Voluntary and reflex control of human back muscles during induced pain.

1. Back pain is known to change motor patterns of the trunk. The purpose of this study was to examine the motor output of the erector spinae (ES) muscles during pain in the lumbar region. First, their voluntary activation was assessed during flexion and re-extension of the trunk. Second, effects of cutaneous and muscle pain on the ES stretch reflex were measured, since increased stretch reflex gain has been suggested to underlie increased muscle tone in painful muscles. 2. The trunk movement and electromyographical (EMG) signals from the right and left ES during pain were compared with values before pain. Controlled muscle pain was induced by infusion of 5 % saline into the right lumbar ES. Cutaneous pain was elicited by mechanical or electrical stimulation of the dorsal lumbar skin. The stretch reflex was evoked by rapidly indenting the right lumbar ES with a servo-motor prodder. 3. The results from the voluntary task show that muscle pain decreased the modulation depth of ES EMG activity. This pattern was associated with a decreased range and velocity of motion of the painful body segment, which would normally serve to avoid further injury. Interestingly, when subjects overcame this guarding tendency and made exactly the same movements during pain as before pain, the EMG modulation depth was still reduced. The results seem to reconcile the controversy of previous studies, in which both hyper- and hypoactivity of back muscles in pain have been reported. 4. In the tapped muscle, the EMG response consisted of two peaks (latency 19.3 +/- 2.1 and 44.6 +/- 2.5 ms, respectively) followed by a trough. On the contralateral side the first response was a trough (26.2 +/- 3.2 ms) while the second (46.4 +/- 4.3 ms) was a peak, similar to the second peak on the tapped side. Cutaneous pain had no effect on the short-latency response but significantly increased the second response on the tapped side. Surprisingly, deep muscle pain had no effect on the stretch reflex. A short-latency reciprocal inhibition exists between the right and left human ES. 5. It is concluded that deep back pain does not influence the stretch reflexes in the back muscles but modulates the voluntary activation of these muscles.

EMG power spectra of trunk muscles during graded maximal voluntary isometric contraction in flexion-rotation and extension-rotation.

The purpose of this study was to determine the electromyographic (EMG) power spectral characteristics of seven trunk muscles bilaterally during two complex isometric activities extension-rotation and flexion-rotation, in both genders to describe the frequency-domain parameters. Eighteen normal young subjects volunteered for the study. The subjects performed steadily increasing isometric extension-rotation and flexion-rotation contractions in a standard trunk posture (40 degrees flexed and 40 degrees rotated to the right). A surface EMG was recorded from the external and internal oblique, rectus abdominis, pectoralis, latissimus dorsi, and erector spinae muscles at the 10th thoracic and the 3rd lumbar vertebral levels, at 1 kHz and 25%, 50%, 75% and 100% of maximal voluntary contraction (MVC). The median frequency (MF), mean power frequency (MPF), frequency spread and peak power were obtained from fast Fourier transform analysis. The MF and MPF for both extension-rotation and flexion-rotation increased with the grade of contraction for both males and females. The EMG spectra in flexion-rotation were different from those of extension-rotation (P < 0.001). The left external and right internal oblique muscles played the role of antagonists in trunk extension-rotation. There was an increase in the MF of the trunk muscles with increasing magnitude of contraction. Frequency-domain parameters for both the male and female subjects were significantly different (P < 0.001).

Electromyographic response of the trunk muscles to postural perturbation in sitting subjects.

Electromyographic (EMG) patterns of the trunk muscles were investigated during balance perturbations in a sitting position. Five healthy subjects (two females and three males, mean age 24.4 yr) were seated on a platform allowing rotational perturbations in the frontal and sagittal planes. Each of the forward, backward, right and left perturbations were delivered with and without expectation at the velocities 8 degrees s-1 (SD +/- 4 degrees s-1) and 26 degrees s-1 (SD +/- 6 degrees s-1). The fast expected and unexpected perturbations were compared in blindfolded subjects. In the slow perturbations the effect of a blindfold on the balance reactions was tested. The root mean square (RMS) EMG signals from 12 trunk muscles were recorded and analysed to determine the EMG magnitudes. During the forward and backward rotations there was always a symmetrical EMG pattern between corresponding muscles on the right and left sides. A reciprocal phasic EMG activity between the left and right back muscles was found during frontal rotations. No reciprocal phasic activity was found in the abdominal muscles. Neither verbal instruction about the upcoming perturbation nor the blindfold changed the activation patterns.

Trunk strength in combined motions of rotation and flexion/extension in normal young adults.

Thirty-eight normal healthy young subjects (14 males, 24 females) with mean ages of 23 years (males) and 21 years (females), performed 36 functional rotational tasks of the trunk. The subject's lower extremities were stabilized in a stabilizing platform, allowing the entire motion of flexion-rotation and extension-rotation to take place in the trunk. Of these tasks, 18 were isometric and the other 18 were isokinetic. The isometric tasks consisted of flexion-rotation and extension-rotation from a 20 degrees, 40 degrees and 60 degrees flexed trunk in 20 degrees, 40 degrees and 60 degrees of axial rotation. The isokinetic activity consisted of flexion-rotation and extension-rotation from upright and flexed postures respectively in 20 degrees, 40 degrees and 60 degrees rotation planes at 15 degrees, 30 degrees and 60 degrees/s angular velocities. The results revealed that the males were significantly stronger than females (p < 0.01) and isometric activities produced significantly greater torque compared to isokinetic efforts (p < 0.01). The degree of trunk flexion was not significant; the angle of rotation, although significant, had only a small effect. The 60 degrees trunk rotation was significantly different from 20 degrees and 40 degrees of trunk rotation. The multiple regressions were all significant (p < 0.01); however, they predicted only 40 to 60% of the variations. Based on the results and analysis, it is suggested that the motion involved rather than the torque may have a consequential effect in the precipitation of back injuries.

Phasic activity in the human erector spinae during repetitive hand movements.

1. Phasic activity in the human back muscle erector spinae (ES) was studied during repetitive hand movements. The hand movements were elicited voluntarily by the subject or induced passively by the experimenter through a servomotor or through cyclical electrical stimulation of muscles acting about the wrist. The aim of the study was to determine whether the rhythmical activation of ES was of supraspinal, intersegmental or segmental origin. 2. When voluntary rhythmical hand movements were performed as fast as possible, cyclical ES EMG bursts occurred at the same frequency. This frequency was significantly higher than that reached when the task was to contract the back muscles as rapidly as possible. This suggests that the ES activity during the fast hand movements was not generated by direct commands descending to the ES muscles from the motor area of the cerebral cortex responsible for voluntary back muscle activation. 3. During imposed rhythmical hand movements, ES EMG bursts remained entrained to the hand movements, even when movement frequencies far exceeded those attainable voluntarily either for the hand or the back. This showed that ES EMG responses could be evoked by the hand movements even when these were not generated by descending neural commands. Two alternative mechanisms of ES activation were considered: (a) propriospinal transmission of afferent input entering the spinal cord from the upper extremity; (b) afferent input from ES and other trunk muscles, responding to local oscillations transmitted mechanically from the hand to the lower back. 4. Activation of ES via proprioceptive signals from the forearm was unlikely since (a) simultaneous electrical stimulation of wrist extensor and wrist flexor muscles did not result in repetitive ES EMG bursting; (b) cyclical vibration of the wrist extensors did not evoke ES EMG bursting; (c) when the forearm was constrained and the hand was moved passively, the lower trunk accelerations and cyclical ES EMG both occurred at a harmonic of the hand movement frequency. 5. We conclude that the repetitive ES EMG bursting during hand movements was probably due to a local segmental reflex rather than to descending commands. Remote mechanical oscillations of the trunk caused by hand movements evidently elicited proprioceptive reflexes in ES that presumably contributed to trunk stabilization.

Comparison of surface EMG signals between electrode types, interelectrode distances and electrode orientations in isometric exercise of the erector spinae muscle.

The influence of electrode type, interelectrode distance (IED) and electrode orientation on EMG signals from the paraspinal muscles was investigated. Bipolar electrodes were placed at distances 2, 3, 4, 6 and 8 cm over the erector spinae in the cranio-caudal direction ("in series") as well as in the direction perpendicular to it ("in parallel"). Ten subjects performed 5 s isometric contractions of the erector spinae at 20, 40, 60, 80 and 100% MVC by pulling upward on a handlebar attached to the floor. RMS EMG signals were analyzed for mean average amplitude (AA). Mean total power (TP) and mean median frequency (MF) of the raw EMG signal were determined using fast Fourier transform. In addition to graded loading, sustained fatiguing contractions were performed from which TP and MF were obtained. With increasing IED the AA and TP increased while MF decreased. Although a trend towards higher AA, TP and MF was found for electrodes "in series", as compared to those "in parallel", the difference never reached significance. It is concluded that consistent information about muscle activity was obtained with Miniature Biopotential Skin Electrodes and 14445C Hewlett-Packard electrodes independently from IED or orientation. Orientation "in parallel" prevented the electrodes from sliding during muscle contraction. The third tested type, electrodes developed in the Neuromuscular Research Center, Boston, proved extremely sensitive to movement.

An electromyographic study of unresisted trunk rotation with normal velocity among healthy subjects.

STUDY DESIGN: An axial rotation tester was designed and fabricated for the study. This allowed stabilization of seated subjects (hip down) and coupling of shoulders, permitting axial rotation and coupled lateral flexion. Using this device, a "flexion-extension free" axial rotation was executed for studying its characteristics. OBJECTIVES: To determine the mechanism of initiation, sustenance, and execution of axial rotation. This was planned to be done by determining the phasic relationship of various torso muscles in the initiation, execution, and termination of axial rotation. Another objective was to determine the total and relative contribution of torso muscles in axial rotation and the small segments of these activities. SUMMARY OF BACKGROUND DATA: There only are a few studies conducted on axial rotation. Generally, these have investigated isometric maximal voluntary contraction in neutral or prerotated postures. The two studies that have reported isokinetic axial rotation have investigated maximal efforts. No study in literature has reported initiation, termination, and execution of unresisted normal velocity axial rotation. METHODS: Fifty healthy young subjects executed a full cycle of axial rotation, starting from neutral position to their extreme left, continuing to their extreme right, and finally moving to the neutral posture in one smooth motion without stopping anywhere. The electromyographic results of external obliques, internal obliques, rectus abdominis, pectoralis major, erectores spinae at T10 and L3, and latissimus dorsi were measured bilaterally simultaneously during this trunk rotation. The timing and relative magnitude analyses were done to determine the global and individual muscle contributions in axial rotation. The correlation between electromyographic and angular displacement, and nonlinear curve fitting regression analyses were performed to decipher individual muscles behavior. RESULTS: The pattern of muscle activation was variable. However, contralateral external obliques, ipsilateral erector spinae, and latissimus dorsi became active before other muscles. These were agonists and the others were antagonists or stabilizers. The agonists contributed 65% of the total electromyographic output, whereas antagonists and stabilizers contributed 35%. The muscle activities during onset and offset periods were biphasic with significantly different slopes. CONCLUSIONS: It was concluded that the axial rotation is achieved through the activities of agonists, and return to neutral position is because of elastic recoil controlled by agonistic muscles. A range of approximately 10-15 degrees on either side of the anatomical midsagittal plane involves little muscle effort, but beyond this region, the osteoligamentous structures become stiff and require increasing effort to execute axial rotation.