Are lumbar multifidus fatigue and transversus abdominis activation similar in patients with lumbar disc herniation and healthy controls? A case control study

Ramos, Luiz Armando Vidal; França, Fábio Jorge Renovato; Callegari, Bianca; Burke, Thomaz Nogueira; Magalhães, Mauro Taveira; Marques, Amélia Pasqual

doi:10.1007/s00586-015-4375-2

Cited by 23 publications

(34 citation statements)

References 38 publications

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“…As a solution, we propose the following: Erector spinae muscles, such as the multifidus, have to be strengthened, with parallel strengthening of the transverse abdominal muscle (Ramos et al, 2016). We could add strengthening of perineal muscles to obtain complete control of abdominal pressure, thereby maintaining good control of the lumbar curvature (Sapsford et al, 2013; Vleeming et al, 2014; Arshad et al, 2016; Ehsani et al, 2016; Giacomini et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Intervertebral Disc Swelling Demonstrated by 3D and Water Content Magnetic Resonance Analyses after a 3-Day Dry Immersion Simulating Microgravity

et al. 2016

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Background: Vertebral deconditioning is commonly experienced after space flight and simulation studies. Disc herniation is quadrupled after space flight.Purpose: The main hypothesis formulated by the authors is that microgravity results in intervertebral disc (IVD) swelling.Study Design: The aim of the study was to identify the morphological changes of the spine and their clinical consequences after simulated microgravity by 3-day dry immersion (DI). The experimental protocol was performed on 12 male volunteers using magnetic resonance imaging and spectroscopy before and after DI.Methods: All the experiment was financially supported by CNES (Centre national d'études spatiales i.e., French Space Agency).Results: We observed an increase in spine height of 1.5 ± 0.4 cm and a decrease in curvature, particularly for the lumbar region with a decrease of −4 ± 2.5°. We found a significant increase in IVD volume of +8 ± 9% at T12-L1 and +11 ± 9% at L5-S1. This phenomenon is likely associated with the increase in disc intervertebral water content (IWC), 17 ± 27%. During the 3 days in DI, 92% of the subjects developed back pain in the lumbar region below the diaphragmatic muscle. This clinical observation may be linked to the morphological changes of the spine.Conclusions: The morphological changes observed and, specifically, the disc swelling caused by increased IWC may contribute to understanding disc herniation after microgravity exposure. Our results confirmed the efficiency of the 3-day DI model to reproduce quickly the effects of microgravity on spine morphology. Our findings raise the question of the subject selection in spatial studies, especially studies about spine morphology and reconditioning programs after space flight. These results may contribute to a better understanding of the mechanisms underlying disc herniation and may serve as the basis to develop countermeasures for astronauts and to prevent IVD herniation and back pain on Earth.

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Section: Discussionmentioning

confidence: 99%

Intervertebral Disc Swelling Demonstrated by 3D and Water Content Magnetic Resonance Analyses after a 3-Day Dry Immersion Simulating Microgravity

et al. 2016

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“…In addition to lumbar spine degeneration, LDH patients also often experience reduced muscle strength and decreased endurance. There is evidence to suggest that highly fatigable lumbar muscles are closely related to LDH [7]. Although the exact pathophysiology of LDH remains elusive, the evaluation of related muscles is valuable when assessing these patients.…”

Section: Introductionmentioning

confidence: 99%

“…Since pain perception influences the development of activity limitations in patients with LDH, it is important to assess muscle function and activation while patients are walking. Additionally, muscle deficits may contribute to gait disturbances or limps [7], and if we can identify the patterns of lower limb muscle activities in LDH patients using SEMG while walking, we can effectively guide their evaluation, diagnosis, and treatment.…”

Section: Introductionmentioning

confidence: 99%

Electromyography activities in patients with lower lumbar disc herniation

Qie

et al. 2020

BMR

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BACKGROUND: Lumbar disc herniation (LDH) can affect lower limb muscle function resulting in an abnormal gait. This study aims to use surface electromyography (SEMG) to evaluate patients with L4/L5 and L5/S1 LDH throughout muscle movement. METHODS: Twenty L4/L5 LDH patients (L5 Group), twenty L5/S1 LDH patients (S1 Group), and twenty healthy controls (Healthy) were recruited for the study. SEMG of bilateral tibialis anterior (TA) and lateral gastrocnemius (LG) muscles of patients were recorded using the DELSYS Wireless EMG System (Trigno TM Wireless Systems, Delsys Inc., USA). Root-mean-square (RMS), mean power frequency (MPF), and median frequency (MF) were compared between bilateral limbs in each participant. RESULTS: Reduced MPF and MF was found in TA measurements of the L5 Group and LG measurements of the S1 Group. The MPF and MF of the TA of symptomatic limbs of the L5 Group were reduced when compared to asymptomatic limbs (p = 0.006, p = 0.012, p < 0.05), and there were no significant differences in LG measurements (p > 0.05). The LG MPF and MF of the S1 Group in symptomatic limbs were reduced when compared to asymptomatic limbs (p = 0.006, p = 0.017, p < 0.05), and there were no significant differences in TA measurements (p > 0.05). Although there were no significant differences in RMS between bilateral limbs of the L5 and S1 Groups, we found some changes in RMS curves. First, compared to asymptomatic limbs of L4/L5LDH patients, β-peaks in the TA of symptomatic limbs appeared earlier. Second, two peaks in the LG of symptomatic limbs were found in L5/S1 LDH patients. CONCLUSION: TA is affected in patients with LDH of L4/L5, and LG is affected in patients with LDH of L5/S1. As demonstrated, SEMG can identify LDH-related muscle dysfunction.

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“…According to published literature [25,29], sensorial factors influence the recruitment of TA and contributed to MF fatigue. The study by Ramos et al [30] utilized surface EMG to assess fatigue of MF and PBU to detect activity of TA in patients with LBP. They reported that patients with LBP had difficulties to depress the abdominal wall at the PBU pressure 70 mmHg and higher.…”

Section: Differences In Muscle Activation Patternmentioning

confidence: 99%

Trunk muscle activity during pressure feedback monitoring among individuals with and without chronic low Back pain

et al. 2020

BMC Musculoskelet Disord

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Background: Pressure biofeedback unit (PBU) is a widely used non-invasive device to assist core muscle training by providing pressure feedback. The aim this study was to compare the muscle activities of transverse abdominis (TA) and multifidus (MF) at different target pressures (50, 60 and 70 mmHg) of PBU between individuals with and without cLBP. Methods: Twenty-two patients with chronic LBP (cLBP) and 24 age matched healthy individuals were recruited. Electromyography (EMG) signals were recorded from the TA and MF muscles while the TA and MF were contracted to achieve PBU pressure value of 50, 60 and 70 mmHg in random order. The average EMG amplitude (AEMG) of 3 replicate trials was used in the analysis after normalization to %MVIC. %MVIC is defined as the mean of the three AEMG divided by the AEMG of MVIC. Two-way ANOVA was performed to assess the effects of groups (healthy and cLBP) and the three different target pressures of PBU. Independent sample t-test was conducted to compare between the two groups. Spearman's correlation analysis was performed in the cLBP group to determine potential correlations between EMG activity, NPRS and ODI. Results: The %MVIC of the TA and MF in the cLBP group were higher than the control group at each pressure value (P<0.05). During maximal voluntary isometric contraction (MVIC) of TA and MF, compared with healthy groups, cLBP subjects showed a decrease (TA mean = 47.61 μV; MF mean = 42.40 μV) in EMG amplitudes (P ≤ 0.001). The MVIC of MF was negatively correlated with Numerical Pain Rating Scale (r = − 0.48, P = 0.024) and Oswestry Disability Index (r = − 0.59, P = 0.004). Conclusions: We measured the trunk muscles activities at different PBU pressure values, which allows the individual to estimate trunk muscle contraction via PBU. Clinicians may be able to confer the data obtained through EMG recordings to adjust the exercise intensity of PBU training accordingly.

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Are lumbar multifidus fatigue and transversus abdominis activation similar in patients with lumbar disc herniation and healthy controls? A case control study

Abstract: Individuals with lumbar disc herniation associated with low back pain have increased fatigue of the LM and decreased activation of the TrA, when compared to the control group.

Cited by 23 publications

References 38 publications

Intervertebral Disc Swelling Demonstrated by 3D and Water Content Magnetic Resonance Analyses after a 3-Day Dry Immersion Simulating Microgravity

Intervertebral Disc Swelling Demonstrated by 3D and Water Content Magnetic Resonance Analyses after a 3-Day Dry Immersion Simulating Microgravity

Electromyography activities in patients with lower lumbar disc herniation

Trunk muscle activity during pressure feedback monitoring among individuals with and without chronic low Back pain

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