Patients with chronic low back pain (LBP) have an impaired dynamic spinal stability, which may lead to arm injuries.
OBJECTIVES:
To examine the latissimus dorsi and gluteus maximus muscles activation pattern and the upward scapular rotation in patients with chronic LBP.
METHODS:
Sixty-one right-handed males were divided into two groups: chronic LBP group ( 31) and healthy controls ( 30). The electromyography (EMG) activities of the right and left latissimus dorsi and gluteus maximus were recorded. The upward scapular rotation in different shoulder positions (neutral, 45, 90, 135 abduction and end range) was measured in both groups.
RESULTS:
The LBP group has a bilateral significant increased EMG of latissimus dorsi ( 0.05) and significantly decreased EMG of gluteus maximus ( 0.05) compared to the control group, without significant differences between the right and left sides ( 0.05). There was a significant increase in upward scapular rotation in the LBP group relative to the control group in all shoulder abduction positions on both sides. The left side upward scapular rotation was more significant than the right ( 0.05).
CONCLUSION:
Chronic LBP increased the latissimus dorsi muscle activities and decreased the gluteus maximus activities. It furthermore increased the upward scapular rotation in different shoulder abduction positions.
KentPMKeatingJL. The epidemiology of low back pain in primary care. Chiropr Osteopat2005; 13. doi: 10.1186/1746-1340-13-13.
2.
AiraksinenOBroxJICedraschiCHildebrandtJKlaber-MoffettJKovacsF, et al. Chapter 4: european guidelines for the management of chronic nonspecific low back pain. Eur Spine J2006; 15: 192-300. doi: 10.1007/s00586-006-1072-1.
3.
SilfiesSPSquillanteDMaurerPWestcottSKA. Trunk muscle recruitment patterns in specific chronic low back pain populations. Clin Biomech2005; 20: 465-473.
4.
PagePFrankCLR. Assessment and treatment of muscle imbalance: the janda approach. J Can Chiropr Assoc2012; 41: 799-800.
5.
AmirHKLeila GhamkharAMA. Effect of the abdominal hollowing and bracing maneuvers on activity pattern of the lumbopelvic muscles during prone hip extension in subjects with or without chronic low back pain: a preliminary study. J Manipulative Physiol Ther2016; 40: 106-117.
6.
VogtLPfeiferKBanzerW. Neuromuscular control of walking with chronic low-back pain. Man Ther2003; 8: 21-8. doi: 10.1054/math.2002.0476.
7.
SekiguchiTHagiwaraYMommaHTsuchiyaMKurokiKKanazawaKNR. Youth baseball players with elbow and shoulder pain have both low back and knee pain: a cross-sectional study. Knee Surgery, Sport Traumatol Arthrosc2016; 26: 1927-35. doi: 10.1177/2325967117S00391.
8.
KiblerWBMcMullenJ. Scapular dyskinesis and its relation to shoulder pain. J Am Acad Orthop Surg2003; 11: 142-51. doi: 10.5435/00124635-200303000-00008.
9.
KimJWKangMHOhJS. Patients with low back pain demonstrate increased activity of the posterior oblique sling muscle during prone hip extension. PM R2014; 14: 400-405. doi: 10.1016/j.pmrj.2013.12.006.
10.
VleemingAPool-GoudzwaardALStoeckartRVan WingerdenJPSnijdersCJ. The posterior layer of the thoracolumbar fascia: its function in load transfer from spine to legs. Spine (Phila Pa 1976)1995; 20: 753-8. doi: 10.1097/00007632-199504000-00001.
11.
do CarvalhaisVOCde OcarinoJMAraújoVLSouzaTRSilvaPLPFonsecaST. Myofascial force transmission between the latissimus dorsi and gluteus maximus muscles: an in vivo experiment. J Biomech2013; 46: 1003-7. doi: 10.1016/j.jbiomech.2012.11.044.
12.
ClarkMLucettS. NASM essentials of corrective exercise training. Sudbury, MA: Lippincott Williams & Wilkins; 2010.
13.
WattananonPSinsurinKSomprasongS. Association between lumbopelvic motion and muscle activation in patients with non-specific low back pain during forward bending task: a cross-sectional study. Hong Kong Physiother J2020; 40: 29-37. doi: 10.1142/S1013702520500043.
14.
LaudnerKGWJ. The relationship between latissimus dorsi stiffness and altered scapular kinematics among asymptomatic collegiate swimmers. Phys Ther Sport2013; 14: 50-3. doi: 10.1016/j.ptsp.2012.02.007.
15.
TaghizadehSPirouziSHemmatiLKhalediFSadatA. Clinical evaluation of scapular positioning in patients with nonspecific chronic low back pain: a case-control study. J Chiropr Med2017; 16: 195-198. doi: 10.1016/j.jcm.2017.08.003.
16.
SuehiroTMizutaniMIshidaHKobaraKOsakaHWatanabeS. Individuals with chronic low back pain demonstrate delayed onset of the back muscle activity during prone hip extension. J Electromyogr Kinesiol2015; 25: 675-80. doi: 10.1016/j.jelekin.2015.04.013.
17.
SahinNKarahanAYAlbayrakI. Effectiveness of physical therapy and exercise on pain and functional status in patients with chronic low back pain: a randomized-controlled trial. Turkish J Phys Med Rehabil2018; 64: 52-58. doi: 10.5606/tftrd.2018.1238.
18.
BrunoPABagustJ. An investigation into motor pattern differences used during prone hip extension between subjects with and without low back pain. Clin Chiropr2007; 10: 68-80. doi: 10.1016/j.clch.2006.10.002.
19.
PirouziSHidesJRichardsonCDarnellRToppenbergR. Low back pain patients demonstrate increased hip extensor muscle activity during standardized submaximal rotation efforts. Spine (Phila Pa 1976)2006; 31: 999-1005. doi: 10.1097/01.brs.0000250076.74366.9d.
20.
ElsayyadLKMatarAGAbdel-aziemAAMohamedSE. Eccentric and concentric torque of the lumbar and hip extensors in females with low back pain. Int J Physiother Res2017; 5: 2545-51.
21.
LeinonenVKankaanpääMAiraksinenOHänninenO. Back and hip extensor activities during trunk flexion/extension: effects of low back pain and rehabilitation. Arch Phys Med Rehabil2000; 81: 32-7.
22.
KouraGMKamelEAABadawyWMHamadaHAZH. Influence of gluteus maximus inhibition on upper trapezius over activity in chronic mechanical neck pain with radiculopathy. Int J Med Res Heal Sci2007; 6: 10-6.
23.
HubertyHKlingbeilJMillerMUttM. EMG analysis of latissimus dorsi, erector spinae and middle trapezius muscle activity during spinal rotation: a pilot study. Grand Forks, North Dakota, 2018.
24.
DankaertsWO’sullivanPBBurnettAFStrakerLMDanneelsLA. Reliability of EMG measurements for trunk muscles during maximal and sub-maximal voluntary isometric contractions in healthy controls and CLBP patients. J Electromyogr Kinesiol2004; 14: 333-342. doi: 10.1016/j.jelekin.2003.07.001.
25.
WatsonLBalsterSMFinchCDalzielR. Measurement of scapula upward rotation: a reliable clinical procedure. Br J Sports Med2005; 39: 599-603. doi: 10.1136/bjsm.2004.013243.
26.
StruyfFNijsJMottramSRousselNACoolsAMMeeusenR. Clinical assessment of the scapula: a review of the literature. Br J Sport Med2014; 48: 883-90. doi: 10.1136/bjsports-2012-091059.
27.
HardieRHaskewRHarrisJHughesG. The effects of bag style on muscle activity of the trapezius, erector spinae and latissimus dorsi during walking in female university students. J Hum Kinet2015; 45: 39-47. doi: 10.1515/hukin-2015-0005.
28.
NorrisCM. Spinal stabilisation. 4. Muscle imbalance and the low back. Physiotherapy1995; 81: 127-38. doi: 10.1016/S0031-9406(05)67068-X.
29.
KimJ-WKwonO-YKimT-HAnD-HOhJ. Effects of external pelvic compression on trunk and hip muscle EMG activity during prone hip extension in females with chronic low back pain. Man Ther2014; 19: 467-71. doi: 10.1016/j.math.2014.04.016.
30.
MasakiMTateuchiHKoyamaYSakumaKOtsukaNIchihashiN. Back muscle activity and sagittal spinal alignment during quadruped upper and lower extremity lift in young men with low back pain history. Gait Posture2018; 66: 221-7. doi: 10.1016/j.gaitpost.2018.09.002.
31.
AbdelraoufORAbdel-AziemAA. The relationship between core endurance and back dysfunction in collegiate male athletes with and without nonspecific low back pain. Int J Sports Phys Ther2016; 11: 337-44.
32.
GhamkharLKahlaeeAH. Trunk muscles activation pattern during walking in subjects with and without chronic low back pain: a systematic review. PM R2015; 5: 519-26. doi: 10.1016/j.pmrj.2015.01.013.
33.
LundJDongaRWidmerCGStohlerCS. The pain-adaptation model: a discussion of the relationship between chronic musculoskeletal pain and motor activity. Can J Physiol Pharmacol1991; 69: 683-94.
34.
CooperRGForbesWSJaysonMI. Radiographic demonstration of paraspinal muscle wasting in patients with chronic low back pain. Rheumatology1992; 31: 389-94. doi: 10.1093/rheumatology/31.6.389.
35.
KankaanpääMTaimelaSLaaksonenDHänninenOAiraksinenO. Back and hip extensor fatigability in chronic low back pain patients and controls. Arch Phys Med Rehabil1998; 79: 412-7. doi: 10.1016/s0003-9993(98)90142-3.
36.
BrunoPABagustJCookJOsborneN. An investigation into the activation patterns of back and hip muscles during prone hip extension in non-low back pain subjects: normal vs. abnormal lumbar spine motion patterns. Clin Chiropr2008; 11: 4-14. doi: 10.1016/j.clch.2008.01.001.
37.
TateuchiHTaniguchiMMoriNIchihashiN. Balance of hip and trunk muscle activity is associated with increased anterior pelvic tilt during prone hip extension. J Electromyogr Kinesiol2012; 22: 391-7. doi: 10.1016/j.jelekin.2012.03.003.
38.
HimmelreichHVogtLBanzerWE. Gluteal muscle recruitment during level, incline and stair ambulation in healthy subjects and chronic low back pain patients. J Back Musculoskelet Rehabil2008; 21: 193-9. doi: 10.3233/BMR-2008-21307.
39.
de GrootMPool-GoudzwaardALSpoorCWSnijdersCJ. The active straight leg raising test (ASLR) in pregnant women: differences in muscle activity and force between patients and healthy subjects. Man Ther2008; 13: 68-74. doi: 10.1016/j.math.2006.08.006.
40.
MacedoLGMageeDJ. Differences in range of motion between dominant and nondominant sides of upper and lower extremities. J Manipulative Physiol Ther2008; 31: 577-82. doi: 10.1016/j.jmpt.2008.09.003.
41.
CrandallKJCarlinTFlynnA. Comparison of dominant and non-dominant range of motion in collegiate baseball pitchers: a pilot study. Int J Hum Mov Sport Sci2015; 3: 16-8. doi: 10.13189/saj.2015.030202.
