Assessment by surface electromyography and therapeutic exercise in non-specific chronic low back pain. Pilot study
DOI:
https://doi.org/10.15359/mhs.22-2.20548Keywords:
low back pain, electromyography, therapeutic exercise, chronic non-specific low back painAbstract
Introduction: Chronic low back pain (CLBP) is a common and disabling disorder in Western society. The use of objective methods for its assessment is relevant because they include indicators that subjective methods do not, and thus have greater reliability and applicability. Surface electromyography seems to be useful and easy to use to objectively analyze lumbar muscle activity. Objective: (1) To evaluate in subjects with DLCI the muscular activity of lumbar spinal erectors and multifidus by means of surface electromyography; and (2) to evaluate the efficacy of a therapeutic exercise program on clinical variables such as pain, disability and kinesiophobia. Methods: 3 subjects with chronic low back pain were evaluated before and after a therapeutic exercise program with electromyography, algometer, NPRS scale, Roland Morris questionnaire and TAMPA scale (TSK-11). Results: after treatment, in the flexion-relaxation phenomenon (FFR), the root mean square (RMS) decreases, but the maximum voluntary contraction (MCV) increases in erectors and decreases in multifidus; in addition, 2 of the participants presented electromyographic silence. The exercise program is effective in reducing pain, disability and kinesiophobia; and the pain threshold to pressure increased. Conclusions: RMS, MCV and electromyographic silence in the FFR could be useful electromyography indicators to quantify therapeutic interventions in subjects with CLBP and could have clinical applicability. However, studies with a sufficiently large sample size are needed to establish reliable results.
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Arokoski, J. P., Valta, T., Kankaanpää, M., & Airaksinen, O. (2004). Activation of lumbar paraspinal and abdominal muscles during therapeutic exercises in chronic low back pain patients. Archives of Physical Medicine and Rehabilitation, 85(5). https://doi.org/10.1016/j.apmr.2003.06.013
Azghani, M. R., Nazari, J., Sozapoor, N., Jafarabadi, M. A., & Oskouei, A. E. (2019). Myoelectric activity of individual Lumbar Erector Spinae muscles variation by differing seat pan depth. International Journal of Occupational and Environmental Medicine, 10(3). https://doi.org/10.15171/ijoem.2019.1551
Borghuis, J., Hof, A. L., & Lemmink, K. A. P. M. (2008). The importance of sensory-motor control in providing core stability: Implications for measurement and training. In Sports Medicine (Vol. 38, Issue 11). https://doi.org/10.2165/00007256-200838110-00002
Calatayud, J., Escriche-Escuder, A., Cruz-Montecinos, C., Andersen, L. L., Pérez-Alenda, S., Aiguadé, R., & Casaña, J. (2019). Tolerability and muscle activity of core muscle exercises in chronic low-back pain. International Journal of Environmental Research and Public Health, 16(19). https://doi.org/10.3390/ijerph16193509
Eash, J., Olsen, A., Breur, G., Gerrard, D., & Hannon, K. (2007). FGFR1 inhibits skeletal muscle atrophy associated with hindlimb suspension. BMC Musculoskeletal Disorders, 8. https://doi.org/10.1186/1471-2474-8-32
Farina, D., Gazzoni, M., & Merletti, R. (2003). Assessment of low back muscle fatigue by surface EMG signal analysis: Methodological aspects. Journal of Electromyography and Kinesiology, 13(4). https://doi.org/10.1016/S1050-6411(03)00040-3
Gómez-Pérez, L., López-Martínez, A. E., & Ruiz-Párraga, G. T. (2011). Psychometric Properties of the Spanish Version of the Tampa Scale for Kinesiophobia (TSK). The Journal of Pain, 12(4), 425–435. https://doi.org/10.1016/J.JPAIN.2010.08.004
Greene, R. D., Frey, M., Attarsharghi, S., Snow, J. C., Barrett, M., & De Carvalho, D. (2019). Transient perceived back pain induced by prolonged sitting in a backless office chair: are biomechanical factors involved? Ergonomics, 62(11). https://doi.org/10.1080/00140139.2019.1661526
Hoffmann, T. C., Glasziou, P. P., Boutron, I., Milne, R., Perera, R., Moher, D., Altman, D. G., Barbour, V., Macdonald, H., Johnston, M., Lamb, S. E., Dixon-Woods, M., McCulloch, P., Wyatt, J. C., Chan, A.-W., & Michie, S. (2014). Better reporting of interventions: template for intervention description and replication (TIDieR) checklist and guide. BMJ (Clinical Research Ed.), 348, g1687. https://doi.org/10.1136/bmj.g1687
Kanas, M., Faria, R. S., Salles, L. G., Sorpreso, I. C. E., Martins, D. E., Da Cunha, R. A., & Wajchenberg, M. (2018). Home-based exercise therapy for treating nonspecific chronic low back pain. Revista Da Associacao Medica Brasileira, 64(9). https://doi.org/10.1590/1806-9282.64.09.824
Kastelic, K., Voglar, M., & Šarabon, N. (2018). Acute effect of full time office work in real environment on postural actions and lumbar range of motion. Journal of Electromyography and Kinesiology, 43.https://doi.org/10.1016/j.jelekin.2018.09.002
Kovacs, F. M., Llobera, J., Gil Del Real, M. T., Abraira, V., Gestoso, M., Fernández, C., & Primaria Group, K.-A. (2002). Validation of the spanish version of the Roland-Morris questionnaire. Spine, 27(5), 538–542. https://doi.org/10.1097/00007632-200203010-00016
Luna, E. G., Hanney, W. J., Rothschild, C. E., Kolber, M. J., Liu, X., & Masaracchio, M. (2019). The Influence of an Active Treatment Approach in Patients With Low Back Pain: A Systematic Review. In American Journal of Lifestyle Medicine (Vol. 13, Issue 2). https://doi.org/10.1177/1559827617697273
Macedo, L. de B., Richards, J., Borges, D. T., Melo, S. A., & Brasileiro, J. S. (2019). Kinesio Taping reduces pain and improves disability in low back pain patients: a randomised controlled trial. Physiotherapy (United Kingdom), 105(1). https://doi.org/10.1016/j.physio.2018.07.005
Magalhães, M. O., Comachio, J., Ferreira, P. H., Pappas, E., & Marques, A. P. (2018). Effectiveness of graded activity versus physiotherapy in patients with chronic nonspecific low back pain: midterm follow up results of a randomized controlled trial. Brazilian Journal of Physical Therapy, 22(1). https://doi.org/10.1016/j.bjpt.2017.07.002
Moher, D., Hopewell, S., Schulz, K. F., Montori, V., Gøtzsche, P. C., Devereaux, P. J., Elbourne, D., Egger, M., & Altman, D. G. (2010). CONSORT 2010 Explanation and Elaboration: updated guidelines for reporting parallel group randomised trials. BMJ, 340, c869. https://doi.org/10.1136/bmj.c869
Monticone, M., Ambrosini, E., Rocca, B., Foti, C., & Ferrante, S. (2016). Responsiveness of the Tampa Scale of Kinesiophobia in Italian subjects with chronic low back pain undergoing motor and cognitive rehabilitation. European Spine Journal, 25(9). https://doi.org/10.1007/s00586-016-4682-2
Nakai, Y., Kawada, M., Miyazaki, T., & Kiyama, R. (2019). Trunk muscle activity during trunk stabilizing exercise with isometric hip rotation using electromyography and ultrasound. In Journal of Electromyography and Kinesiology (Vol. 49). https://doi.org/10.1016/j.jelekin.2019.102357
Owen, P. J., Miller, C. T., Mundell, N. L., Verswijveren, S. J. J. M., Tagliaferri, S. D., Brisby, H., Bowe, S. J., & Belavy, D. L. (2020). Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. British Journal of Sports Medicine, 54(21), 1279–1287. https://doi.org/10.1136/bjsports-2019-100886
Panjabi, M. M. (2003). Clinical spinal instability and low back pain. Journal of Electromyography and Kinesiology, 13(4). https://doi.org/10.1016/S1050-6411(03)00044-0
Qiao, J., Zhang, S. L., Zhang, J., Feng, D., & Schaller, B. (2019). A study on the paraspinal muscle surface electromyography in acute nonspecific lower back pain. Medicine (United States), 98(34). https://doi.org/10.1097/MD.0000000000016904
Rose-Dulcina, K., Armand, S., Dominguez, D. E., Genevay, S., & Vuillerme, N. (2019). Asymmetry of lumbar muscles fatigability with non-specific chronic low back pain patients. European Spine Journal, 28(11). https://doi.org/10.1007/s00586-019-06140-9
Slade, S. C., Dionne, C. E., Underwood, M., & Buchbinder, R. (2016). Consensus on Exercise Reporting Template (CERT): Explanation and Elaboration Statement. British Journal of Sports Medicine, 50(23). https://doi.org/10.1136/bjsports-2016-096651
Suh, J. H., Kim, H., Jung, G. P., Ko, J. Y., & Ryu, J. S. (2019). The effect of lumbar stabilization and walking exercises on chronic low back pain: A randomized controlled trial. Medicine, 98(26), e16173. https://doi.org/10.1097/MD.0000000000016173
Suni, J. H., Kolu, P., Tokola, K., Raitanen, J., Rinne, M., Taulaniemi, A., Parkkari, J., & Kankaanpää, M. (2018). Effectiveness and cost-effectiveness of neuromuscular exercise and back care counseling in female healthcare workers with recurrent non-specific low back pain: A blinded four-arm randomized controlled trial. BMC Public Health, 18(1). https://doi.org/10.1186/s12889-018-6293-9
George SZ, Fritz JM, Silfies SP, Schneider MJ, Beneciuk JM, Lentz TA, Gilliam JR, Hendren S, Norman KS. (2021). Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. The Journal of Orthopaedic and Sports Physical Therapy, 51(11), CPG1–CPG60. https://doi.org/10.2519/JOSPT.2021.0304
Wang, S. Q., Chen, M., Wei, X., Gao, X. X., & Zhao, G. D. (2019). Clinical research on lumbar oblique-pulling manipulation in combination with sling exercise therapy for patients with chronic nonspecific low back pain. Revista Da Associacao Medica Brasileira, 65(6). https://doi.org/10.1590/1806-9282.65.6.886
Zhao, L., Manchikanti, L., Kaye, A. D., & Abd-Elsayed, A. (2019). Treatment of Discogenic Low Back Pain: Current Treatment Strategies and Future Options-a Literature Review. Current Pain and Headache Reports, 23(11), 86. https://doi.org/10.1007/s11916-019-0821-x
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