Co-contraction characteristics of lumbar muscles in patients with lumbar disc herniation during different types of movement

Abstract

BackgroundMuscular performance is an important factor for the mechanical stability of lumbar spine in humans, in which, the co-contraction of lumbar muscles plays a key role. We hypothesized that when executing different daily living motions, the performance of the lumbar muscle co-contraction stabilization mechanism varies between patients with lumbar disc herniation (LDH) and healthy controls. Hence, in this study, co-contraction performance of lumbar muscles between patients with LDH and healthy subjects was explored to check if there are significant differences between the two groups when performing four representative movements.MethodsTwenty-six LDH patients (15 females, 11 males) and a control group of twenty-eight subjects (16 females, 12 males) were recruited. Surface electromyography (EMG) signals were recorded from the external oblique, lumbar multifidus, and internal oblique/transversus abdominis muscles during the execution of four types of movement, namely: forward bending, backward bending, left lateral flexion and right lateral flexion. The acquired EMG signals were segmented, and wavelet decomposition was performed followed by reconstruction of the low-frequency components of the signal. Then, the reconstructed signals were used for further analysis. Co-contraction ratio was employed to assess muscle coordination and compare it between the LDH patients and healthy controls. The corresponding signals of the subjects in the two groups were compared to evaluate the differences in agonistic and antagonistic muscle performance during the different motions. Also, sample entropy was applied to evaluate complexity changes in lumbar muscle recruitment during the movements.ResultsSignificant differences between the LDH and control groups were found in the studied situations (p < 0.05). During the four movements considered in this study, the participants of the LDH group exhibited a higher level of co-contraction ratio, lower agonistic, and higher antagonistic lumbar muscle activity (p < 0.01) than those of the control group. Furthermore, the co-contraction ratio of LDH patients was dominated by the antagonistic muscle activity during the movements, except for the forward bending motion. However, in the healthy control group, the agonistic muscle activity contributed more to the co-contraction ratio with an exception for the backward bending motion. Conversely, the sample entropy value was significantly lower for agonistic muscles of LDH group compared to the control group (p < 0.01) while the entropy value was significantly greater in antagonistic muscles (p < 0.01) during the four types of movement, respectively.ConclusionsLumbar disc herniation patients exhibited numerous variations in the evaluated parameters that reflect the co-contraction of lumbar muscles, the agonistic and antagonistic muscle activities, and their respective sample entropy values when compared with the healthy control group. These variations could be due to the compensation mechanism that was required to stabilize the spine. The resu...

Dysfunctional muscle activities and co-contraction in the lower-limb of lumbar disc herniation patients during walking

“…LDH patients should strengthen muscle activities of the TA and LG, especially the RF, and weaken the muscle activity of the BL by choosing an appropriate rehabilitation training. Our findings are consistent with those of previous studies showing greater co-contraction between antagonistic muscles around the lumbar region of LDH patients and in the lower limb of older adults; additionally, this observation is extended to the lower limb muscles of LDH patients during walking 3,19 . The TA-LG co-contraction increased in LDH patients as an inefficient muscular coordination strategy, which can compensate for pain, numbness, stability, and proprioception caused by prolonged muscle co-contraction or disordered timing of muscle activation in the TA and LG during walking 5,26 .…”

“…Older adults showed increased muscle co-contraction of the lower extremity to stiffen joints, in order to compensate for deteriorations in postural control and sensory processing 15 . A previous study showed inadequate muscular coordination of LDH patients considering the greater co-contraction between antagonistic muscles around the lumbar region during backward bending 3 . Although co-contraction reflects the neuromuscular control and coordination between muscles during walking, the lower-limb intermuscular co-contraction during walking in LDH patients has not been reported.…”

Evaluation of the abdominal transverse muscle in individuals with low back pain: a literature review

“…9,20 One study evaluated the activation of the stabilizing musculature in different situations, evaluating the neuromuscular activation during eccentric activity, observing that there was an increase in the activation of the antagonist (Transverse Abdominal) during spinal extension compared to the control group. 22 In individuals with acute and subacute low back pain, no change in neuromuscular activation was observed between the groups, suggesting that these changes may be related to the process of pain chronification.…”

“…Electroneuromyography was the most widely used method for assessing neuromuscular muscle activation, being used in 8 studies, but no review study was observed for validation of the method. [7][8][9]17,18,20,22,23 Regarding the alterations in neuromuscular activation it was observed that individuals with pain present a delay in the anticipatory neuromuscular activation at the beginning of the movement of the lower limbs, when getting up and during long periods in the sitting position. 7,8,20,23 These situations have been reported as frequent complaints from patients with pain.…”

Analysis of Influencing Factors on Short-Term Efficacy of Percutaneous Transforaminal Endoscopic Lumbar Discectomy in the Treatment of Lumbar Disc Herniation

“…Lumbar disc herniation (LDH) is a common disease in spine surgery. It is the most common cause of lower back and lower leg pain and it mainly occurs in middleaged and old people [1] . The clinical manifestations of LDH include lumbago and sciatica, as well as pain, numbness and weakness of lower limbs [2] .…”