Electromyography of lumbar erector spinae muscles--influence of posture, interelectrode distance, strength, and fatigue

Evaluation of Lumbar Muscle Activation Patterns during Trunk Movements using High-Density Electromyography: A Preliminary Report

Lumbar paraspinal muscles are heavily involved in daily and work-related activities including trunk bending, trunk twisting, and lifting. Repetitive or inappropriate activation of the lumbar muscles while performing these activities can lead to low back pain. The aim of this preliminary study was to quantify the activation patterns of multiple lumbar muscles when participants performed three different trunk movement tasks, including sustained lumbar flexion posture, dynamic lumbar flexion and extension, and left-right twisting movements. Two 8×8 high-density electromyogram (HD-EMG) electrode arrays were used to record the lumbar muscle activity during these movements. We observed a symmetric and rapid increase in the amplitude of EMG in the erector spinae muscles during the sustained flexion or oscillation tasks. Asymmetric activation patterns were observed in bilateral lumbar muscles during the trunk twisting task. In addition, we observed substantial bilateral co-activation of the lumbar muscles for both twisting directions. These preliminary results demonstrated the potential feasibility of using HD-EMG as a tool to monitor spatial activation patterns of the lumbar muscles during different trunk movements. This approach can also be further developed to assess lumbar muscle function in individuals with low back pain.

Low-profile elastic exosuit reduces back muscle fatigue

We investigated the extent to which an un-motorized, low-profile, elastic exosuit reduced the rate of fatigue for six lumbar extensor muscles during leaning. Six healthy subjects participated in an A-B-A (withdrawal design) study protocol, which involved leaning at 45º for up to 90 s without exosuit assistance (A1), then with assistance (B), then again without assistance (A2). The exosuit provided approximately 12–16 Nm of lumbar extension torque. We measured lumbar muscle activity (via surface electromyography) and assessed fatigue rate via median frequency slope. We found that five of the six subjects showed consistent reductions in fatigue rate (ranging from 26% to 87%) for a subset of lumbar muscles (ranging from one to all six lumbar muscles measured). These findings objectively demonstrate the ability of a low-profile elastic exosuit to reduce back muscle fatigue during leaning, which may improve endurance for various occupations.

Association between spectral characteristics of paraspinal muscles and functional disability in patients with low back pain: a cohort study

OBJECTIVES

Characteristics of muscle activity, represented by surface electromyography (EMG), have revealed differences between patients with low back pain (LBP) and healthy adults; how they relate to functional and clinical parameters remains unclear. The purpose of the current study was to examine the correlation between frequency characteristics of EMG (analysed using continuous wavelet transform (CWT) analysis) and patients' self-rated score of disability.

DESIGN AND SETTING

This is a case-control study with 15 patients with mechanical LBP without radicular symptoms. Patients were recruited from the orthopaedic clinic at Charing Cross Hospital. Ten healthy adults were recruited from the staff working in the hospital and associated university. Patients completed the Roland-Morris Disability Questionnaire (RMDQ) and bilateral EMG activity was obtained from erector spinae at vertebral levels L4 and T12. Subjects performed three brief maximal voluntary isometric contractions (MVICs) of the back extensors and the torque was measured using a dynamometer. CWT was applied to the EMG signals of each muscle in a 200 ms window centred around the peak torque obtained during the MVICs. The ratio (low/high frequencies) of the energy, the peak power and the frequency of the peak power were calculated for each recording site, averaged and correlated with the individual's RMDQ score.

RESULTS

Patients had lower peak power (T12 and L4) and lower frequency of the peak power (at T12) than the healthy adults. Additionally, RMDQ positively correlated to the average ratio of energy at T12 (r=0.63; p=0.012), that is, greater self-rated disability corresponded to a dominant distribution of energy in the lower frequencies.

CONCLUSION

The current findings reveal alterations in EMG profile and its association with self-related back pain disability, suggesting that spectral characteristics of EMG reflect muscle function.

The potential use of spectral electromyographic fatigue as a screening and outcome monitoring tool of sarcopenic back muscle alterations

Background

To examine whether or not median frequency surface electromyographic (MF-EMG) back muscle fatigue monitoring would be able to identify alterations in back muscle function in elderly muscles, if a protocol was used that allowed optimum standardization of the processes underlying electromyographic fatigue, and whether these tests were reliable from day to day.

Methods

A total of 42 older (21 females; 67 (±10.5) years old) and 44 younger persons (19 females; 33 (±10) years) performed maximum isometric back extensions which were followed by one 30 s lasting 80% submaximum extension. Participants were seated on a dynamometer with their trunks 30° anteflexed, and they repeated all tests after 1-2 days and 6 weeks. SEMG was recorded bilaterally from the L1 (iliocostalis lumborum), L2 (longissimus), and L5 (multifidus) recording sites. Outcome variables included maximum back extension torque, initial MF-EMG (IMF-EMG), MF-EMG slope declines, and individual MF-EMG muscular imbalance scores. Two-factorial ANOVAs served to examine the age and gender-specific effects, and models from Generalizability Theory (G-Theory) were used for assessing retest-reliability.

Results

Maximum back extension moment was non-significantly smaller in elders. IMF-EMG was overall higher in elders, with significant differences at the L5 recordings sites. In the elderly, MF-EMG fatigue declines were significantly smaller in L5, in the recording with the most negative slope, or if the slope of all electrodes was considered. Retest reliability was unanimous in young and older persons. ICC-type measurements from G-Theory of both the IMF and the fatigue slopes ranged from 0.7 to 0.85. Absolute SEM values were found clinically acceptable for the IMF-EMG, but relatively high for the fatigue slope declines.

Conclusions

The MF-EMG fatigue method is able to elucidate alterations of aging back muscles. This method, thus, might be suggested as a potential biomarker to objectively identify persons at risk for sarcopenia. Considering the clinical relevance of the IMF-EMG relative to the MF-EMG slope declines, spectral EMG may also be used as an outcome monitoring tool in elderly populations.

The effects of muscle length and force output on the EMG power spectrum of the erector spinae

In many skeletal muscles the myoelectric power spectrum median frequency (MF) increases with increasing force output, possibly reflecting the greater size and conduction velocity of the later-recruited (fast twitch) fibres. Muscles, such as the erector spinae, in which fast twitch fibres are smaller than slow twitch, may display an atypical relationship between force output and median frequency. The present study sought to investigate this possibility. Ten healthy men held forces ranging from 20-80% maximal voluntary contraction (MVC) of the back extensors for 4-6 s, at muscle lengths corresponding to 30, 60 and 90% of the lumbar spine's range of flexion (ROF). MF was determined from surface electromyograms recorded from thoracic and lumbar regions of the erector spinae. In each region, MF was significantly higher at 30% ROF (short muscle length) than at 60 or 90% ROF (P < 0.005) and slightly (but not significantly) higher at 60 than 90% ROF. The muscle length effect on MF may reflect a reduction in conduction velocity of the stretched and narrowed muscle fibres. Force output had a significant effect on MF (P < 0.0004), although the shape of the relationship differed between the two levels of the erector spinae: in the thoracic region MF increased with force up to 40-50% MVC and then levelled off, whereas in the lumbar region MF was relatively stable up to 30-40% MVC and then declined with increasing force. The results suggest that the mean fibre size of the later recruited motor units is, in the thoracic region, larger, and in the lumbar region, smaller, than that of the earlier-recruited motor units.

Task dependency in back muscle fatigue--correlations between two test methods

BACKGROUND

Various test methods which engage the back muscles in different tasks have been used in studies of back muscle fatigue with electromyography. The present objective was to study task dependency in lumbar muscle fatigue by comparing two test methods.

METHODS

In this cross-sectional study, 22 healthy subjects performed a seated (45s) and a prone test (to the limit of endurance) of back muscle fatigue in randomised order. Fatigue of the lumbar muscles was assessed using electromyography spectral variables and ratings of back muscle fatigue (Borg scale). Linear regression of the median frequency during contraction, and conventional statistical tests of group differences and correlations were used.

FINDINGS

Significant differences (P<0.001) between the seated and the prone test were found for the initial median frequency, the slope, the median frequency decrease during the whole contraction, and for the ratings. However, correlation coefficients between the seated and the prone test were low for the median frequency decrease (r=0.42), absent for the slopes of median frequency (r=-0.08), higher for the Borg ratings (r(s)=0.51; P<0.05) and highest for the initial median frequency (r=0.69; P<0.05). Within each test, correlations between the Borg ratings and the electromyography variables were essentially absent (r<0.19).

INTERPRETATION

Electromyography variables assessed in one type of task in a fatiguing test may not be valid for other types of fatiguing tasks, for example in daily life work situations. Thus task dependency has to be considered when using surface electromyography in determining lumbar muscle fatigue. Ratings of fatigue, however, seem to be less task dependent than the electromyography variables.

Assessment of low back muscle fatigue by surface EMG signal analysis: methodological aspects

This paper focuses on methodological issues related to surface electromyographic (EMG) signal detection from the low back muscles. In particular, we analysed (1) the characteristics (in terms of propagating components) of the signals detected from these muscles; (2) the effect of electrode location on the variables extracted from surface EMG; (3) the effect of the inter-electrode distance (IED) on the same variables; (4) the possibility of assessing fatigue during high and very low force level contractions. To address these issues, we detected single differential surface EMG signals by arrays of eight electrodes from six locations on the two sides of the spine, at the levels of the first (L1), the second (L2), and the fifth (L5) lumbar vertebra. In total, 42 surface EMG channels were acquired at the same time during both high and low force, short and long duration contractions. The main results were: (1) signal quality is poor with predominance of non-travelling components; (2) as a consequence of point (1), in the majority of the cases it is not possible to reliably estimate muscle fiber conduction velocity; (3) despite the poor signal quality, it was possible to distinguish the fatigue properties of the investigated muscles and the fatigability at different contraction levels; (4) IED affects the sensitivity of surface EMG variables to electrode location and large IEDs are suggested when spectral and amplitude analysis is performed; (5) the sensitivity of surface EMG variables to changes in electrode location is on average larger than for other muscles with less complex architecture; (6) IED influences amplitude initial values and slopes, and spectral variable initial values; (7) normalized slopes for both amplitude and spectral variables are not affected by IED and, thus, are suggested for fatigue analysis at different postures or during movement, when IED may change in different conditions (in case of separated electrodes); (8) the surface EMG technique at the global level of amplitude and spectral analysis cannot be used to characterize fatigue properties of low back muscles during very low level, long duration contractions since in these cases the non-stable MU pool has a major influence on the EMG variables. These considerations clarify issues only partially investigated in past studies. The limitations indicated above are important and should be carefully discussed when presenting surface EMG results as a means for low back muscle assessment in clinical practice.

EMG power spectra of cervical muscles in lateral flexion and comparison with sagittal and oblique plane activities

The purpose of this study was to calculate electromyographic (EMG) power spectra of the sternocleidomastoid (SCM), the splenius capitis (SPL) and the trapezius (TRP) muscles from both sides of the body in bilateral lateral flexion and compare them with the EMG spectral characteristics of the same muscles in the sagittal and oblique planes recorded from the same subjects in the same experimental session but reported elsewhere in the literature. Forty normal and healthy young adults (21 males, 19 females) volunteered for the study. The subjects were prepared and positioned appropriately to exert linearly ramping isometric exertion aided by visual feedback against a rigid and load cell instrumental device. Exertions were carried out in a random order. The maximal voluntary contraction was reached within a 5-s test period. The torque and EMG from the SCM, SPL and TRP muscles were sampled bilaterally at a rate of 1 kHz. The EMG data were subjected to fast Fourier transform analysis. During lateral flexion, the torque generated by females was significantly lower than males ( P<0.01) and represented at 75% of male torque. Contrary to flexion/extension and oblique plane activities, the ipsilateral SCM was most active with highest power and up to four dominant frequencies demonstrating four distinct peaks. The bandwidth of this muscle progressively increased with the grade of contraction up to 400 Hz, similar to flexion/extension with median frequency (MF) spread between 21 and 109 Hz for males and 78 and 99 Hz for females. The ipsilateral SPL was the second most active muscle, which maintained a narrow bandwidth (200 Hz) and one dominant frequency, rising in power with increasing grade of contraction. Flexion and extension caused symmetrical activity bilaterally. The results of MANOVA revealed a significant main effect of gender, activity direction, grade of contraction and individual muscles ( P<0.001). There was a significant interaction between muscle and activity direction ( P<0.001) implying significantly different MF and mean power frequency if the direction of exertion was changed. Male and female subjects responded to direction differently ( P<0.001).

Between-days reliability of electromyographic measures of paraspinal muscle fatigue at 40, 50 and 60% levels of maximal voluntary contractile force

OBJECTIVE

To ascertain which percentage of maximal voluntary contractile force of the paraspinal muscles, when tested in a functional position, is most reliable for assessing electromyographic (EMG) fatigue changes.

SUBJECTS

Ten healthy volunteers with no history of low back pain (six males).

MAIN OUTCOME MEASURES

The surface EMG signal during 60-second isometric contractions of the paraspinal muscles at 40, 50 and 60% levels of maximal voluntary contractile force was captured and analysed. Each contraction level was assessed on two occasions, at least three days apart. The initial median frequency, the decline in median frequency slope and the increase in root mean square values were assessed for between-days reliability, using intraclass correlation coefficients (ICCs) and standard errors of measurements (SEM). Normalized median frequency and root mean square values were also assessed.

RESULTS

At 40% of maximal voluntary contraction, little or no EMG fatigue changes occurred in any of the observed parameters. At 50% maximal voluntary contraction the initial mean frequency and root mean square changes proved highly reliable, with ICCs ranging from 0.74 to 0.86 and 0.75 to 1.00 respectively. Normalizing the root mean square data reduced the reliability, but this was still acceptable with ICCs 0.70-0.83. The median frequency decline slope proved less reliable with ICCs 0.24-0.74 for raw and 0.26-0.77 for normalized data. At 60% maximal voluntary contraction the initial mean frequency proved as reliable as initial median frequency at 50% with ICCs 0.70-0.89. The raw and normalized root mean squares (ICCs 0.43-0.89 and 0.30-0.87 respectively) and raw and normalized median frequency (ICCs 0.27-0.51 and 0.24-0.53 respectively) changes were less reliable than at 50% MVC. Overall, the reliability is better at the L4/5 than at the L2/3 level.

CONCLUSION

Outcome measures taken at 50% maximal voluntary contraction are the most reliable in functional testing the paraspinal muscles of healthy volunteers. With initial median frequency and root mean square values being more reliable parameters than median frequency decline. At the L4/5 level, however, all parameters were acceptably reliable at 50% of maximum effort. However the between-subject variability of the median frequency decline and root mean square incline slopes suggest that these parameters are not yet fully suitable for monitoring fatigue changes during prolonged isometric contraction.

Influence of interelectrode distance and force level on the spectral parameters of surface electromyographic recordings from the lumbar muscles

In order to study the influence of interelectrode distance and force level on the electromyographic (EMG) spectral parameters and on their reliability, bipolar surface EMG measurements were performed on the lumbar muscles of 15 subjects. Two test contractions (45 s) at 40% of maximal voluntary contraction (MVC) were performed, one with 2 cm interelectrode distance and the other with 4 cm, followed by two contractions at 80% MVC with the same change in interelectrode distance. Increasing the interelectrode distance from 2 to 4 cm caused a significant mean decrease (about 8%) in the initial median frequency. It is shown that this shift is of an order of magnitude that may be expected from the bipolar electrode filter factor, and we further conclude that the observed individual variations in the shift are likely to be connected to fluctuations in the shape of the power spectrum and to variations in conduction velocity. No significant change was found for the median frequency slope when changing the interelectrode distance. Increasing the force (from 40 to 80% MVC) also caused a significant mean decrease (about 10%) in the initial median frequency. The median frequency slope became significantly more negative by more than 200%. We conclude, however, that torque fluctuations during the fatigue contractions should have had only minor influence on the standard error of measurement of the initial median frequency and of the median frequency slope.

An EMG technique for measuring spinal loading during asymmetric lifting

OBJECTIVES

To compare two methods of calibrating the erector spinae electromyographic signal against moment generation in order to predict extensor moments during asymmetric lifting tasks, and to compare the predicted moments with those obtained using a linked-segment model.

METHODS

Eight men lifted loads of 6.7 and 15.7 kg at two speeds, in varying amounts of trunk rotation. For each lift, the following were recorded at 60 Hz; the rectified and averaged surface electromyographic signal, bilaterally at T10 and L3, lumbar curvature using the 3-Space Isotrak, movement of body segments using a 4-camera Vicon system, and ground reaction forces using a Kistler force-plate. Electromyographic (EMG) and Isotrak data were used to calculate lumbosacral extensor moments using the electromyographic model, whereas movement analysis data and ground reaction forces were used to estimate net moments using the linked-segment model. For the electromyographic technique, predictions of extensor moment were based on two different sets of EMG-extensor moment calibrations: one performed in pure sagittal flexion and the other in flexion combined with 45 degrees of trunk rotation.

RESULTS

Extensor moments predicted by the electromyographic technique increased significantly with load and speed of lifting but were not influenced by the method of calibration. These moments were 7-40%greater than the net moments obtained with the linked-segment model, the difference increasing with load and speed.

CONCLUSIONS

The calibration method does not influence extensor moments predicted by the electromyographic technique in asymmetric lifting, suggesting that simple, sagittal-plane calibrations are adequate for this purpose. Differences in predicted moments between the electromyographic technique and linked-segment model may be partly due to different anthropometric assumptions and different amounts of smoothing and filtering in the two models, and partly due to antagonistic muscle forces, the effects of which cannot be measured by linked-segment models. RelevanceAsymmetric lifting is a significant risk factor for occupationally-related low back pain. Improved techniques for measuring spinal loading during such complex lifting tasks may help to identify work practices which place the spine at risk of injury.

Spectral profile of superficial cervical muscles

The objective of the study was to determine the median frequency (MF) and mean power frequency (MPF) of the stermodeidomastorial, splenius capitis and trapezius in progressively and linearly increasing isometric cervical flexion and extension. There is a dearth of data on spectral parameters of cervical muscles. Such data have been generated from 40 young adult subjects (21 male and 19 female). The subjects were seated upright in an individually adjusted chair and stabilized with a 4-point Velcro restraint system to stabilize the torso. These subjects exerted isometric flexor and extensor forces in a random sequence on an instrumented resistance device (specifically designed for the study) in a gradual and linearly increasing manner with a visual feedback to their maximal voluntary contraction (MVC) within a 5 s period. Surface EMG was sampled from the sternocleidomastoid, the splenius capitis and the trapezius muscles bilaterally at 1 kHz. The EMG signals were subjected to Fast Fourier Transform (FFT) analysis. Spectral profiles of all muscles in the dimensions of frequency, power, and grade of contraction were plotted. The mean median frequency (MF), mean power frequency (MPF), peak power and total power were analyzed. In the sternocleidomastoid, and the splenius the MF increased with the grade of contraction, widening its bandwidth at higher grades. The trapezius maintained a narrow bandwidth and its MF declined with the grade of contraction.

EMG spectral characteristics of spinal muscles during isometric axial rotation

The objective of this study was to determine the frequency profile, median frequency (MF) and mean power frequency (MPF) of trunk muscles in an isometric graded maximal voluntary contraction (MVC) in isometric axial trunk rotation from a neutral upright seated posture. Twelve young healthy subjects (seven males, five females) were instrumented with surface electrodes on their external obliques, internal obliques, rectus abdominis, pectoralis, latissimus dorsi and erector spinae at T10 and L3 levels bilaterally. These subjects were stabilized in seated posture in an axial rotation tester (AROT) and asked to perform a graded isometric contraction of their maximal value to both right and left directions from a neutral posture within a period of 10s. EMG from all 14 channels were sampled at 1 kHz at 10% intervals of MVC from 10% to MVC. These samples were subjected to fast Fourier transform analysis. The frequency profile plots demonstrated the power of muscles involved in agonistic and antagonistic activity. However, the frequency composition showed little difference between them. The MF was higher in agonists of the same muscle. The MPF was always higher than MF. Both values were generally insignificantly different between different levels of contraction. However, with increasing level of contraction there was increase in power.

The muscular load on the lower back and shoulders due to lifting at different lifting heights and frequencies

The aim of the study was to investigate the muscular load on the lower back and shoulders and the circulatory load on employees at a post center during repetitive lifting of mail transport boxes. A mock-up was designed in the laboratory, a total of nine combinations of lifting height and frequency were studied. Surface EMG was recorded bisymmetrically from m. erector spinae (L3-level) and m. trapezius. The circulatory load was evaluated by measuring the heart rate. The results show a trade off between the low back and shoulders. The maximum load on the low back occurred at the low lifting height (363 and 54.4 cm) whereas the maximum load on the shoulders occurred at the high lifting height (144.9 and 163.0 cm).

Estimation of trunk muscle forces and spinal loads during fatiguing repetitive trunk exertions

STUDY DESIGN

The effects of human trunk extensor muscle fatigue on the estimated trunk muscle forces and spinal loading were investigated during the performance of repetitive dynamic trunk extension.

OBJECTIVE

To evaluate if alterations in the trunk muscle recruitment patterns resulted in a greater estimated active loading of the spine and, in turn, an increased risk of injury.

SUMMARY OF BACKGROUND DATA

Epidemiologic studies highlight the increased risk of low back injury during repetitive lifting, implicating fatigue of muscles and/or passive tissues as causes of such injury. Increased trunk muscle activity or altered recruitment patterns resulting from fatigue in the primary trunk extensor muscles may indicate an increase in the active loading of the spine, which could contribute to an increased risk of injury.

METHODS

Sixteen healthy study participants performed repetitive isokinetic trunk extension endurance tests at two load levels and two repetition rates, while their net muscular torque output and trunk muscular activity were measured. During each exertion, trunk torque, position, and velocity were controlled, so that any change in muscle activity could be attributed to fatigue. An electromyography-assisted model, adapted to accommodate the decline in maximum muscular tension generation resulting from fatigue, was used to estimate the 10 trunk muscle forces and spinal loading. Linear regression was used to quantify the rate of change in muscle force and spinal loading resulting from fatigue, while analysis of variance was used to determine if the rate of change was dependent on the task conditions (load and repetition rate).

RESULTS

Significant elevations were estimated for the latissimus dorsi and external oblique muscle forces in more than 70% of the endurance tests, whereas significant reductions in the erector spinae muscle force were predicted in 75% of the trials. The magnitude of the range of change of the erector spinae and latissimus dorsi muscle forces was dependent on the load level and repetition rate. The reduction in erector spinae forces offset the augmented force in the other muscles, because the net changes in compression and lateral shear forces on the spine were not significant, and the anteroposterior shear was reduced.

CONCLUSION

The results of the study do not suggest that an increase in the muscular loading of the spine occurs as a result of changing trunk muscular recruitment patterns. Therefore, future studies should focus on injury mechanisms that may occur as a result of a change in the viscoelastic passive tissue responses, muscular insufficiency, or a decline in neuromuscular control and coordination.

Assessment of spinal musculature using surface electromyographic spectral color mapping

STUDY DESIGN

A technique is described for analyzing electromyogram data from lumbar spinal muscles, with special reference to discrimination of people with back pain. The ability to discriminate was evaluated in 99 people (61 healthy and 38 with chronic or acute back pain), and the influence of load was assessed.

OBJECTIVES

To evaluate methods of analysis of complex electromyogram data and to assess correlation of electromyogram information with clinical condition in people with and without back pain.

SUMMARY OF BACKGROUND INFORMATION

In previous analyses of electromyogram data, only a small part of the data have been used. Spinal muscular decompensation has been postulated in chronic low back pain, but there has been no direct demonstration of this phenomenon. Objective measures are still elusive.

METHODS

Lumbar spinal surface electromyograms were recorded during an isometric lifting task. The data were represented graphically as color-coded plots of electromyogram frequency, time, and electromyogram amplitude. Spectral width at half-peak amplitude (spectral half width) was calculated from the digitized, summed data. Ninety-nine people were tested: 48 men (29 with no recent [in the past 2 years] history of back pain, 16 with chronic back pain, 3 with acute back pain) and 51 women (32 with no recent back pain and 19 with chronic back pain).

RESULTS

Spectral color maps in people with chronic back pain were markedly different from those in healthy people. Spectral half width was greater in people with chronic back pain than in healthy people (P < 0.01). Blinded analysis of spectral color maps allowed discrimination of people with back pain from healthy people with a sensitivity of 76% and a specificity of 81%. People with a history of back pain had markedly variable half widths.

CONCLUSIONS

A new method of analysis of electromyogram data from lumbar spinal muscles has allowed discrimination between people with back pain and healthy people. This provides direct evidence of a correlation between muscular electrical function, measured by electromyogram, and low back pain. This technique may have potential as an objective measurement tool.

Repetitive lifting tasks fatigue the back muscles and increase the bending moment acting on the lumbar spine

During manual handling, the back muscles protect the spine from excessive flexion, but in doing so impose a high compressive force on it. Epidemiological links between back pain and repetitive lifting suggest that fatigued muscles may adversely affect the balance between bending and compression. Fifteen volunteers lifted and lowered a 10 kg weight from floor to waist height 100 times. Throughout this task, the bending moment acting on the osteoligamentous lumbar spine was estimated from continuous measurements of lumbar flexion, obtained using the 3-Space Isotrak. Spinal compression was estimated from the electromyographic (EMG) activity of the erector spinae muscles, recorded from skin-surface electrodes at the levels of T10 and L3. EMG signals were calibrated against force when subjects pulled up on a load cell, and correction factors were applied to account for changes in muscle length and contraction velocity. Fatigue in the erector spinae muscles was quantified by comparing the frequency content of their EMG signal during static contractions performed before, and immediately after, the 100 lifts. Results showed that peak lumbar flexion increased during the 100 lifts from 83.3 +/- 14.8% to 90.4 +/- 14.3%, resulting in a 36% increase in estimated peak bending moment acting on the lumbar spine (P = 0.008). Peak spinal compression fell by 11% (p = 0.007). The median frequency of the EMG signal at L3 decreased by 5.5% following the 100 lifts (p = 0.042) confirming that the erector spinae were fatigued, but measures of fatigue showed no significant correlation with increased bending. We conclude that repetitive lifting induces measurable fatigue in the erector spinae muscles, and substantially increases the bending moment acting on the lumbar spine.

Relations between compressive axial forces in an instrumented massive femoral implant, ground reaction forces, and integrated electromyographs from vastus lateralis during various 'osteogenic' exercises

A subject, who had undergone surgery to replace one hip joint and the proximal half of the femur with an instrumented titanium implant, performed brief exercises whilst simultaneous measurements were made of compressive axial force in the implant using short-range wireless telemetry, ground reactions using a Kistler force plate, and electromyographic activity of the vastus lateralis (VL) and erector spinae (ES) muscles using surface electrodes. Recordings were made barefoot and wearing 'trainers'. The exercises (slow jumping in counter movement style, fast continuous jumping, and jogging on the spot) have been found effective in controlled interventions for increasing bone mineral density in women. The implant forces were 250-400% BW. The values were about twice the magnitude of the ground reaction forces and significantly correlated with them for both peak force and its rate of rise but their relative magnitudes varied depending on mode of activity (jumping or jogging). Implant forces were significantly related to the muscle activity; in multiple regression analysis implant forces during take off from slow jumps VL contributed significantly in addition to the ground reaction (98% total explained variance). There was more activity in VL during jumping than jogging for the same implant force which may explain why jumping appears to be more osteogenic than jogging for the femur. For the same ground reaction, wearing trainers increased both the magnitude of the compressive loading of the femur and its rate of rise.

Spectral and temporal responses of trunk extensor electromyography to an isometric endurance test

STUDY DESIGN

This study investigated the effect of trunk extensor muscle location on the spectral and temporal electromyographic activity of the muscles during a fatiguing isometric extension of the torso against gravity.

OBJECTIVES

To determine the spectral responses of the trunk extensor muscles at more locations than have been studied previously, to determine if fatigue in the knee flexors limits this test, and to quantify the recruitment patterns of the trunk extensor muscles in a group of healthy subjects.

SUMMARY OF BACKGROUND DATA

Isometric endurance tests appear to have more value than strength tests in predicting the occurrence of low back pain. Electromyographic activity of trunk extensor muscles during these tests may provide clues to the etiology of neuromuscular-based low back pain. Spectral electromyographic measures appear to be successful discriminators between low back pain patient and normal populations, although which muscles provide the best information is unclear. Likewise, the recruitment patterns of the trunk extensors during fatiguing isometric tasks is not well quantified.

METHODS

Ten healthy men performed an isometric trunk endurance test. Surface electromyography was recorded from the erector spinae medially and laterally at vertebral levels of L1 and L3, medially at L5, and from the biceps femoris and gastrocnemius. Spectral parameters were calculated from the Fast Fourier Transform, and temporal parameters were calculated from the root mean square of the raw data. Linear regression was used to determine their responses as a function of time.

RESULTS

There was a significant effect of vertebral level and medial-lateral location on the initial median frequency and linear slope of the median frequency regressions. No significant evidence of fatigue in the lower extremities was observed. For most subjects, the temporal response of the surface electromyography was parabolic (concave-down), peaking at 30-50% of the endurance time.

CONCLUSION

Establishment of which muscle locations provide the best information and knowledge of the recruitment patterns are essential for the development of clinical diagnostic procedures and rehabilitation protocols.

Reproducibility of lumbar paraspinal surface electromyogram power spectra

OBJECTIVE: To establish the reproducibility of surface recordings of electromyograms from lumbar erector spinae muscles. DESIGN: Repeated measurements in 10 male volunteers under controlled conditions. METHODS: While isometric load was held constant at (2/3) and (1/3) of maximum voluntary contraction, surface electromyograms were recorded from the 4th/5th lumbar interspace on three occasions separated by at least a day. Fresh surface electrodes were applied on each test occasion. The raw electromyographic signal was filtered and digitized and the signal processed by fast Fourier transformation to give median frequency and total amplitude spectra. Linear regression lines of median frequency and amplitude against time were calculated. The 'spectral halfwidth" was defined as the full width at half maximum of the composite amplitude spectrum. Reproducibility was assessed by calculation of the intraclass correlation coefficient. RESULTS: Reproducibility of initial median frequency and spectral halfwidth were found to be excellent at both (2/3) (ICCC 0.91 and 0.88) and (1/3) (ICCC 0.84 and 0.83) maximum voluntary contraction. Initial power and regression slopes of power and median frequency were not reproducible. CONCLUSIONS: The reproducibility of two electromyographic variables, the initial median frequency and the spectral halfwidth, were found to be satisfactory.

Flexion relaxation during lifting: implications for torque production by muscle activity and tissue strain at the lumbo-sacral joint

During the full flexion phase of the back lift movement the lumbar part of the erector spinae muscle exhibits a reduced activity level (flexion relaxation). This study addresses the question how the required extension torque in the lumbo-sacral joint (L5/S1 joint) is balanced during the period in which apparently the lumbar erector spinae ceases to take its share. Six subjects participated in the experiment in which they performed seven lifting tasks. The load, the range of movement, and the phase in which the load was handled (lifting or lowering) were varied. A dynamic linked segment model was applied to determine the momentary torques acting at the L5/S1 joint, while the EMGs of the lumbar and thoracic part of the erector spinae muscle were measured. Furthermore, the lengths between markers on the lumbar and thoracic part of the trunk were determined to reveal changes in length during the movement. The dynamic EMGs were normalized to trunk angle-dependent maximal levels. The L5/S1 joint torques were analysed and combined with the normalized EMG data and the kinematics of the trunk, which are assumed to indicate the elongation of passive tissues. Although in the normalization procedure the change of the length-force relationship of the erector spinae was taken into account, the dynamic lumbar EMG activity decreased to a low-activity level (the phenomenon of flexion relaxation). This coincided with a 25% increase in lumbar length suggesting that passive tissue strain provided part of the required extension torque. In the tasks where a barbell was handled a significant increase in EMG level of the thoracic part of the erector spinae occurred just before the flexion relaxation at the lumbar level. Apparently, the extensor function of the lumbar part is then taken over by the thoracic part of the erector spinae muscle. This suggests that an intricate coordinating mechanism is operative that apportions the load to be balanced over active--(lumbar and thoracic part of the erector spinae) and passive structures (post vertebral ligaments).

Control of positioning the cervical spine and its application to measuring extensor strength

The great variability of the flexion of the cervical spine renders an exact description of the control of various positions difficult. A method was developed enabling a precise control of positioning the cervical spine and head in the sagittal plane. In three repeated measurements the mean values of the position of external anatomical landmarks and distances between them exhibited a good reproducibility. Any variable effect of gravity on the activity of the neck muscles at different positions of the cervical spine was eliminated by the passive compensation of gravity. The significance of methodical details is illustrated by the results of an applied study. The maximum strength of neck extensors was examined in 12 male subjects in a supine position at four different flexion angles from 0 to 30 degrees of the cervical spine. The vertical force component was measured. The maximum voluntary moments of forces about the bilateral motion axis of the C7T1 motion segment exhibited a tendency to decrease with increasing flexion.

The relationship between the electromyogram-amplitude and isometric extension torques of neck muscles at different positions of the cervical spine

A group of 12 healthy men volunteered for the experiment. Electromyograms (EMG) were obtained from semispinalis capitis, splenius capitis, levator scapulae, and trapezius muscles. The flexion angle of the cervical spine was precisely adjusted to 0 degrees, 10 degrees, 20 degrees, and 30 degrees relative to the horizontal, with a constant angle of the atlanto-occipital joint. The subjects made eight short (about 2 s) vertical extension forces (6%, 12%, 18%, 24%, 30%, 36%, 42%, and 48% of maximal voluntary peak contraction force). For each position, the centre of pressure under the head was determined as the basis for the calculation of the external lever arm. The presence of motor endplate regions was ascertained by multiple surface electrodes. The slopes of individual linear regression lines for the root mean square (rms)-values were dependent on the existence of endplates in the area of the electrodes - endplates caused smaller rms values per Newton metres of external torque. Significant intersubject differences between regression equations could not be eliminated by the normalization of EMG-parameters and/or torques. The elimination of gravity, the continuous monitoring of positions, and the consideration of localization of motor endplate regions were essential prerequisites for the acquisition of reliable relationships between EMG of different neck muscles and external torques. Two important conclusions were derived for the prediction of torques from EMG measurements: firstly, individual regression equations which take into account the position of the head and neck should be used; secondly, normalization procedures do not justify the application of average regressions to a group of subjects.

Physiological and subjective responses to maximal repetitive lifting employing stoop and squat technique

To establish safe levels for physical strain in occupational repetitive lifting, it is of interest to know the specific maximal working capacity. Power output, O2 consumption, heart rate and ventilation were measured in ten experienced forestry workers during maximal squat and stoop repetitive lifting. The two modes of repetitive lifting were also compared with maximal treadmill running. In addition, electromyogram (EMG) activity in four muscles was recorded and perceived central, local low-back and thigh exertion were assessed during the lifting modes. No significant difference was found in power output between the two lifting techniques. Despite this the mean O2 consumption was significantly greater during maximal squat lifting [38.7 (SD 5.8) ml.kg-1.min-1] than maximal stoop lifting [32.9 (SD 5.7) ml.kg-1.min-1] (P < 0.001). No significant correlation was found between O2 consumption (in millilitres per kilogram per minute) during maximal treadmill running and maximal stoop lifting, while O2 consumption during maximal squat lifting correlated highly with that of maximal treadmill running (r = 0.928, P < 0.001) and maximal stoop lifting (r = 0.808, P < 0.01). While maximal heart rates were significantly different among the three types of exercise, no such differences were found in the central rated perceived exertions. Perceived low-back exertion was rated significantly lower during squat lifting than during stoop lifting. The EMG recordings showed a higher activity for the vastus lateralis muscle and lower activity for the biceps femoris muscle during squat lifting than during stoop lifting. Related to the maximal voluntary contraction, the erector spinae muscle showed the highest activity irrespective of lifting technique.

The relationship between EMG activity and extensor moment generation in the erector spinae muscles during bending and lifting activities

The relationship between EMG activity and extensor moment generation in the erector spinae muscles was investigated under isometric and concentric conditions. The full-wave rectified and averaged EMG signal was recorded from skin-surface electrodes located over the belly of the erector spinae at the levels of T10 and L3, and compared with measurements of extensor moment. The effects of muscle length and contraction velocity were studied by measuring the overall curvature (theta) and rate of change of curvature (d theta/dt) of the lumbar spine in the sagittal plane, using the '3-Space Isotrak' system. Isometric contractions were investigated with the subjects pulling up on a load cell attached to the floor. Hand height was varied to produce different amounts of lumbar flexion, as indicated by changes in lumbar curvature. The extensor moment was found to be linearly related to EMG activity, and the 'gradient' and 'intercept' of the relationship were themselves dependent upon the lumbar curvature at the time of testing. Concentric contractions were investigated with the subjects extending from a seated toe-touching position, at various speeds, while the torque exerted on the arm of a Cybex dynamometer was continuously measured. Under these conditions the EMG signal (E) was higher than the isometric signal (E0) associated with the same torque. E and E0 were related as follows: E0 = E/(1 + A d theta/dt), where A = 0.0014 exp (0.045P) and P = percentage lumbar flexion. This equation was used to correct the EMG data for the effect of contraction velocity. The corrected data were then used, in conjunction with the results of the isometric calibrations, to calculate the extensor moment generated by the erector spinae muscles during bending and lifting activities. The extensor moment can itself be used to calculate the compressive force acting on the lumbar spine.

Influence of posture on the relation between surface electromyogram amplitude and back muscle moment: consequences for the use of surface electromyogram to measure back load

The aim of the study was to analyse the effect of posture on the relation between EMG amplitude and moment of the back muscles in different subjects, in order to gain a better insight into the possibilities of EMG as a means of measuring individual back load. Eight healthy subjects participated in the experiments. Isometric back extensions were performed in three postures: upright standing, standing with the spine flexed, and upright sitting. In each posture the lumbar moments of three maximal voluntary contractions were measured and then exertions of 10 to 90% of maximal voluntary contraction (increments of 10) were performed. EMG signals from the back muscles were recorded with four pairs of surface electrodes located 3 cm and 6 cm lateral to the midline of the spine at the L3 level. EMG signals were full-wave rectified and averaged over 2 s intervals of constant moment. The results show that posture has a considerable influence on the relationship between EMG and the lumbar moment. Besides this, large individual differences and an influence of electrode position on the relationship were found. Therefore it is concluded that whenever EMG is to be used as a means to measure individual back load, a calibration of the EMG amplitude to lumbar moment ratio is necessary for each subject, each electrode position, and each posture. Interpretation of EMG amplitudes has to be done on an individual basis and taking influences of posture and electrode location on the EMG-lumbar moment relationship into account.

Surface electromyogram spectral characterization and motor unit activity during voluntary ramp contraction in men

The relationships were investigated between the surface electromyographic (SEMG) power spectrum analysed by the 20 order autoregressive model (AR spectrum) and underlying motor unit (MU) activity during isometric contractions increasing linearly from 0% to 80% maximal voluntary contraction. Intramuscular spikes and SEMG signals were recorded simultaneously from biceps brachii muscle; the former were analysed by a computer-aided intramuscular MU spike amplitude-frequency (ISAF) histogram and the latter subjected to AR spectral analysis. Results indicated that there was a positive correlation between the force output and the mean amplitude of the ISAF histogram but not with the mean frequency. These changes were accompanied by changes in relative power of the high frequency (100-200 Hz) peak (HL) in the AR spectrum. It was also found that there was a positive correlation between the mean amplitude of the ISAF histogram and the HL value. These data suggested that the power of the high frequency peak in the AR spectrum of the SEMG signal preferentially reflected the progressive recruitment of underlying MU according to their size. Differences between the AR spectrum and the spectrum estimated by fast Fourier transform algorithm have also been discussed.