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

Júlia Jubany, Lieven Danneels, Rosa Angulo-Barroso, Júlia Jubany, Lieven Danneels, Rosa Angulo-Barroso

Abstract

Background: Chronic low back pain (CLBP) has been associated with altered trunk muscle responses as well as increased muscle fatigability. CLBP patients and fatigued healthy subjects could experience similar neuromuscular strategies to attempt to protect the spine. The current study examined muscle activation differences between healthy and CLBP subjects following a perturbation. In addition, the possible role of muscle fatigue was evaluated by investigating the healthy control subjects in a non-fatigued and a fatigued condition. Both experiments were combined to evaluate possible similar strategies between CLBP and fatigued samples.

Methods: Cross-sectional study where 24 CLBP subjects and 26 healthy subjects were evaluated. Both groups (CLBP vs. healthy) and both conditions (non-fatigued and a fatigued condition) were evaluated while a weight was suddenly dropped on a held tray. Erector spinae, multifidus, obliques and biceps brachii were recorded using surface electromyography. Variables describing the bursts timing and variables describing the amount of muscle activity (number of bursts and amplitude increase) post impact were studied. The analysis between groups and conditions was carried out using ANOVAs with repeated measurements for the muscle factor.

Results: CLBP subjects reacted similarly to healthy subjects regarding muscle activity post impact. However, the CLBP group showed temporal characteristics of muscle activity that were in between the fatigued and non-fatigued healthy group. Clear differences in muscle activity were displayed for healthy subjects. Fatigued healthy subjects presented more reduced activity after impact (upper limb and trunk muscles) than non-fatigued healthy subjects and different temporal characteristic in the same way than CLBP patients. This same temporal characteristic with CLBP and healthy fatigued people was a delay of the first burst of muscle activity after impact.

Conclusion: Though similar muscle pattern existed between CLBP and healthy people, CLBP temporal characteristics of muscle activity showed a pattern in between healthy people and fatigued healthy people. While the temporal muscle pattern dysfunction used by CLBP subjects could be related to maladaptive patterns, temporal and muscle activity characteristics used by healthy fatigued people may lead to back injuries.

Keywords: Electromyography; Fatigue; Low back pain; Muscle pattern; Semi-squat.

Figures

Fig. 1
Fig. 1
External perturbation test
Fig. 2
Fig. 2
Temporal representation of the average value of the bursts of each muscle (biceps brachii (BB) thoracic spinal erector (SE) right multifidus (RM), left multifidus (LM), external oblique (EO), internal oblique (IO)) for both groups and for the condition of fatigue. a Group without lumbar pathology (H); b Group with nonspecific chronic low back pain (CLBP); c Condition of fatigue (With-F). The coloured bars represent, for different muscles, the moment when the first and second bursts after impact starts and their duration. The striped areas represent the parts of the bursts belonging to two different bursts (overlapping)
Fig. 3
Fig. 3
Mean and standard deviation (error bars) of each muscle (biceps brachii (BB), thoracic spinal erector (SE), right multifidus (RM), left multifidus (LM), external oblique (EO), internal oblique (IO)) of variables describing the timing and variables describing the amount of muscle activity post impact between healthy subjects and those with chronic low back pain and between healthy subjects without fatigue and healthy subjects with fatigue
Fig 4
Fig 4
Mean and standard deviation (error bars) of each muscle (biceps brachii (BB), thoracic spinal erector (SE), right multifidus (RM), left multifidus (LM), external oblique (EO), internal oblique (IO)) of the variable of first burst post impact between healthy subjects, those with chronic low back pain and between healthy subjects with fatigue

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Source: PubMed

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