changes between the two groups were analysed using paired t-tests.Results: The VAS score decreased significantly after analgesic injections (66.9 ± 0.97 vs. 32.2 ± 13.1 mm, P < 0.001). DL, DA, DT, and SP were significantly increased (P < 0.001) after providing analgesia compared to pre-analgesia. More unstable segments were found from radiography after ketorolac injection.Conclusion: Ketorolac 30 mg injections provided effective analgesia. The radiographic change and diagnosis of instability segments, which might be masked by back pain, significantly changed after IM Ketorolac in patients with symptomatic spondylolisthesis.

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Section: Discussionmentioning

confidence: 99%

“…However, the spinal curve and instability segments may be masked due to LBP [17,18]. Previous studies demonstrated that lumbar range of motion (ROM) or curvature might change with LBP relief in patients with spondylolisthesis [19].…”

Section: Introductionmentioning

confidence: 99%

The radiographic effects of ketorolac on patients with spondylolisthesis

Chou¹,

Lu²,

Lin³

et al. 2020

Preprint

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“…When the persistence of low back pain is greater than three months, it is classified as chronic low back pain (CLBP) (2,4) . The main cause of CLBP is muscular dysfunction, which leads to changes in motor control and, as a consequence, inadequate recruitment of the trunk muscles, especially during voluntary activities (1,(5)(6)(7) . Changes in motor control interfere with the ability to detect conditions of instability and to anticipate or respond to these disorders adequately, making subjects susceptible to injury (5,6) .…”

Section: Introductionmentioning

confidence: 99%

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

Nava¹,

Tozim²,

Morcelli³

et al. 2020

mtprehabjournal

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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.

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“…Among normal healthy subjects, activity of the lumbar paraspinal muscles during flexion initially increases, and then decreases as the ligaments begin to support the trunk as the angle of flexion increases (Alschuler et al 2009). However, in people with LBP, this paraspinal relaxation in maximum voluntary flexion tends to be absent or decreased (Ahern et al 1988; Alschuler et al 2009; Ambroz et al 2000; Colloca and Hinrichs 2005; Descarreaux et al 2008; Geisser 2007; Maher et al 2005; Mayer et al 2009; Watson et al 1997; Schinkel-Ivy et al 2013; Sanchez-Zuriaga et al 2015). The assumption is that this altered motor control is due to anticipation of the presence of LBP (Hodges et al 2003; Moseley and Hodges 2005) leading to a “smudging of the brain” on the sensory motor cortex and possibly an altered neural drive of muscles (Tsao et al 2010; Chiou et al 2014).…”

Section: Introductionmentioning

confidence: 99%

Changes in spontaneous overt motor execution immediately after observing others’ painful action: two pilot studies

et al. 2018

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Research has demonstrated that motor control is directly influenced by observation of others’ action, stimulating the mirror neuron system. In addition, there is evidence that both emotion and empathy after observing a painful stimulus affects motor cortical excitability and reaction times. Aim of the present two pilot studies is a) to test for significant influence of observing other’s painful bending of the trunk on execution of the same activity in a self-directed bending action (study 1) and to compare these results with a bending action according to a strict bending protocol (study 2). In addition to study 1, differences between Low Back Pain (LBP) patients versus healthy subjects are tested. Video footage of a (1) neutral, (2) painful, and (3) happy bending action was presented in random order. Changes in flexion–relaxation phenomenon (FRP) of back muscles were studied directly after watching the videos with surface EMG, in study 1 during a self-directed bending action in LBP patients and healthy subjects, in study 2 according to a strict bending protocol. FRP ratios were calculated by a custom-made analysis scheme tested for sufficient reliability prior to both studies. Evoked emotions were measured with an Emotional Questionnaire after each video. A Mixed Model ANOVA was used to test for the effect video and the difference between LBP and healthy subjects on the FRP-rs. Differences in evoked emotion will be tested with a Wilcoxon Signed Rank Test. In study 1, 24 healthy controls and 16 LBP patients FRP-rs were significantly influenced after observing a painful video in all subjects versus a happy and neutral video (p = 0.00). No differences were present between LBP and healthy controls. All subjects experienced more fear after observation of the painful video (p 0.05). In study 2, 6 healthy subjects followed the strict FRP bending protocol for three times after observing each video. No significant changes occurred in FRPs per video compared to FRPs of six healthy subjects carrying out the spontaneous bending activity. Observing a painful action in another person changes motor performance and increases fear in both people with and without back pain, during self-directed trunk flexion, but not during a protocolled trunk flexion.

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A Comparison of Lumbopelvic Motion Patterns and Erector Spinae Behavior Between Asymptomatic Subjects and Patients With Recurrent Low Back Pain During Pain-Free Periods

Cited by 40 publications

References 32 publications

The radiographic effects of ketorolac on patients with spondylolisthesis

The radiographic effects of ketorolac on patients with spondylolisthesis

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

Changes in spontaneous overt motor execution immediately after observing others’ painful action: two pilot studies

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