Voluntary activation of trunk extensors appears normal in young adults who have recovered from low back pain
File(s)Chiou et al 2015 EJP accepted.docx (110.28 KB)
Accepted version
Author(s)
Chiou, SY
Jeevathol, A
Odedra, A
Strutton, PH
Type
Journal Article
Abstract
Background
Low back pain (LBP) is associated with alterations in control of trunk movements and changes within central nervous system (CNS). Evidence shows that some of these alterations within the CNS are reversible when the symptoms are relieved, whereas other shows the opposite. Therefore, the purpose of the current study was to investigate whether alterations in voluntary activation (VA) of central neural drive, as assessed using twitch interpolation to measure VA, are present in subjects with a history of low back pain (HLBP), who are free from pain at the time of experiment.
Methods
Twelve adults with HLBP and 12 controls participated. Bilateral electromyographic recordings were obtained from erector spiane muscles at two vertebral levels (T12 and L4) and from rectus abdominis. Participants performed a series of brief isometric back extensions (50–100% maximum voluntary contraction) during which transcranial magnetic stimulation was delivered. The sizes of the evoked (superimposed) twitches were measured using dynamometry and VA was derived. The amplitude of motor evoked potentials (MEPs) and duration of cortical silent period (CSP) in erector spinae muscles were calculated; questionnaires were used to evaluate disability, levels of physical activity, quality of life and pain.
Results
The level of VA was not significantly different between HLBP and control groups. Additionally, there were no between‐group differences in the time‐to‐peak amplitudes of the twitches, MEP amplitudes or duration of CSP.
Conclusions
The ability to voluntarily activate back extensor muscles maximally does not appear to be impaired in subjects with a history of LBP during pain‐free episodes.
Low back pain (LBP) is associated with alterations in control of trunk movements and changes within central nervous system (CNS). Evidence shows that some of these alterations within the CNS are reversible when the symptoms are relieved, whereas other shows the opposite. Therefore, the purpose of the current study was to investigate whether alterations in voluntary activation (VA) of central neural drive, as assessed using twitch interpolation to measure VA, are present in subjects with a history of low back pain (HLBP), who are free from pain at the time of experiment.
Methods
Twelve adults with HLBP and 12 controls participated. Bilateral electromyographic recordings were obtained from erector spiane muscles at two vertebral levels (T12 and L4) and from rectus abdominis. Participants performed a series of brief isometric back extensions (50–100% maximum voluntary contraction) during which transcranial magnetic stimulation was delivered. The sizes of the evoked (superimposed) twitches were measured using dynamometry and VA was derived. The amplitude of motor evoked potentials (MEPs) and duration of cortical silent period (CSP) in erector spinae muscles were calculated; questionnaires were used to evaluate disability, levels of physical activity, quality of life and pain.
Results
The level of VA was not significantly different between HLBP and control groups. Additionally, there were no between‐group differences in the time‐to‐peak amplitudes of the twitches, MEP amplitudes or duration of CSP.
Conclusions
The ability to voluntarily activate back extensor muscles maximally does not appear to be impaired in subjects with a history of LBP during pain‐free episodes.
Date Issued
2015-11-01
Date Acceptance
2015-01-07
Citation
European Journal of Pain, 2015, 19 (10), pp.1506-1515
ISSN
1090-3801
Publisher
Wiley
Start Page
1506
End Page
1515
Journal / Book Title
European Journal of Pain
Volume
19
Issue
10
Copyright Statement
© 2015 European Pain Federation ‐ EFIC®. This is the peer reviewed version of the following article, which has been published in final form at https://onlinelibrary.wiley.com/doi/full/10.1002/ejp.684. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Sponsor
Dunhill Medical Trust
Dunhill Medical Trust
The INSPIRE Foundation
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000362691400013&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
R401/0215
R401/0215
N/A
Subjects
Science & Technology
Life Sciences & Biomedicine
Anesthesiology
Clinical Neurology
Neurosciences
Neurosciences & Neurology
TRANSCRANIAL MAGNETIC STIMULATION
ERECTOR SPINAE
CORTICOSPINAL EXCITABILITY
TWITCH INTERPOLATION
HUMAN MUSCLES
MOTOR CORTEX
ENDURANCE
STRENGTH
QUESTIONNAIRE
RELIABILITY
Publication Status
Published
Date Publish Online
2015-02-25