Individuals With Impaired Lumbopelvic Control Demonstrate Lumbar Multifidus Muscle Activation Deficit Using Ultrasound Imaging in Conjunction With Electrical Stimulation: A Cross-sectional Study

Sungnak, Panakorn; Songjaroen, Sranya; Krityakiarana, Warin; Wang, Hsing‐Kuo; Richards, Jim; Wattananon, Peemongkon

doi:10.1016/j.apmr.2022.02.010

Cited by 3 publications

(12 citation statements)

References 43 publications

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“…Then, the researcher placed the RUSI transducer over the painful side of the LM (2 cm lateral to the lower half of the L4 spinous process; Fig. 2 A) 14 , 30 . Several EMG and MRI studies showed no significant difference between painful and non-painful sides 11 – 13 .…”

Section: Methodsmentioning

confidence: 99%

“…Lumbar multifidus muscle (LM) is responsible for static and dynamic stability of the lumbar spine 11 – 14 . Alteration of the LM can cause an inability to control the lumbar spine resulting in MCI.…”

Section: Introductionmentioning

confidence: 99%

“…Electromyography studies reveal decreased bilateral LM activity during functional tasks 12 , 13 . One study investigated LM activation using ultrasound imaging in patients with CLBP suspected to have underlying MCI 14 . The researchers found lower LM activation in patients with CLBP during remission compared with individuals without LBP 14 .…”

Section: Introductionmentioning

confidence: 99%

“…One study investigated LM activation using ultrasound imaging in patients with CLBP suspected to have underlying MCI 14 . The researchers found lower LM activation in patients with CLBP during remission compared with individuals without LBP 14 . Although reduced LM activation can be resulted from several factors including muscle atrophy, fatty infiltration, or slow-to-fast muscle transition 13 , recent studies demonstrated that LM activation deficit may be caused by reduced neural drive from the primary motor cortex (M1) 15 – 18 .…”

Section: Introductionmentioning

confidence: 99%

“…However, this proposed mechanism has not been systematically investigated. In addition, some studies found changes in cortical excitability 15 – 18 , while others found LM activation deficits in patients with CLBP 12 – 14 . However, no study has investigated the relationship between cortical excitability and LM activation.…”

Section: Introductionmentioning

confidence: 99%

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Cortical excitability and multifidus activation responses to transcranial direct current stimulation in patients with chronic low back pain during remission

Wattananon,

Thu,

Maharjan

et al. 2023

Sci Rep

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Evidence indicates that patients with chronic low back pain (CLBP) have lumbar multifidus muscle (LM) activation deficit which might be caused by changes in cortical excitability. Anodal transcranial direct current stimulation (a-tDCS) can be used to restore cortical excitability. This study aimed to (1) determine the immediate effects of a-tDCS on the cortical excitability and LM activation and (2) explore the relationship between cortical excitability and LM activation. Thirteen participants with CLBP during remission and 11 healthy participants were recruited. Cortical excitability (peak-to-peak motor evoked potential amplitude; P2P and cortical silent period; CSP) and LM activation were measured at pre- and post-intervention. We found significant difference (P < 0.05) in P2P between groups. However, no significant differences (P > 0.05) in P2P, CSP and LM activation were found between pre- and post-intervention in CLBP. The CLBP group demonstrated significant correlation (P = 0.05) between P2P and LM activation. Although our finding demonstrates change in P2P in the CLBP group, one-session of a-tDCS cannot induce changes in cortical excitability and LM activation. However, moderate to strong correlation between P2P and LM activation suggests the involvement of cortical level in LM activation deficit. Therefore, non-significant changes could have been due to inadequate dose of a-tDCS.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Cortical excitability and multifidus activation responses to transcranial direct current stimulation in patients with chronic low back pain during remission

Wattananon,

Thu,

Maharjan

et al. 2023

Sci Rep

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Effects of combined anodal transcranial direct current stimulation and motor control exercise on cortical topography and muscle activation in individuals with chronic low back pain: A randomized controlled study

Sornkaew,

Thu,

Silfies

et al. 2024

Physiotherapy Res Intl

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BackgroundAberrant movement in chronic low back pain (CLBP) is associated with a deficit in the lumbar multifidus (LM) and changes in cortical topography. Anodal transcranial direct current stimulation (a‐tDCS) can be used to enhance cortical excitability by priming the neuromuscular system for motor control exercise (MCE), thereby enhancing LM activation and movement control. This study aimed to determine the effects of a 6‐week MCE program combined with a‐tDCS on cortical topography, LM activation, movement patterns, and clinical outcomes in individuals with CLBP.MethodsTwenty‐two individuals with CLBP were randomly allocated to the a‐tDCS group (a‐tDCS; n = 12) or sham‐tDCS group (s‐tDCS; n = 10). Both groups received 20 min of tDCS followed by 30 min of MCE. The LM and erector spinae (ES) cortical topography, LM activation, movement control battery tests, and clinical outcomes (disability and quality of life) were measured pre‐ and post‐intervention.ResultsSignificant interaction (group × time; p < 0.01) was found in the distance between LM and ES cortical locations. The a‐tDCS group demonstrated significantly fewer discrete peaks (p < 0.05) in both ES and LM and significant improvements (p < 0.05) in clinical outcomes post‐intervention. The s‐tDCS group demonstrated a significant increase (p < 0.05) in the number of discrete peaks in the LM cortical topography. No significant changes (p > 0.05) in LM activation were observed in either group; however, both groups demonstrated improved movement patterns.DiscussionOur findings suggest that combined a‐tDCS with MCE can separate LM and ES locations over time while s‐tDCS (MCE alone) reduces the distance. Our study did not find superior benefits of adding a‐tDCS before MCE for LM activation, movement patterns, or clinical outcomes.

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The role of an active muscular subsystem in prone instability test during rest and leg raise conditions

Maharjan

Thu

Kongoun

et al. 2023

Eur J Phys Rehabil Med

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Individuals With Impaired Lumbopelvic Control Demonstrate Lumbar Multifidus Muscle Activation Deficit Using Ultrasound Imaging in Conjunction With Electrical Stimulation: A Cross-sectional Study

Cited by 3 publications

References 43 publications

Cortical excitability and multifidus activation responses to transcranial direct current stimulation in patients with chronic low back pain during remission

Cortical excitability and multifidus activation responses to transcranial direct current stimulation in patients with chronic low back pain during remission

Effects of combined anodal transcranial direct current stimulation and motor control exercise on cortical topography and muscle activation in individuals with chronic low back pain: A randomized controlled study

The role of an active muscular subsystem in prone instability test during rest and leg raise conditions

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