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Suo M, Zhou L, Wang J, Huang H, Zhang J, Sun T, Liu X, Chen X, Song C, Li Z. The Application of Surface Electromyography Technology in Evaluating Paraspinal Muscle Function. Diagnostics (Basel) 2024; 14:1086. [PMID: 38893614 PMCID: PMC11172025 DOI: 10.3390/diagnostics14111086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 05/01/2024] [Accepted: 05/07/2024] [Indexed: 06/21/2024] Open
Abstract
Surface electromyography (sEMG) has emerged as a valuable tool for assessing muscle activity in various clinical and research settings. This review focuses on the application of sEMG specifically in the context of paraspinal muscles. The paraspinal muscles play a critical role in providing stability and facilitating movement of the spine. Dysfunctions or alterations in paraspinal muscle activity can lead to various musculoskeletal disorders and spinal pathologies. Therefore, understanding and quantifying paraspinal muscle activity is crucial for accurate diagnosis, treatment planning, and monitoring therapeutic interventions. This review discusses the clinical applications of sEMG in paraspinal muscles, including the assessment of low back pain, spinal disorders, and rehabilitation interventions. It explores how sEMG can aid in diagnosing the potential causes of low back pain and monitoring the effectiveness of physical therapy, spinal manipulative therapy, and exercise protocols. It also discusses emerging technologies and advancements in sEMG techniques that aim to enhance the accuracy and reliability of paraspinal muscle assessment. In summary, the application of sEMG in paraspinal muscles provides valuable insights into muscle function, dysfunction, and therapeutic interventions. By examining the literature on sEMG in paraspinal muscles, this review offers a comprehensive understanding of the current state of research, identifies knowledge gaps, and suggests future directions for optimizing the use of sEMG in assessing paraspinal muscle activity.
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Affiliation(s)
- Moran Suo
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (M.S.); (J.W.); (H.H.); (J.Z.); (T.S.); (X.L.)
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Dalian 116000, China
| | - Lina Zhou
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China;
| | - Jinzuo Wang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (M.S.); (J.W.); (H.H.); (J.Z.); (T.S.); (X.L.)
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Dalian 116000, China
| | - Huagui Huang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (M.S.); (J.W.); (H.H.); (J.Z.); (T.S.); (X.L.)
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Dalian 116000, China
| | - Jing Zhang
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (M.S.); (J.W.); (H.H.); (J.Z.); (T.S.); (X.L.)
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Dalian 116000, China
| | - Tianze Sun
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (M.S.); (J.W.); (H.H.); (J.Z.); (T.S.); (X.L.)
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Dalian 116000, China
| | - Xin Liu
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (M.S.); (J.W.); (H.H.); (J.Z.); (T.S.); (X.L.)
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Dalian 116000, China
| | - Xin Chen
- Musculoskeletal Research Laboratory, Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China;
| | - Chunli Song
- Department of Neurology, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China;
| | - Zhonghai Li
- Department of Orthopedics, First Affiliated Hospital of Dalian Medical University, Dalian 116011, China; (M.S.); (J.W.); (H.H.); (J.Z.); (T.S.); (X.L.)
- Key Laboratory of Molecular Mechanism for Repair and Remodeling of Orthopedic Diseases, Dalian 116000, China
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Zhang G, Gao L, Zhang D, Li H, Shen Y, Zhang Z, Huang Y. Mawangdui-Guidance Qigong Exercise for patients with chronic non-specific low back pain: Study protocol of a randomized controlled trial. Front Neurosci 2023; 17:1090138. [PMID: 36992848 PMCID: PMC10040536 DOI: 10.3389/fnins.2023.1090138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/23/2023] [Indexed: 03/15/2023] Open
Abstract
IntroductionWorldwide, there is a high frequency of chronic non-specific low back pain (CNLBP), which is a significant public health concern. The etiology is complicated and diverse, and it includes a number of risk factors such as diminished stability and weak core muscles. Mawangdui-Guidance Qigong has been employed extensively to bolster the body in China for countless years. However, the effectiveness of treating CNLBP has not been assessed by a randomized controlled trial (RCT). In order to verify the results of the Mawangdui-Guidance Qigong Exercise and examine its biomechanical mechanism, we intend to perform a randomized controlled trial.Methods and analysisOver the course of 4 weeks, 84 individuals with CNLBP will be randomly assigned to receive either Mawangdui-Guidance Qigong Exercise, motor control exercise, or medication (celecoxib). Electromyographic data, including muscle activation time, iEMGs, root mean square value (RMS) and median frequency (MF), will be the main outcomes. The Japanese Orthopedic Association (JOA) Score, the Mcgill Pain Questionnaire (MPQ), beta-endorphin, and substance P are examples of secondary outcomes. At the start of treatment and 4 weeks later, all outcomes will be evaluated. SPSS version 20.0 (SPSS Inc., Chicago, IL, USA) will be used for all of the analysis.DiscussionThe prospective findings are anticipated to offer an alternative treatment for CNLBP and provide a possible explanation of the mechanism of Mawangdui-Guidance Qigong Exercise on CNLBP.Ethics and disseminationThe Sichuan Regional Ethics Review Committee on Traditional Chinese Medicine has given the study approval (Approval No. 2020KL-067). It has also registered at the website of China Clinical Trial Center Registration. The application adheres to the Declaration of Helsinki’s tenets (Version Edinburgh 2000). Peer-reviewed papers will be used to publicize the trial’s findings.Trial registration numberClinicalTrials.gov, identifier ChiCTR2000041080.
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Affiliation(s)
- Guilong Zhang
- Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Liang Gao
- Beijing Bo’ai Hospital China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, China
| | - Di Zhang
- Department of Rehabilitation, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Hongjian Li
- Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Department of Orthopedics, Yibin Hospital of Traditional Chinese Medicine, Yibin, Sichuan, China
| | - Yuquan Shen
- Department of Rehabilitation, The First People’s Hospital of Longquanyi District, Chengdu, China
| | - Zhengsong Zhang
- Traditional Chinese Medicine (TCM) Preventive Medical Center, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yong Huang
- Department of Orthopedics, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
- *Correspondence: Yong Huang,
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Gasibat Q, Rani B, Čaušević D, Perveen W, Alexe CI, Albina AE, Alexe DI. A Comparative Electromyographic Analysis of Flying Squirrel and 3-Point Quadripod Exercise for Lumbar Multifidus Muscle Activations among Healthy Female Subjects. Healthcare (Basel) 2023; 11:healthcare11060833. [PMID: 36981490 PMCID: PMC10048022 DOI: 10.3390/healthcare11060833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/01/2023] [Accepted: 03/10/2023] [Indexed: 03/14/2023] Open
Abstract
Physical therapists employ several exercises to alleviate low back pain (LBP). Electromyography (EMG) examination of exercises can monitor muscle activation to help clinicians determine the exercise’s effect on stabilisation, endurance, or strength. This study evaluated surface EMG activity comparison for Flying Squirrel Exercise (FSE) and the novel 3-Point Quadripod Exercise (3-PQE) to find the most effective exercise for stimulating the lumbar multifidus (LM) muscle. The study recruited 64 healthy young females (19–24 years). Raw data were normalized and are expressed as the percentage of maximum voluntary isometric contraction (%MVIC). The test–retest reliability of the EMG recordings was estimated using intraclass correlation coefficient (ICC3,1). One-way ANOVA was used to statistically analyse and compare the EMG amplitudes during the two exercises. The ICCs for 3-PQE and FSE were 0.94 (SEM, 21.7% MVIC) and 0.87 (SEM, 19.05% MVIC), respectively. The 3-PQE (69 ± 26% MVIC) demonstrated significantly higher activity than did FSE (30 ± 18% MVIC) (F = 15.573, p = 0.001). Thus, 3-PQE might be a feasible strategy for the prevention and rehabilitation of LBP in females.
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Affiliation(s)
- Qais Gasibat
- Department of Sports Studies, Universiti Putra Malaysia UPM, Selangor 43400, Malaysia
| | - Babina Rani
- Department of Physical Rehabilitation & Medicine (Physiotherapy), Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Denis Čaušević
- Faculty of Sport and Physical Education, University of Sarajevo, 71000 Sarajevo, Bosnia and Herzegovina
| | - Wajida Perveen
- School of Allied Health Sciences, CMH Lahore Medical College & IOD (NUMS Rawalpindi), Lahore 54810, Pakistan
| | - Cristina Ioana Alexe
- Department of Physical Education and Sports Performance, Faculty of Movement, Sports and Health Sciences, “Vasile Alecsandri” University of Bacău, 600115 Bacău, Romania
- Correspondence: (C.I.A.); (A.E.A.)
| | - Alina Elena Albina
- Department of Theory and Methodology of Motor Activities, Faculty of Physical Education and Sports, University of Craiova, Alexandru Ioan Cuza nr.13, 200585 Craiova, Romania
- Correspondence: (C.I.A.); (A.E.A.)
| | - Dan Iulian Alexe
- Department of Physical and Occupational Therapy, Faculty of Movement, Sports and Health Sciences, “Vasile Alecsandri” University of Bacău, 600115 Bacău, Romania
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Baig AAM, Ansari B. Bilateral Asymmetrical Limb Proprioceptive Neuromuscular Facilitation Effects on Pain, Multifidus Activity, Range of Motion, and Disability in Low Back Pain: A Randomized Controlled Trial. J Manipulative Physiol Ther 2022; 45:604-613. [PMID: 37294220 DOI: 10.1016/j.jmpt.2023.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 04/12/2023] [Accepted: 04/12/2023] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The purpose of this study was to determine the effects of bilateral asymmetrical limb proprioceptive neuromuscular facilitation (PNF) pattern exercises on lumbar multifidus (LM) activity, pain, disability, and lumbar range of motions (ROMs) compared to Swiss ball exercises in patients with chronic low back pain (CLBP). METHODS A randomized controlled trial was conducted at the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan, between March 2020 and January 2021. A sample size of 150 patients with CLBP was randomized into 2 groups. Participants in the intervention group (n = 75) received bilateral asymmetrical limb PNF, while the comparison group (n = 75) received Swiss ball exercises. The scores of the visual analog scale, Oswestry Disability Index, Modified-Modified Schober's test, and percentage of the maximum voluntary contractions of LM (%MVC LM) through surface electromyography were recorded before and after 15 sessions of exercises. The Wilcoxon signed rank and Mann-Whitney U tests were employed for within-group and between-group comparisons of all outcomes, respectively. The considered level of significance was 0.05. The trial was registered with ClinicalTrials.gov (NCT04206137). RESULTS Pain (in sitting, standing, and walking), disability on the Oswestry Disability Index, and left side %MVC LM were significantly improved (P < .001) in the PNF group compared to the comparison group except for right side %MVC LM and ROMs on the Modified-Modified Schober's test (P > .05). CONCLUSION Bilateral asymmetrical limb PNF exercises showed improvement in pain, disability, and LM activity of patients with CLBP more than those who used Swiss ball exercises.
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Affiliation(s)
- Aftab Ahmed Mirza Baig
- Department of Physiotherapy, Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Sindh, Pakistan.
| | - Basit Ansari
- Health, Physical Education and Sports Sciences, University of Karachi, Karachi, Sindh, Pakistan
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Clemente PC, de Almeida LL, Vicente EJD, Fonseca DS, Souza VH, Felício DC, Garcia MAC. Perceived exertion, postural control, and muscle recruitment in three different quadruped exercises performed by healthy women. Front Physiol 2022; 13:948469. [PMID: 36117695 PMCID: PMC9473345 DOI: 10.3389/fphys.2022.948469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
Although quadruped exercises (QE) have been a part of rehabilitation and sports programs, there is no clarity on how these exercises challenge the musculoskeletal system. Therefore, this cross-sectional study investigated the perceived exertion, postural demands, and muscle recruitment profiles imposed by three QE postures. Surface electromyographic (sEMG) signals were recorded from transverse abdominis, longissimus dorsi, multifidus, and iliocostalis lumborum from 30 sedentary healthy women, bilaterally. They performed the classic quadruped exercise (CQ), a variation with shoulder flexion (FQ), and the homolateral quadruped (HQ). Borg scores (BS) and the center of pressure (CoP) from the palmar statokinesiogram were also recorded. Surface EMG signals were normalized using the myoelectric activity recorded from two other postures while performing isometric voluntary contractions (IVC). Results were analyzed using one- (CoP) and three-way (sEMG data) ANOVA with Bonferroni post hoc tests (α = 0.05). The Borg scale was analyzed using the Friedman test. The CQ provided lower BS and CoP than HQ (p < 0.05), followed by a higher sEMG activity (∼51% of IVC) than FQ (∼47% of IVC; p = 0.53) and HQ (∼44% of IVC; p = 0.01). In turn, HQ provided greater BS (p > 0.05) than CQ and FQ. The results suggested that the HQ was the most challenging exercise regarding CoP and BS, although CQ presented a higher symmetrical sEMG activity. Since QE are often prescribed in exercise programs, specific knowledge of the characteristics of each QE makes prescribing safer and more efficient.
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Affiliation(s)
- Patrícia Cardoso Clemente
- Programa de Pós-Graduação em Ciências da Reabilitação e Desempenho Físico Funcional, Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
- Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (SUPREMA), Juiz de Fora, Minas Gerais, Brazil
| | - Luane Landim de Almeida
- Programa de Pós-Graduação em Ciências da Reabilitação e Desempenho Físico Funcional, Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
- Faculdade de Ciências Médicas e da Saúde de Juiz de Fora (SUPREMA), Juiz de Fora, Minas Gerais, Brazil
| | - Eduardo José Danza Vicente
- Departamento de Fisioterapia Cardiorrespiratória e Musculoesquelética, Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Diogo Simões Fonseca
- Programa de Pós-Graduação em Ciências da Reabilitação e Desempenho Físico Funcional, Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
- Departamento de Fisioterapia Cardiorrespiratória e Musculoesquelética, Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Victor Hugo Souza
- Programa de Pós-Graduação em Ciências da Reabilitação e Desempenho Físico Funcional, Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
- Department of Neuroscience and Biomedical Engineering, Aalto University, School of Science, Espoo, Finland
- Grupo de Neuro Biomecânica, Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Diogo Carvalho Felício
- Programa de Pós-Graduação em Ciências da Reabilitação e Desempenho Físico Funcional, Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Marco Antonio Cavalcanti Garcia
- Programa de Pós-Graduação em Ciências da Reabilitação e Desempenho Físico Funcional, Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
- Grupo de Neuro Biomecânica, Faculdade de Fisioterapia, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
- Departamento de Fisiologia, Instituto de Ciências Biológicas, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
- *Correspondence: Marco Antonio Cavalcanti Garcia,
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Wu Z, Ye X, Ye Z, Hong K, Chen Z, Wang Y, Li C, Li J, Huang J, Zhu Y, Lu Y, Liu W, Xu X. Asymmetric Biomechanical Properties of the Paravertebral Muscle in Elderly Patients With Unilateral Chronic Low Back Pain: A Preliminary Study. Front Bioeng Biotechnol 2022; 10:814099. [PMID: 35223786 PMCID: PMC8866935 DOI: 10.3389/fbioe.2022.814099] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Clinical incidences of chronic low back pain among the elderly are increasing. However, studies have not fully elucidated on changes in biomechanical properties of paravertebral muscles in patients with unilateral chronic low back pain. We evaluated the changes in biomechanical properties of painful and non-painful paravertebral muscles in elderly patients with unilateral chronic low back pain.Methods: Biomechanical properties of paravertebral muscles, including muscle tone and stiffness, in elderly patients with unilateral chronic low back pain were measured using MyotonPRO. Lumbar Lordosis and Sacral Slope were measured by magnetic resonance imaging. Cross-sectional areas of paravertebral muscles were evaluated using ImageJ software version 1.53. Chronic low back pain severity was assessed by Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores. The correlations between VAS scores, ODI scores, Lumbar Lordosis, Sacral Slope, cross-sectional areas (painful side), disease duration, and biomechanical properties of paravertebral muscles in the painful side were analyzed.Results: A total of 60 elderly patients with unilateral chronic low back pain were enrolled in this study. The muscle tone and stiffness of paravertebral muscles on the painful side were significantly higher than those on the non-painful side (p < .05). Cross-sectional areas of paravertebral muscles on the painful side at the L3 level were smaller than those of the non-painful side (p < .05). The VAS scores and ODI scores were significantly positively correlated with muscle tone and stiffness of paravertebral muscles on the painful side (p < .05 and p < .01, respectively). There were no significant correlations between disease duration, cross-sectional areas (painful side), Lumbar Lordosis, or Sacral Slope and muscle tone and stiffness of paravertebral muscles on the painful side (p > .05).Conclusion: In elderly patients with unilateral chronic low back pain, muscle tone and stiffness of paravertebral muscles on the painful side are higher than for those on the non-painful side. The asymmetry of biomechanical properties of paravertebral muscles is associated with severity of chronic low back pain.
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Affiliation(s)
- Zugui Wu
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xiangling Ye
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zixuan Ye
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Kunhao Hong
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Zehua Chen
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi Wang
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Congcong Li
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Junyi Li
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jinyou Huang
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
| | - Yue Zhu
- Baishui Health Center, Qujing, China
| | - Yanyan Lu
- Luoyang Orthopedic Hospital Of Henan Province (Orthopedic Hospital of Henan Province), Zhengzhou, China
- *Correspondence: Xuemeng Xu, ; Wengang Liu, ; Yanyan Lu,
| | - Wengang Liu
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
- *Correspondence: Xuemeng Xu, ; Wengang Liu, ; Yanyan Lu,
| | - Xuemeng Xu
- The Fifth Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, China
- Guangdong Second Traditional Chinese Medicine Hospital, Guangzhou, China
- *Correspondence: Xuemeng Xu, ; Wengang Liu, ; Yanyan Lu,
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