The relationship of extraneous movements to lumbar paraspinal muscle activity: Implications for EMG biofeedback training applications to low back pain patients

Wolf, Steven L.; Wolf, Lois B.; Segal, Richard

doi:10.1007/bf00999341

Cited by 19 publications

(8 citation statements)

References 14 publications

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“…The functional level of each participant was determined according to the wrist and digit active extension range of motion, a measure that had been determined to predict improvement in UE function use in past biofeedback studies 15,16 and had adopted as an inclusion criterion for many subsequent CIMT studies. Those in the high functioning group demonstrated active wrist extension of at least 20 degrees and active extension of the metacarpophalangeal joints and interphalangeal joints of at least 10 degrees.…”

Section: Methodsmentioning

confidence: 99%

Can the Wolf Motor Function Test be Streamlined?

Bogard

Wolf

Zhang

et al. 2009

Neurorehabil Neural Repair

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Background To assess upper extremity (UE) capabilities following stroke, the Wolf Motor Function Test (WMFT) measures time to complete 15 UE tasks and 2 strength tasks, but takes 30 to 45 minutes for the clinician to complete. Objective In an effort to streamline the WMFT, this study evaluated the association between the magnitude of improvement on any timed task of the WMFT and the change score on all other tasks among participants in the Extremity Constraint Induced Therapy Evaluation (EXCITE) trial. Methods This association was evaluated using regression methods according to chronicity and controlling for key covariates (functional level, gender, concordance) for log mean WMFT scores. Results After controlling for covariates, 6 tasks (hand to table (front), hand to box (front), reach and retrieve, lift can, lift pencil, and fold towel) influenced the overall WMFT score for survivors meeting EXCITE criteria and treated within 3 to 9 months poststroke. Six different tasks (extend elbow weight, hand to box (front), lift can, lift pencil, turn key in lock, and fold towel) influenced the overall WMFT score for those receiving constraint-induced movement therapy (CIMT) 1 year later. The importance of certain tasks relative to others may best represent overall UE function, but this streamlining enables the clinician to prioritize these tasks in the evaluation. Conclusions The delineation of those tasks depends on the time poststroke from enrollment to CIMT. This study demonstrates that the WMFT can be streamlined from 17 to 6 tasks.

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Section: Methodsmentioning

confidence: 99%

Can the Wolf Motor Function Test be Streamlined?

Bogard

Wolf

Zhang

et al. 2009

Neurorehabil Neural Repair

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“…Reliability was assessed on the LM percentage thickness change data using the intraclass correlation coefficient (ICC). 39 The reliability of test-retest designs is best analyzed using 2-way ICC models 46 ; in this study, the reliability of an average of 3 trials, which has been shown to optimize the precision of estimates, 27 was used to assess interexaminer reliability (ICC 3,3 ). To determine whether the repeatability of image measurement could impact same-day interexaminer reliability estimates, a single examiner (D.M.D.)…”

Section: Methodsmentioning

confidence: 99%

Behavior of the Lumbar Multifidus During Lower Extremity Movements in People with Recurrent Low Back Pain During Symptom Remission

MacDonald¹,

Dawson²,

Hodges³

2011

Journal of Orthopaedic & Sports Physical Therapy

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Study Design Cross-sectional design. Objectives To investigate lumbar multifidus (LM) thickness differences, using ultrasound imaging in people during remission from recurrent low back pain (LBP) and healthy participants, during the following lower extremity movements: (1) active straight leg raise (ASLR), (2) crook-lying active leg raise (CLR), and (3) prone straight leg raise (PSLR). Background ASLR, CLR, and PSLR are used clinically to challenge the ability of the trunk muscles to control spinal motion in people with LBP, and it is believed that decreased LM activity is related to altered spinal control in this population. However, it is unclear whether LM behavior differs between healthy individuals and people with recurrent LBP during symptom remission in such tasks. Methods The present study used ultrasound imaging to measure LM percentage thickness change parasagitally at the L4-5 and L5-S1 levels in people with recurrent LBP during symptom remission and in healthy participants, during the ASLR, CLR, and PSLR tasks. Results LM percentage thickness change was greater in the recurrent LBP group than in healthy participants during the PSLR task (P<.01) and greater in both groups during the PSLR than the ASLR and CLR tasks (P<.01). LM percentage thickness change was greatest at L4-5 in both groups (P<.01) and during all tasks (P≤.02). No difference was found in LM percentage thickness change between groups in either the ASLR (P = .70)or CLR(P = .69)task. Conclusions These data suggest that, during symptom remission, individuals with recurrent LBP, compared to healthy individuals, may have greater activity in at least some parts of the LM. Further investigation is required to determine whether the LM percentage thickness change observed in this study may be explained by differential changes in deep and/or superficial fibers of LM activity. This observation may have implications for clinical practice, but requires further investigation. J Orthop Sports Phys Ther 2011;41(3):155–164, Epub 4 January 2011. doi:10.2519/jospt.2011.3410

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“…First, participants were either in pain during testing and the direct effect of pain on muscle responses cannot be excluded, or second, recordings were made with surface electromyography (EMG), which makes it impossible to draw conclusions about activity of specific muscles. 10,11 Investigation of the response of specific paraspinal muscles, and their discrete fascicles, to trunk loading is important because paraspinal muscles do not contribute equally to the control of spinal motion nor are they uniformly affected by LBP. Within the paraspinal muscles, the lumbar multifidus contributes up to 2/3 of the stiffness at individual lumbar segments 12 and has a high cross-sectional area and a low fiber length-to-muscle length ratio, making it uniquely designed to generate high forces.…”

mentioning

confidence: 99%