Altered Trunk Motor Planning in Patients with Nonspecific Low Back Pain

Abstract

The authors investigated differences in trunk muscle activation timing between patients with chronic nonspecific low back pain (NSLBP) and asymptomatic controls during a self-initiated postural challenge. The authors compared 30 participants with NSLBP to 30 controls. Surface electromyographic data were collected from bilateral trunk muscles. Dependent variables were trunk muscle onset and offset relative to extremity muscle activation and duration of the trunk muscle burst and abdominal-extensor cocontraction. Patients with NSLBP demonstrated significantly delayed trunk muscle onset latency (p< .01), and shorter burst (p = .02) and cocontraction durations (p < .01). Results suggest that patients with NSLBP may be inefficient in regulating trunk posture during voluntary extremity movements. These alterations could also represent a compensatory control pattern imposed by the CNS to avoid pain.

Effect of Nonspecific Chronic Low Back Pain on Walking Economy: An Observational Study

“…Patients with chronic low back pain showed little skilled in postural control and to stabilization of the spine during a self-initiated perturbation (Mehta, Cannella, Smith, & Silfies, 2010). It is speculated that if this deficiency persists for dynamic and cyclical activities, such as walking, there is greater muscle demand and hence higher metabolic energy expenditure.…”

Manipulation under anesthesia for patients with failed back surgery: retrospective report of 3 cases with 1-year follow-up

“…When patients have chronic spine and/or disk pain, they tend to develop compensatory postural habits and locomotion patterns to minimize their pain levels. [14][15][16][17] When patients have spinal fusion surgery to correct the initial origin of the chronic pain (ie, nerve root compression, spinal cord effacement), they still maintain these abnormal gait and postural adaptations. 18 These adaptations may then themselves promote chronic pain patterns and also promote accelerated degeneration of spinal motion segments adjacent to the surgery sites by increasing the gravitational stress upon them.…”

The influence of fatigue and chronic low back pain on muscle recruitment patterns following an unexpected external perturbation

“…The co-contraction parameter of this study is based on muscle onset and offset times so similar co-contraction between groups is because no more burst synchronisation is found in CLBP group compared with the healthy one. The co-contraction parameter of this study may be contrasted with studies like Mehta et al [17], Radebold [3] and Cholewicki [23]. Mehta et al [17] analysed the coincidence in time of the first burst on a sudden perturbation showing a lower synchronisation in CLBP subjects.…”

“…The current results can only be compared with other studies investigating the first reaction response since, to the authors’ knowledge, other research up to now, does not consider subsequent reactions. Only one study evaluated the completion time of the first burst without observing differences between the CLBP group and the healthy group in that parameter [17]. The variability among subjects in the motor recruitment pattern [5] could be greater in subsequent muscular reactions rather than in the first reaction.…”

“…The analysis between groups (CLBP vs. healthy) was carried out for each variable using mixed group by muscle ANOVAs with repeated measurements for the muscle factor [16, 17]. Post hoc Tukey corrections were performed to analyse the muscle factor significance.…”