Skip to main content
Top
Published in: European Spine Journal 2/2005

01-03-2005 | Original Article

The value of electromyography of the lumbar paraspinal muscles in discriminating between chronic-low-back-pain sufferers and normal subjects

Authors: Anthony R. Humphrey, Antoni V. F. Nargol, Anthony P. C. Jones, Amy A. Ratcliffe, Charles G. Greenough

Published in: European Spine Journal | Issue 2/2005

Login to get access

Abstract

The authors studied the surface electromyographic (EMG) spectrum of the paraspinal muscles of 350 subjects. They were classified by their history as normal (n=175), chronic low back pain (n=145), or past history (n=30). They pulled upwards on a floor-mounted load cell at two-thirds of their maximum voluntary contraction for 30 s, while the EMG was measured from the paraspinal muscles at the L4/L5 level. From the EMG signal the root-mean-square (RMS) was calculated. Power spectrum analysis allowed calculation of the median frequency slope, the initial median frequency (IMF), modal frequency, peak amplitude and spectral width at half peak amplitude (half-width). All of the variables of the chronic group were significantly different from the normal group, except the median frequency slope, RMS slope and mode. Half-width, age and maximum voluntary contraction were shown to be independent predictors of back pain classification. Half-width classified the subjects with a sensitivity of 0.65 and a specificity of 0.75.
Literature
1.
go back to reference Adams MA, Mannion AF, Dolan P (1999) Personal risk factors for first time low back pain. Spine 24:2497–2505CrossRefPubMed Adams MA, Mannion AF, Dolan P (1999) Personal risk factors for first time low back pain. Spine 24:2497–2505CrossRefPubMed
2.
go back to reference Ahern DK, Follick MJ, Council JR, Laser-Wolston N, Litchman H (1988) Comparison of lumbar paravertebral EMG patterns in chronic low back pain patients and non patient controls. Pain 34:153–160CrossRefPubMed Ahern DK, Follick MJ, Council JR, Laser-Wolston N, Litchman H (1988) Comparison of lumbar paravertebral EMG patterns in chronic low back pain patients and non patient controls. Pain 34:153–160CrossRefPubMed
3.
go back to reference Arena JG, Sherman RA, Bruno GM, Young TR (1991) Electromyographic recordings of low back pain subjects and non-pain controls in six different positions: effect of pain levels. Pain 45:23–28CrossRefPubMed Arena JG, Sherman RA, Bruno GM, Young TR (1991) Electromyographic recordings of low back pain subjects and non-pain controls in six different positions: effect of pain levels. Pain 45:23–28CrossRefPubMed
4.
go back to reference Biedermann HJ, Shanks GL, Forrest WJ, Inglis J (1991) Amplitude spectrum analyses of electromyographic activity. Discriminators in the differential assessment of patients with chronic low back pain. Spine 16:1179–1184PubMed Biedermann HJ, Shanks GL, Forrest WJ, Inglis J (1991) Amplitude spectrum analyses of electromyographic activity. Discriminators in the differential assessment of patients with chronic low back pain. Spine 16:1179–1184PubMed
5.
go back to reference Cassisi JE, Robinson ME, O’Conner P, MacMillan M (1993) Trunk strength and lumbar paraspinal muscle activity during isometric exercise in chronic low back pain patients and controls. Spine 18:245–251PubMed Cassisi JE, Robinson ME, O’Conner P, MacMillan M (1993) Trunk strength and lumbar paraspinal muscle activity during isometric exercise in chronic low back pain patients and controls. Spine 18:245–251PubMed
6.
go back to reference Cooper RG; Stokes MJ (1994) Load induced inflexion of the surface electromyographic signal during isometric fatiguing activity of normal human paraspinal muscle. Electromyogr Clin Neurophysiol 34:117–184PubMed Cooper RG; Stokes MJ (1994) Load induced inflexion of the surface electromyographic signal during isometric fatiguing activity of normal human paraspinal muscle. Electromyogr Clin Neurophysiol 34:117–184PubMed
7.
go back to reference De Luca CJ (1985) Myoelectrical manifestations of localised muscular fatigue in humans. Crit Rev Biomed Eng 11:251–279 De Luca CJ (1985) Myoelectrical manifestations of localised muscular fatigue in humans. Crit Rev Biomed Eng 11:251–279
8.
go back to reference De Vries HA (1968) Efficiency of electrical activity as a physiological measure of the functional state of muscle. Am J Phys Med 47:10–22PubMed De Vries HA (1968) Efficiency of electrical activity as a physiological measure of the functional state of muscle. Am J Phys Med 47:10–22PubMed
9.
go back to reference Donoghue WG (1985) How to measure your % body fat. Creative Health Products Donoghue WG (1985) How to measure your % body fat. Creative Health Products
10.
go back to reference Edwards RG, Lippold OCJ (1956) The relation between force and integrated electrical activity in fatigued muscle after exercise. J Physiol 132:677–681PubMed Edwards RG, Lippold OCJ (1956) The relation between force and integrated electrical activity in fatigued muscle after exercise. J Physiol 132:677–681PubMed
11.
go back to reference Goldspink G, Scutt A, Loughna PT, Wells DJ, Jaenicke T, Gerlach GF (1992) Gene expression in skeletal muscle in response to stretch and force generation. Am J Physiol 262:356–363 Goldspink G, Scutt A, Loughna PT, Wells DJ, Jaenicke T, Gerlach GF (1992) Gene expression in skeletal muscle in response to stretch and force generation. Am J Physiol 262:356–363
12.
go back to reference Greenough CG, Oliver CW, Jones APC (1998) Assessment of spinal musculature using surface electromyographic spectral colour mapping. Spine 23:1768–1774CrossRefPubMed Greenough CG, Oliver CW, Jones APC (1998) Assessment of spinal musculature using surface electromyographic spectral colour mapping. Spine 23:1768–1774CrossRefPubMed
13.
go back to reference Haslock l (1996) In: Weatherall DJ, Ledingham JGG, Warrell DA. (eds) Oxford textbook of medicine, Oxford, p 2993 Haslock l (1996) In: Weatherall DJ, Ledingham JGG, Warrell DA. (eds) Oxford textbook of medicine, Oxford, p 2993
14.
go back to reference Humphrey AR, Jones APC, Greenough CG (1998) The effect of load on the variables of the lumbar para spinal EMG. J Bone Joint Surg Br 80 [Suppl 2]:198 (Abstract) Humphrey AR, Jones APC, Greenough CG (1998) The effect of load on the variables of the lumbar para spinal EMG. J Bone Joint Surg Br 80 [Suppl 2]:198 (Abstract)
15.
go back to reference Jallovaara P, Ninnimaki T, Vanharanta H (1995) Pocket size, portable surface EMG device in the differentiation of low back pain patients. Eur Spine J 4:210–212CrossRefPubMed Jallovaara P, Ninnimaki T, Vanharanta H (1995) Pocket size, portable surface EMG device in the differentiation of low back pain patients. Eur Spine J 4:210–212CrossRefPubMed
16.
go back to reference Klein AB, Snyder-Mackler L, Roy SH, De Luca CJ (1991) Comparison of spinal mobility and isometric trunk extensor forces with EMG spectral analysis in identifying low back pain. Phys Ther 71:445–454PubMed Klein AB, Snyder-Mackler L, Roy SH, De Luca CJ (1991) Comparison of spinal mobility and isometric trunk extensor forces with EMG spectral analysis in identifying low back pain. Phys Ther 71:445–454PubMed
17.
go back to reference Lee DJ, Stokes MJ, Taylor RJ, Cooper RG (1992) Electro and acoustic myography for non-invasive assessment of paraspinal muscle function. Eur J Appl Physiol 64(3):199–203 Lee DJ, Stokes MJ, Taylor RJ, Cooper RG (1992) Electro and acoustic myography for non-invasive assessment of paraspinal muscle function. Eur J Appl Physiol 64(3):199–203
18.
go back to reference Mannion AF (1999) Fibre type characteristics and function of human paraspinal muscles: Normal values and changes in association with low back pain. J Electromyogr Kinesiol 9:363–377CrossRefPubMed Mannion AF (1999) Fibre type characteristics and function of human paraspinal muscles: Normal values and changes in association with low back pain. J Electromyogr Kinesiol 9:363–377CrossRefPubMed
19.
go back to reference Mannion AF, Dolan P (1994) Electromyographic median frequency changes during isometric contraction of the back extensors to fatigue. Spine 19(11):1223–1229PubMed Mannion AF, Dolan P (1994) Electromyographic median frequency changes during isometric contraction of the back extensors to fatigue. Spine 19(11):1223–1229PubMed
20.
go back to reference Mannion AF, Dolan P (1996) The effects of muscle length and force output on the EMG power spectrum of the erector spinae. J Electromyogr Kinesiol 6(3):159–168CrossRef Mannion AF, Dolan P (1996) The effects of muscle length and force output on the EMG power spectrum of the erector spinae. J Electromyogr Kinesiol 6(3):159–168CrossRef
21.
go back to reference Mannion AF, Adams MA, Cooper RG, Dolan P (1999) Prediction of maximal back muscle strength from indices of body mass and fat-free body mass. Rheumatology 38:652–655CrossRefPubMed Mannion AF, Adams MA, Cooper RG, Dolan P (1999) Prediction of maximal back muscle strength from indices of body mass and fat-free body mass. Rheumatology 38:652–655CrossRefPubMed
22.
go back to reference Mayer TG, Kondraske G, Mooney V, Carmichael TW, Butsch R (1989) Lumbar myoelectric spectral analysis for endurance assessment. A comparison of normals with de-conditioned patients. Spine 14:986–991PubMed Mayer TG, Kondraske G, Mooney V, Carmichael TW, Butsch R (1989) Lumbar myoelectric spectral analysis for endurance assessment. A comparison of normals with de-conditioned patients. Spine 14:986–991PubMed
23.
go back to reference Meyer JJ (1994) The validity of thoracolumbar paraspinal scanning EMG as a diagnostic test: an examination of the current literature. J Manipulative Physiol Ther 17:539–551PubMed Meyer JJ (1994) The validity of thoracolumbar paraspinal scanning EMG as a diagnostic test: an examination of the current literature. J Manipulative Physiol Ther 17:539–551PubMed
24.
go back to reference Nargol AVF, Jones APC, Kelly PJ, Greenough CG (1999) Factors in the reproducibility of electromyographic amplitude spectrum analysis of lumbar paraspinal muscle fatigue. Spine 24(9):883–888CrossRefPubMed Nargol AVF, Jones APC, Kelly PJ, Greenough CG (1999) Factors in the reproducibility of electromyographic amplitude spectrum analysis of lumbar paraspinal muscle fatigue. Spine 24(9):883–888CrossRefPubMed
25.
go back to reference Nouwen A, Bush C (1994) The relationship between paraspinal EMG and chronic low back pain. Pain 20:109–123CrossRef Nouwen A, Bush C (1994) The relationship between paraspinal EMG and chronic low back pain. Pain 20:109–123CrossRef
26.
go back to reference Oddsson LIE, Giphart JE, Buijs RJC, Roy SH, Taylor HP, De Luca CJ (1997) Development of new protocols and analysis procedures for the assessment of LBP by surface EMG techniques. J Rehabil Res Dev 34(4):415–426PubMed Oddsson LIE, Giphart JE, Buijs RJC, Roy SH, Taylor HP, De Luca CJ (1997) Development of new protocols and analysis procedures for the assessment of LBP by surface EMG techniques. J Rehabil Res Dev 34(4):415–426PubMed
27.
go back to reference Oliver CW, Tillotson KM, Jones APC, Royal RA, Greenough CG (1996) Reproducibility of lumbar paraspinal surface electromyogram amplitude spectra. Clin Biomech (Bristol, Avon) 11:317–321 Oliver CW, Tillotson KM, Jones APC, Royal RA, Greenough CG (1996) Reproducibility of lumbar paraspinal surface electromyogram amplitude spectra. Clin Biomech (Bristol, Avon) 11:317–321
28.
go back to reference Peach JP, McGill SM (1998) Classification of low back pain with the use of spectral electromyogram parameters. Spine 23:1117–1123CrossRefPubMed Peach JP, McGill SM (1998) Classification of low back pain with the use of spectral electromyogram parameters. Spine 23:1117–1123CrossRefPubMed
29.
go back to reference Robinson ME, Cassisi JE, O’Connor PD, MacMillan M (1992) Lumbar iEMG during isotonic exercise: chronic low back pain patients versus controls. J Spinal Disord 5:8–15PubMed Robinson ME, Cassisi JE, O’Connor PD, MacMillan M (1992) Lumbar iEMG during isotonic exercise: chronic low back pain patients versus controls. J Spinal Disord 5:8–15PubMed
30.
go back to reference Roy SH (1991) Instrumented back testing. Physical Therapy Practice 1:32–42 Roy SH (1991) Instrumented back testing. Physical Therapy Practice 1:32–42
31.
go back to reference Roy SH, De Luca CJ, Schneider J (1986) Effects of electrode location on myoelectric conduction velocity and median frequency estimates. J Appl Physiol 61:1510–1517PubMed Roy SH, De Luca CJ, Schneider J (1986) Effects of electrode location on myoelectric conduction velocity and median frequency estimates. J Appl Physiol 61:1510–1517PubMed
32.
go back to reference Roy SH, De Luca CJ, Casavant DA (1989) Lumbar muscle fatigue and chronic lower back pain. Spine 14:992–1001PubMed Roy SH, De Luca CJ, Casavant DA (1989) Lumbar muscle fatigue and chronic lower back pain. Spine 14:992–1001PubMed
33.
go back to reference Roy SH, De Luca CJ, Emley M, Buijs RJC (1995) Spectral electromyographic assessment of back muscles in patients with low back pain undergoing rehabilitation. Spine 20:38–48PubMed Roy SH, De Luca CJ, Emley M, Buijs RJC (1995) Spectral electromyographic assessment of back muscles in patients with low back pain undergoing rehabilitation. Spine 20:38–48PubMed
34.
go back to reference Saltin B, Gollnick P (1983) Skeletal muscle adaptability: significance for metabolism and performance. In: Handbook of physiology. American Physiological Society, Bethesda, MD, USA pp 555–631 Saltin B, Gollnick P (1983) Skeletal muscle adaptability: significance for metabolism and performance. In: Handbook of physiology. American Physiological Society, Bethesda, MD, USA pp 555–631
Metadata
Title
The value of electromyography of the lumbar paraspinal muscles in discriminating between chronic-low-back-pain sufferers and normal subjects
Authors
Anthony R. Humphrey
Antoni V. F. Nargol
Anthony P. C. Jones
Amy A. Ratcliffe
Charles G. Greenough
Publication date
01-03-2005
Publisher
Springer-Verlag
Published in
European Spine Journal / Issue 2/2005
Print ISSN: 0940-6719
Electronic ISSN: 1432-0932
DOI
https://doi.org/10.1007/s00586-004-0792-3

Other articles of this Issue 2/2005

European Spine Journal 2/2005 Go to the issue