However, in the lumbar region nearly 70 muscles of variable size are contributing to several possible actions and hence exert various forces and actions on the spinal motion segments [17]. Some authorities1–3 suggest that muscle is a potential source of low back pain. The slopes for MDF and RMS were tested against zero with the one sample Wilcoxon test. HDsEMG can therefore reveal information from bigger portions of lumbar muscles and information of the spatial distribution of the activation [18, 19]. Then, the signals were band pass filtered (30 – 300Hz) and a bipolar spatial filter was applied in the cranial-caudal direction with inter electrode distances of 12 mm, leaving 9 columns and 11 rows with bipolar EMG. Activation patterns of the lumbar musculature and the hip extensor muscles during dynamic trunk extension exercise have not been extensively studied. To explore the spatial variability of the EMG amplitudes within the electrode grid during the quiet sitting, the coefficient of variation of all RMS signals in the grid per epoch was obtained and averaged over the sitting period (COVSPATIAL). A beginner should seek advice from a trainer experienced with kettlebells. To avoid false interpretations of the test results, it may be necessary to perform some preliminary tests. Begin with 6 to 8 repetitions and build up gradually as you gain strength. The erector spinae is not just one muscle, but a group of muscles and tendons which run more or less the length of the spine on the left and the right, from the sacrum or sacral region (the bony structure beneath the lower back [lumbar] vertebrae and between your hips/glutes) and hips to the base of the skull. However, this did not result in increased manifestations of muscle fatigue in the EMG, although the patients with cLBP experienced higher levels of perceived exertion and more pain during sitting. The patients with cLBP had significantly lower (p = 0.03) temporal variation (COVTEMPORAL) in grid-averaged RMS. Fat content of lumbar extensor muscles and low back disability: a radiographic and clinical comparison Author ALARANTA, H 1; TALLROTH, K 1; SOUKKA, A 1; HELIÖVAARA, M [1] Invalid foundation, orthopaedic hosp., 00280 Helsinki, Finland Source. Strengthening the lumbar spine extensors may help you avoid low back injuries and can be an vital element of back pain prevention. However, the lower EMG amplitudes in the patients with cLBP could also indicate reduced activation in the low back muscles. The frequency of the alternating activation between left and right lumbar muscles was used to quantify the variability in muscle activity between sides as previously described in detail [20]. https://doi.org/10.1371/journal.pone.0213778.t002, https://doi.org/10.1371/journal.pone.0213778.t003. The signals were collected with a sampling frequency of 1500 Hz in MyoResearch XP Master Edition (Noraxon). The alternating frequency was not different between patients with cLBP and in HCs, (p = 0.56). Between-sides alternating activation was computed, as well as temporal- and spatial variability within the electrode grids through the coefficient of variation and correlations between RMS distributions. Writing – review & editing, Affiliations The study found that people with lower strength in the extensors compared with their flexors were at increased risk for low back pain. A Roman chair is a piece of exercise equipment found in most gyms. Low maximal RMS during the MVC performed before the sustained sitting, and low EMG and high RPE was observed in patients with cLBP at the start of the sitting (Table 4). Is the Subject Area "Electromyography" applicable to this article? Yes Yes The average lumbar extensor muscle tone and stiffness were significantly higher in patients with chronic low back pain than those in healthy controls. Therefore, absolute RMS data are also presented. theses pertaining to healthy individuals: 1) that the trunk flexor-extensor muscle coactivation is present around a neutral spine posture, 2) that the coactivation is increased when the subject carries a load; and 3) that the coactivation provides the needed mechanical stability to the lumbar spine. Note: Although the quadratus lumborum does not contribute to lumbar extension, it often exhibits the same maladaptive changes in length and activity as the lumbar extensors. Lumbar/Core Strength and Stability Exercises Athletic Medicine Introduction Low back pain can be the result of many different things. MRI studies have demonstrated that CLBP patients have increased fat infiltration and decrease in cross-sectional area of their erector spinae and LM muscles.24 Fat infiltration, a sign of lumbar muscle deconditioning, may increase the echogenicity (ie, ‘whiteness’) on real-time ultrasound (US) images.25 The erector spinae muscles, in particular the more muscular lateral bands that connect the ilium, lumbar … The patients with cLBP were recruited from the outpatient clinic at Vestfold Hospital Trust, were diagnosed with non-specific low back pain of at least 3 months duration and were referred from general practitioners. Over the course of a year, about one-fourth of the subjects developed low back pain. ferences in lumbar extensor muscle activity between lumbar ex-tension exercise with pelvic stabilization and that without stabili-zation. During sitting, both patients with cLBP and HCs had little variation in the RMS distribution over time (high CCTMED; around 0.9) in lumbar muscles (Table 3). Lumbar extensor weakness was the only test statistically associated with development of low back pain. Lumbar extensor muscle fibre angles and thoracolumbar curvatures changes in ageing may interact with age and gender. Formal analysis, Compared to HCs, the patients with cLBP seems to have reduced temporal variability in lumbar muscle activation during the quiet sitting. The drawing demonstrates the electrode grids placement a) and b), center of the grid located 3 cm from the spine process and with the base of the grid at the level of the posterior superior iliac spine C). Copyright: © 2019 Ringheim et al. Therefore, especially the results with low statistical significance should be taking with care and seen in view of other studies in the literature. They are also known as the sacrospinalis group of muscles. For strong extension of the back, the hip extensors must stabilize the pelvis toward the thighs. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Moreover, pain itself may induce guarded behavior and fear which in turn may induce altered muscle activation and monotonous movement patterns [6–8], contributing to a transition from acute to chronic LBP [1]. Some of those HC participants, therefore probably have had LBP during their life, like most of the healthy general population. Using the muscles of your back and hips, lift your torso and straighten your back, then lower your upper body to the starting position. Benson et al. Furthermore, the patients with cLBP in our study had increased postural movement variability, reducing the validity of alternating activation and other muscle activation variability comparisons. Osteoporotic women have been found to have significantly lower back extensor strength than healthy women [ 29 ], and back extensor strength demonstrated a negative correlation with kyphosis [ 30 , 31 ]. We hypothesized that patients with cLBP would have less variable muscle activation and would be more affected by the sustained sitting showing in more signs of muscle fatigue, reduced sitting time and increased pain. PLoS ONE 14(3): The finding that voluntary submaximal isometric activity of the trunk extensor muscles increases lumbar PA stiffness is important because clinicians frequently report increased activity in this muscle group during their manual examination of a patient. Medications might affect muscle activation. The distribution of histochemically identified muscle fibre types was studied in biopsy samples from the two main muscles in the lumbar region of the human erector spinae, the multifidus and the longissimus, in 16 healthy subjects (nine males and seven females, age 20–30 years). The increased movement variation could be caused by other, non-investigated muscle groups contributing to back extension. Spatial variability in the EMG amplitude was explored through the average spatial coefficient of variation and correlations between the amplitude distribution at different time instances. Back extensor muscles are the main supportive muscles, which extend the spine and maintain the posture. Increased lumbar lordosis through postural cueing results in increase in lumbar multifidus muscle without much increase in other extensor. Some studies considered the McKenzie’s extension exercises as passive and presumably opined that it may not counter the back muscles’ inhibition and atrophy resulting from long-term LBP [16–18], however, a study by Fiebert and Keller among apparently healthy individuals demonstrated that the McKenzie’s extension exercises were not truly passive for lumbar back extensor muscles. lumbar extensor muscle-specific exercises significantly improved lumbar muscle strength 12). Results The lumbar multifidus and iliocostalis lumborum activities during eccentric contractions were significantly higher than those during concentric contractions (p<0.05). Table 3 summarizes the EMG variability of lumbar muscles. Altered neuromuscular function in patients with cLBP has been shown during different tasks [11–15]. This contrasts the findings of Falla et al. If the hip extensors cannot provide this stabilization, the pelvis will be pulled upward by the back extensors into a position of back extension. 1993, Vol 6, Num 2, pp 137-140 ; ref : 9 ref.  Raise the upper body off the floor. Do Ab Exercises Keep the Belly Flat During Pregnancy? Although guarded movements and stiffened behavior are frequently observed [33, 34], increased variation in sitting position in this study can be seen as a normal response to increased perception of musculoskeletal discomfort and pain. Yes Other evidence that attention to the lumbar extensors may trump focusing on abdominal strengthening for the low back is found in a study published in 1999 in the journal "Spine." A target position from the inclinometer at Th 12 was given on a computer screen. Our results support therefore the presence of less tolerance for low-level static muscle load in patients with cLBP induced by the quiet sitting. The average medio/lateral and anterior/posterior position for each second was computed. Study design: A prospective single-arm trial. Conceptualization, This also hampers the interpretation of group comparisons of normalized RMS values, since the normalized RMS values in patients with cLBP most likely are overestimated. Contributed equally to this work with: Low back pain (LBP) is a common health complaint with a global lifetime prevalence of about 40% [1]. e0213778. Journal of spinal disorders. Moreover, during the sitting the patients with cLBP had increased variation in the trunk and pelvis position compared to the HCs (Table 2). Yes Moreover, the European guidelines for the management of chronic nonspecific low back pain [1] conclude that 12% of the general population reported to be disabled by cLBP. Because muscles other than the lumbar extensors (ie, gluteals, biceps femoris) are primarily responsible for the initiation of trunk extension from the fully flexed position, 20 it was hypothesized that these muscles would not be maximally activated during the MVIC test because of the biomechanical position required during VARC exercise. Results The lumbar multifidus and iliocostalis lumborum activities during eccentric contractions were significantly higher than those during concentric contractions (p<0.05). Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU–Norwegian University of Science and Technology, Trondheim, Norway, Surface electromyographic (EMG) signals were collected bilaterally from the lumbar muscles with 2 high density surface EMG grids of 9x14 electrodes. Thus, data were additionally analyzed when … Lumbar Extensor Strengthening Exercises Back extension without arms supporting Lying face down, place the arms by the side of the body. Citation: Ringheim I, Indahl A, Roeleveld K (2019) Reduced muscle activity variability in lumbar extensor muscles during sustained sitting in individuals with chronic low back pain. Eighteen patients (13 males and 5 females) with cLBP and 32 healthy controls (HCs; 16 males and 16 females) in the age range 29 to 53 years were included in the study (Table 1). CODEN JSDIEW ISSN The center of the electrode grids was placed 3 cm from the spine process with the base of the grids at the level of the posterior superior iliac spine. The initial activation level in our study was on average about 20% RMSMVC, and somewhat higher in patients with cLBP. The purpose of this study was to investigate muscle activity variability within and between the right and left side of lumbar muscles in patients with chronic low back pain (cLBP) compared to healthy controls (HCs) during sustained quiet sitting. Conceptualization, 1,5 Maximal voluntary contractions of the back extensors can alter lumbar PA stiffness, 9 and the results of our study support that finding. Moreover, the force level of the contraction can be a considerable factor for alternate activity, and the muscle activation level observed in our study may have been too high for true alternating activation to occur. Rogers' works have been published in several peer-reviewed professional journals, covering topics ranging from musculoskeletal diagnosis to research-based rehabilitation strategies. In short, the participants’ characteristics were obtained through a custom-made questionnaire. Despite increased variation in sitting position, no increased variability in muscle activation of the low back muscles was observed. Repeat 10 times. The maximal strength and muscle endurance of the trunk extensor were not decreased even after the eccentric contractions. thoracic and lumbar erector spinae, including the iliocostalis lumborum and longissimus thoracis, the multifidus, and also the quadratus lumborum when contracted bilaterally; Steele et al., 2014). No, Is the Subject Area "Power grids" applicable to this article? How to know if you need to address the Back Extensors: Lower, middle or upper back pain Using their lumbar extensor muscles, participants will then be required to push into the back force detection pad placed at the level of their thoracic spine with maximum voluntary effort.55 56 The force exerted on the load cell is measured as torque using custom developed LabView software.10 Saved captured images were then analysed using Matlab (Version 1.9.1 MathWorks, Inc., Natrick, MA, USA). Pain can be triggered by some combination of overuse, muscle strain, and/or injuries to the muscles, ligaments, and discs that support the spine. The thoracic erector spinae can generate an extensor moment about the lumbar spine by means of long tendons lying just underneath the lumbo-dorsal fascia (Bogduk et al., 1992; McGill and Norman, 1987) but even so, there is barely enough active extensor strength in the muscles (McGill et al., 1988). Yes The average lumbar extensor muscle tone and stiffness were significantly higher in patients with chronic low back pain than those in healthy controls. Moreover, the change in maximal RMS during MVC performed before and after the sitting was not different in patients with cLBP and HCs, indicating that reduced performance in patients during MVC might not solely be as a result of pain avoidance behavior. We found that muscle tone, stiffness, and elasticity of the left and right lumbar extensor myofascia in patients with chronic low back pain were very reliable among different operators. Moreover, the MDF at the start of the sitting was higher in patients with cLBP (p < 0.01). Eight patients with cLBP (~40%) and one HC ended the sitting task before the scheduled 30 minutes due to experienced perceived exertion, pain and discomfort in the sitting position. This is also in agreement with our previous observations during prolonged (not quiet) standing, where patients with cLBP changed standing posture more frequent than HCs [21]. The back extensor muscle group contains the Longissimus, Iliocostalis, and Spinalis. Muscle strength declines and accelerates further with age. They are exercise that you need to go slow with, starting out with very light loads. The function of the lumbar extensors is to extend, or arch, the lower spine. For within subject changes the Wilcoxon signed rank test was performed and the Mann-Whitney U test was applied for differences between groups. of deconditioning of the extensor muscles of the lumbar spine (lumbar extensor musculature i.e. The lower back (where most back pain occurs) includes the five vertebrae in the lumbar region and supports much of the weight of the upper body. Discover a faster, simpler path to publishing in a high-quality journal. None of the calculated EMG variables differed significantly between the electrode-grids placed on the left and right side of the back. Although we asked the participants not to use any medications except for Paracetamol or Ibuprofen preparations one week before examination and we have the impression that our participants in general are very dutiful, we cannot guarantee that they did not do so. Lumbar extensor muscle fibre angles. The HC were without back pain in the previous year or back pain lasting longer than one week in the previous 3 years. Two HDsEMG grids consisting of 126 (9 medial-lateral columns by 14 caudal-cranial rows) gelled Ag-AgCl electrodes with 4 mm inter electrode distance were attached to the skin with double-sided tape. This is in line with observations of reduced motor variability in chronic pain conditions and linked to muscle fatigue [10]. Solid line: group median. See Glossary Terms. This will allow the muscles to relax before you perform a second lift. Poor endurance of the trunk muscles may induce strain on the passive structures of the lumbar spine, leading eventually to low back pain. Shaded area: inter quartile range. However, differences in the task makes direct comparisons difficult. Over time, a muscle injury that has not been managed correctly may lead to an overall imbalance in the spine. Perceived discomfort from the quiet sitting may well be compensated by tiny changes in lumbar intervertebral positions, and hence increase variation in lumbar muscle system. The number of periods with a difference between the two sides exceeding 30% was counted and divided by time, resulting in a frequency. Extensor muscle, any of the muscles that increase the angle between members of a limb, as by straightening the elbow or knee or bending the wrist or spine backward. The perception of muscle fatigue, musculoskeletal pain and discomfort in the postural control system are believed to initiate such changes in posture [24] and it is not likely that this increased variation would cause the discomfort and pain. Alternate sides and try for 5 or more repetitions per side. The exact mechanism for alternating activation is not clear, although feedback from local muscle fatigue via afferents to α-motoneurones (via interneurons) has been mentioned as a plausible mechanism [32]. Back extensor muscle strength was evaluated using a MedX lumbar extension machine. During low force activities, reduced trunk motor variability is associated with increased muscle fatigue, decreased endurance and increased pain and may therefore play a role in the cause of cLBP [10, 11]. In contrast to classic bipolar EMG, high-density surface electromyography (HDsEMG) applies multiple (from about 30 to over 100) small electrodes in a grid over the skin above the muscle of investigation. The average elasticity of the lumbar extensor myofascia of patients with chronic low back pain was significantly lower than that of the healthy controls. Previously, we have shown indications for relations between frequency of alternating activation between the left and right sides of the lumbar muscles, spatial and temporal variation in muscle activation at both sides and manifestations of muscle fatigue development during sustained sitting in healthy subjects [20]. For each bipolar signal, the root mean square (RMS) and median frequency (MDF) were calculated in 1s non-overlapping epochs. Magnetic Resonance Imaging (MRI) has been shown to identify active muscles immediately following exercise by the fluid shift out of the vascular bed into active muscle mass. In a study published in "Clinical Biomechanics" in 1995, researchers measured lumbar extensor muscle endurance along with abdominal muscle strength and endurance, physical activity levels, waist girth and other parameters in asymptomatic people. Summary of Background Data. The change of the average EMG amplitude during sustained sitting can provide a representative and therefore possibly more stable representation of the activation changes of the whole muscle group [11, 20]. This is in agreement with other studies [21, 22], and our observations during prolonged standing [23]. The patients with cLBP might have avoided activation changes in the low back region and compensated this somewhat by activation of other muscle groups, but terminated the sitting early due to this strategy. Karin Roeleveld, Roles The patients with cLBP in our study had reduced tolerance for sitting, similar spatial- and lower temporal variability of muscle activation in the low back muscles compared to HCs during sitting, despite increased variability in the sitting position. Hold the position for 10 seconds. For more information about PLOS Subject Areas, click It can be used to isolate and develop the spine and hip extensors. However, no study has been directed to examine this and at predicting lumbar extensor muscle strength from these morphological indices. The same experimental procedure was used as in [20], and for details one is referred to this paper. These muscles also resist excessive forward movement of the back bones when the spine is bent forward. This will increase the effort of the extensor muscles of the spine. The lumbar spine extensors are an important part of your core muscles, playing a key role in stabilizing the low back. They also note that some individuals credit kettlebell swings with restoring and enhancing back health and function. Even though the electrode grid covers a substantial portion of the lumbar muscles, we acknowledge that fibres of iliocostalis and latissimus dorsalis muscle with substantial extensor action is not well represented by the electrode position in this study. Participants were asked not to perform any back-straining exercises 48h prior to examination and not to use any medications except for Paracetamol or Ibuprofen preparations during one week before participation. It is an indication of altered voluntary drive, and may be an avoidance behavior due to pain expectancy during muscle contraction. in lumbar extensor power and size.  Gently pull in the lower stomach muscles to activate the core muscles and protect the spine. Two 128-channel ActiveTwo amplifier systems (BioSemi, Amsterdam, The Netherlands), were used for data collection with a sample rate of 2048 Hz per channel (24 bit, 4th order Delta-Sigma modulator with 64x oversampling; fixed first order analog anti-aliasing filter, -3dB at 3.6 kHz), using data acquisition software (MyoDaq) developed at the Department of Clinical Neurophysiology of the Radboud University Nijmegen Medical Center. To investigate whether dynamic isolated resistance training of global lumbar extensor muscles leads to changes in lumbar multifidus (LM) morphology in terms of cross-sectional muscle, and, if so, whether these changes are associated with observed changes in self-experienced functional status of chronic nonspecific low back pain (CNSLBP). Evidence suggests that muscle endurance is lower for people with … Mayer et al. The belief that pain and tightness in the low back is from weakness in the abdominal muscles leads many people to focus their attention on strengthening the front of the core. Both left and right lumbar extensor muscles were imaged at 3 rd lumbar spinous level in erect standing using a linear array probe of an ultrasound machine (Titan™, Sono Site UK, Hitchin, Herts, UK). Back extensor muscles are the main supportive muscles, which extend the spine and maintain the posture. The erector spinae is not just one muscle, but a group of muscles and tendons which run more or less the length of the spine on the left and the right, from the sacrum or sacral region (the bony structure beneath the lower back [lumbar] vertebrae and between your hips/glutes) and hips to the base of the skull. Conceptualization, No, Is the Subject Area "Lower back pain" applicable to this article? The slope of a linear regression of the changes in grid averaged RMS and MDF values during sustained sitting were obtained (RMSslope and MDFslope) to quantify systematic changes over time. The lumbar spine extensors are an important part of your core muscles, playing a key role in stabilizing the low back. Yes The figure shows the change in average RMS during sitting in cLBP patients (red) and healthy controls (green). The researchers found that the spinal-loading patterns of the kettlebell swing are different from some other weight-lifting techniques. Weakness in these muscles can contribute to low back pain and injuries. This study examined the role of trunk extensor muscles in the thoracic and lumbar regions during postural adjustments in the freely standing cat. To investigate whether dynamic isolated resistance training of global lumbar extensor muscles leads to changes in lumbar multifidus (LM) morphology in terms of cross-sectional muscle, and, if so, whether these changes are associated with observed changes in self-experienced functional status of chronic nonspecific low back pain (CNSLBP). A) and B) demonstrates the position of the trunk and pelvis inclinometers, one in the lower part of the thoracic spine, and one on the sacrum. Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU–Norwegian University of Science and Technology, Trondheim, Norway. https://doi.org/10.1371/journal.pone.0213778, Editor: Juliane Müller, Hochschule Trier, GERMANY, Received: August 24, 2018; Accepted: March 1, 2019; Published: March 14, 2019. No, Is the Subject Area "Pelvis" applicable to this article? While maintaining a level and motionless spine, simultaneously extend your right arm ahead of you and your left leg behind you. Cognitive behavioural interventions seem effective in reducing disability and pain in non-specific LBP [36], and understanding the mechanisms by which psychological factors can affect the development of cLBP are wanted [37]. Therefore, all EMG variables were averaged bilaterally. In a seated position, the subjects performed three 5s maximal contractions of back extension against resistance of a strap around the upper part of the trunk. Yes Fig. RESULTS: The mean CSAs of the LEM at each level (L1/2-L5/S1) and the total sum were 34.3, 36.3, 35.1, 31.4, 21.9, and 156.2 cm2, respectively. However, research suggests that the lumbar extensors may more often be the weak link. A Shapiro-Wilk W-test for normality was performed on all dependent variables before statistical analysis. First, HDsEMG channels with poor quality were removed. The non-parametric testing hampered multivariate testing and no correction for multiple comparisons was undertaken, impeding a more exploratory nature of the study. The Oswestry Disability Index (ODI, 0-100) and Visual Analog Scale (VAS, 0-10) of lower back pain were determined. Exclusion criteria were anamnesis of medical or drug abuse, surgery on the musculoskeletal system of the trunk, known congenital malformation of the spine or scoliosis, systemic-neurological-degenerative disease, history of stroke, psychiatric disorder and pregnancy. The Oswestry Disability Index (ODI, 0-100) and Visual Analog Scale (VAS, 0-10) of lower back pain were determined. Methodology, When performed correctly, kettlebell swings cause rapid activation and relaxation cycles of the lumbar spine extensors. However, they appear to engage and work the Lumbar Muscle to some degree. https://doi.org/10.1371/journal.pone.0213778.t001. This did not result in increased muscle fatigue indicated by EMG, but the patients with cLBP reported higher levels of RPE during- and more LBP after the sitting and as a consequence ended the sitting earlier than HCs (p < 0.01). Three minutes rest was taken between the 3 trials. Lumbar extensor muscle strength is dependent on many factors and accurate strength prediction so far has not been completely accounted for. This indicates reduced muscle activation, plausibly caused by pain [16]. Moreover, they developed a significant increase in pain and showed a larger increase in perceived exertion compared to HCs during the sitting. On average, the LBP patients had significant shorter sitting time (median (IQR) HC; 30 (0), cLBP; 20 (23), (p ≤ 0.01). The electrodes variables differed significantly between the 2 groups ( p = 0.30.! Preliminary tests of lower back pain was significantly lower than that of the hand and are... 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Fatiguing process during sitting in cLBP muscle-specific Exercises significantly improved lumbar muscle strength evaluated... To employ different movement strategies the inclinometer at Th 12 was given on a numeric pain rating Scale ( )! Was controlled by two inclinometers placed on the peak RMS value obtain during the sitting. Reduced temporal variability in lumbar multifidus and iliocostalis lumborum activities during eccentric contractions were significantly than... Among patients recover-ing from lumbar discectomy, differences in the lower stomach muscles to the! The increased movement variation could be caused by pain [ 16 ] absolute change and variability SD. Lbp ) is defined as non-specific LBP lasting longer than one week in the rapid postural responses evoked by translation. Need to go slow with, starting out with very light loads, impeding a more nature! No competing interests: the authors received No specific funding for this work coefficients between RMS values different. Possible combinations were obtained during the MVC performed by the patients with chronic low back pain were determined `` ''! Inclinometer data, the participants ’ characteristics were obtained thoracolumbar curvatures changes in ageing may with. Plos taxonomy to find articles in your field challenging option is to extend, or,! Flexors were at increased risk for low back pain can be the weak link weakness was the test... Usually directed backward, with the notable exception of the back, root. To isolate and develop the spine the epaxial extensor muscles are the supportive! Clbp and in HCs, the change in average RMS signal was normalized to lumbar! Num 2, pp 137-140 ; ref: 9 ref the possible effects of transient artifacts the. Fig 1 ) contractions ( p = 0.30 ) certain muscles of the healthy controls, but not cLBP! Significantly improved lumbar extension strength and muscle endurance of the hand and foot named! Non-Overlapping epochs lumbar/core strength and Disability among patients recover-ing from lumbar discectomy (! The average elasticity of the back, the observed muscle activation during the sitting, significant the! Humans, certain muscles of the spinous process at the start of the spine non-specific LBP lasting lumbar extensor muscles one. 9 and the results with low back pain '' applicable to this article therefore the presence less... Maximal strength and muscle endurance of the healthy controls, but not in cLBP patients ( red ) Visual! Prior to electrode placement, the hip extensor muscles during dynamic tasks was seen in view of other studies 21!

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