Document Detail

Activation of lumbar paraspinal and abdominal muscles during therapeutic exercises in chronic low back pain patients.
MedLine Citation:
PMID:  15129408     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To assess the activities of paraspinal and abdominal muscles during therapeutic exercises for the treatment of patients with nonspecific chronic low back pain (CLBP), and to study the effects of active physical rehabilitation on these activities. DESIGN: A cross-sectional study comparing muscle activities during 18 stabilization exercises, and a prospective follow-up of patients with CLBP during rehabilitation. SETTING: Rehabilitation clinic in university hospital in Finland. PARTICIPANTS: Nine volunteers (5 men, 4 women) aged 27 to 58 years. INTERVENTION: Three months of active outpatient rehabilitation (4 to 6 times in a rehabilitation clinic, supplemented with self-motivated exercise at home) supervised by a physiotherapist. MAIN OUTCOME MEASURES: Surface electromyography was recorded bilaterally from L5 level paraspinal, rectus abdominis, and obliquus externus abdominis muscles. The recorded signal was averaged and normalized to the maximal electromyographic amplitude obtained during the maximal voluntary contraction. The measurements were taken before and after the exercise treatment period. RESULTS: CLBP patients showed variable trunk muscle activity patterns during the different therapeutic exercises, similar to those that we reported earlier in healthy subjects. The maximal trunk isometric extension (pre, 147.3+/-75.9Nm; post, 170.1+/-72.3Nm) and flexion (pre, 72.0+/-37.9Nm; post, 93.5+/-42.5Nm) torques did not show a significant changes during the exercise period. However, trunk rotation-flexion torque (pre, 52.9+/-26.5Nm; post, 82.4+/-65.8Nm) increased significantly (35.8%) after the exercise period (P<.05). The corresponding maximal electromyographic amplitudes of back and abdominal muscles remained unchanged. Disability, as assessed by visual analog scale and Oswestry Disability Index, did not change. CONCLUSIONS: The CLBP patients performed therapeutic exercises with similar abdominal and back extensor muscle activities in the same way as the healthy subjects in our earlier studies. In this study, active physical rehabilitation had no effect on the abdominal and back muscle activities or on pain and functional disability indices.
Jari P Arokoski; Taru Valta; Markku Kankaanpää; Olavi Airaksinen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  85     ISSN:  0003-9993     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-05-06     Completed Date:  2004-06-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  823-32     Citation Subset:  AIM; IM    
Department of Physical and Rehabilitation Medicine, Kuopio University Hospital, Kuopio, Finland.
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MeSH Terms
Abdominal Muscles / physiology*
Chronic Disease
Cross-Sectional Studies
Exercise Therapy*
Low Back Pain / rehabilitation*
Lumbosacral Region
Middle Aged
Muscle, Skeletal / physiology*

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