Effect of Increased Lumbar Lordosis on Lumbar Multifidus and Longissimus Thoracis Activation During Quadruped Exercise in Patients With Chronic Low Back Pain: An EMG Study

Abstract

The objective was to investigate the electromyographic activity of the lumbar multifidus (MF) muscle and longissimus thoracis muscle, along with their activity ratio (MF longissimus thoracis ratio), during quadruped stabilization exercise performed with neutral posture and with increased lumbar lordosis in patients with chronic low back pain (CLBP). A total of 23 patients with CLBP (12 females and 11 males) were recruited based on inclusion and exclusion criterion. Each patient performed 4 exercises in random order, with surface electromyography electrodes and an electrogoniometer attached. A cross-sectional study design was used to measure the amplitude of muscle activation (as a percentage of maximum voluntary contraction) in each patient across the 2 muscles (MF and longissimus thoracis) during quadruped stabilization exercise with neutral posture and with increased lumbar lordosis. A 2-way analysis of variance was conducted, which demonstrated a statistically significant increase in the recruitment of MF with increased lumbar lordosis in patients with CLBP during quadruped exercise. An increase of 9.7% and 16.9% maximum voluntary contraction in MF electromyographic activity was observed in lumbar lordosis posture during the quadruped leg raise and quadruped leg-arm raise exercise, respectively (P < .01), when compared to the neutral posture. The increased recruitment of MF with lumbar lordosis in the quadruped position has strong implications in the assessment and management of patients with CLBP.

Differences in Lumbar Multifidus Activity and its Association with Lumbar Range of Motion among patients With Unilateral Chronic Low Back Pain

“…The increased activity in painful side LM may be in response to the perception of pain in multifidus. 16,17 The results of previous studies with the comparison of symptomatic and symptomatic individuals with CLBP and with the comparison of painful and nonpainful sides are the same as current study elaborating the higher muscle contraction in CLBP than control. 17,18 However, contrary to this another study found no significant difference between non-painful and painful individuals with CLBP 19 .…”

“…16,17 The results of previous studies with the comparison of symptomatic and symptomatic individuals with CLBP and with the comparison of painful and nonpainful sides are the same as current study elaborating the higher muscle contraction in CLBP than control. 17,18 However, contrary to this another study found no significant difference between non-painful and painful individuals with CLBP 19 . These differences in results may be due to differences in movement during the measurement of %MVC.…”

Immediate Effect of Serratus Posterior Inferior Muscle Direction Taping on Thoracolumbar Junction Rotation Angle During One Arm Lifting in the Quadruped Position

“…In addition, NET can increase joint stability by improving proprioception to control joint alignment [19,45,46]. When TLJ rotation occurs, a neutral position is maintained by stabilizers and rotators, such as the LD, multifidus, and SPI [47]. This is consistent with the fact that if taping is applied parallel to the muscle fibers, it can facilitate muscle function [16][17][18].…”

Asymmetric Biomechanical Properties of the Paravertebral Muscle in Elderly Patients With Unilateral Chronic Low Back Pain: A Preliminary Study

“…Pain increases muscle tone, which then aggravates pain, leading to improper postural control ( Roland, 1986 ; Lo et al, 2019 ). Although there are many methods for treating CLBP ( Rubinstein et al, 2011 ; Haładaj and Topol, 2016 ), selection of appropriate intervention measures and their effects should be clinically assessed ( Kravitz et al, 1981 ; Shah et al, 2020 ). Manual palpation is often used for clinical evaluation of musculoskeletal diseases, such as lower back muscles and spine ( Abbott et al, 2009 ; Masaki et al, 2017 ).…”