File
Hofste A1,2, Soer R1,3, Salomons E4, Peuscher J5, Wolff A2, van der Hoeven H6, Oosterveld F1, Groen G2, Hermens H7
1Saxion University of Applied Sciences, Health, Enschede, Netherlands, 2University Medical Center Groningen, Pain Anesthesiology, Groningen, Netherlands, 3University Medical Center Groningen, Spine Center, Groningen, Netherlands, 4Saxion University of Applied Sciences, Ambient Intelligence, Enschede, Netherlands, 5Twente Medical Systems International, Oldenzaal, Netherlands, 6University Medical Center Groningen, Clinical Neurophysiology, Groningen, Netherlands, 7University of Twente, Biomedical Signals & Systems, Enschede, Netherlands
Background: There is debate on the contributing role of the lumbar multifidus in onset and persistence of low back pain, and consequently on the effect of stabilizing therapies. It is unknown if studies based on electromyography represent isolated multifidus contraction or whether there is overlap from surrounding musculature.
Purpose: To compare intramuscular EMG (iEMG) and surface EMG (sEMG) from lumbar multifidus muscle and erector spinae muscle during different physiotherapeutical tests
Methods: In a cross sectional design, fifteen healthy adults performed five tests: resting, two submaximal contraction, abdominal contraction and a biofeedback test. iEMG and sEMG were used to measure lumbar multifidus muscle and erector spinae muscle. Three outcome measures were studied using correlation coefficients:
(a) direct signal of the iEMG compared the sEMG of the corresponding muscle,
(b) co-contraction signal between the intramuscular multifidus and intramuscular erector spinae and
(c) cross-talk signal, the correlation between the multifidus iEMG and the erector spinae sEMG and vice versa.
Results: Correlation coefficients of direct signal lumbar multifidus muscle and erector spinae muscle varied between r = 0.38 - 0.84. In all test, co-contraction correlation ranged between r = 0.30 - 0.74 and cross-talk correlations varied between r = 0.26 - 0.75. Most cross-talk is found during the biofeedback test, for sEMG erector spinae r = 0.71 and for sEMG lumbar multifidus r = 0.75.
Conclusion(s): In all the tests in this study, co-contraction and cross-talk is measured in the surface electrodes meaning that sEMG represents iEMG insufficiently. None of the previously validated lumbar multifidus muscle tests were accurate enough to measure isolated lumbar multifidus muscle activity.
Implications: Multifidus and erector musculature are active simultaneously in all multifidus tests, and separate contraction does not appear. A functional approach, rather than a specific stabilization therapy should be followed in re-activation of patients with low back pain
Keywords: electromyography, low back pain, multifidus
Funding acknowledgements: Stichting Innovatie Alliantie (Raak-SIA)
Purpose: To compare intramuscular EMG (iEMG) and surface EMG (sEMG) from lumbar multifidus muscle and erector spinae muscle during different physiotherapeutical tests
Methods: In a cross sectional design, fifteen healthy adults performed five tests: resting, two submaximal contraction, abdominal contraction and a biofeedback test. iEMG and sEMG were used to measure lumbar multifidus muscle and erector spinae muscle. Three outcome measures were studied using correlation coefficients:
(a) direct signal of the iEMG compared the sEMG of the corresponding muscle,
(b) co-contraction signal between the intramuscular multifidus and intramuscular erector spinae and
(c) cross-talk signal, the correlation between the multifidus iEMG and the erector spinae sEMG and vice versa.
Results: Correlation coefficients of direct signal lumbar multifidus muscle and erector spinae muscle varied between r = 0.38 - 0.84. In all test, co-contraction correlation ranged between r = 0.30 - 0.74 and cross-talk correlations varied between r = 0.26 - 0.75. Most cross-talk is found during the biofeedback test, for sEMG erector spinae r = 0.71 and for sEMG lumbar multifidus r = 0.75.
Conclusion(s): In all the tests in this study, co-contraction and cross-talk is measured in the surface electrodes meaning that sEMG represents iEMG insufficiently. None of the previously validated lumbar multifidus muscle tests were accurate enough to measure isolated lumbar multifidus muscle activity.
Implications: Multifidus and erector musculature are active simultaneously in all multifidus tests, and separate contraction does not appear. A functional approach, rather than a specific stabilization therapy should be followed in re-activation of patients with low back pain
Keywords: electromyography, low back pain, multifidus
Funding acknowledgements: Stichting Innovatie Alliantie (Raak-SIA)
Topic: Musculoskeletal: spine; Electrophysical & isothermal agents; Pain & pain management
Ethics approval required: Yes
Institution: University Medical Center Groningen
Ethics committee: METC of UMCG
Ethics number: NL58616.042.16
All authors, affiliations and abstracts have been published as submitted.
