Electromyographic activity of the lumbar extensor muscles: effect of angle and hand position during Roman chair exercise.

OBJECTIVE: To evaluate the effects of angle and hand position during variable-angle Roman chair (VARC) back extension exercise on lumbar paraspinal electromyographic (EMG) activity. DESIGN: Descriptive, repeated measures. SETTING: University-based musculoskeletal research laboratory. PARTICIPANTS: Two female and eight male volunteers recruited from a university setting. INTERVENTION AND OUTCOME MEASURES: Surface integrated EMG activity was recorded from the L3-L4 paraspinal region during 24 10-second repetitions of dynamic back extension exercise, each consisting of a unique VARC angle (six total) and subject hand position (four total). Lumbar paraspinal surface integrated EMG activity measured in millivolts per repetition was used for analysis. RESULTS: Significant lumbar paraspinal EMG activity was evident during each of the 24 repetitions (p < or = .05), with a 104% increase in activity noted between the lowest and highest. EMG activity increased progressively among hand positions and as the VARC angle became more horizontal. VARC angle affected EMG activity more than hand position, but the greatest impact on EMG activity was produced by modifying both angle and hand position. CONCLUSION: Lumbar paraspinal EMG activity can be altered during VARC back extension exercise by changing angle and hand position. Clinicians can use these data to develop progressive resistance exercise programs using the VARC apparatus.

Rotary manipulation for cervical radiculopathy: observations on the importance of the direction of the thrust.

OBJECTIVE: To describe the clinical presentation of eight patients with cervical spine radiculopathy, the manipulation technique used for each patient and the outcomes of treatment. CLINICAL FEATURES: The cause of radiculopathy in four patients was disc herniation. The other four patients had a combination of spondylosis, disc herniation and sprain injury. INTERVENTION AND OUTCOME: Six of eight patients had a good outcome associated with receiving manipulation performed by contacting the cervical spine at the level of the radiculopathy, laterally flexing toward the side of radiculopathy, rotating the neck away from the side of the radiculopathy and applying a gentle high-velocity, low-amplitude thrust. Two patients had an exacerbation of arm pain and increased neurological deficit associated with manipulation performed with the neck rotated toward the side of radiculopathy. CONCLUSION: There is little compelling evidence supporting or disputing the use of manipulation for patients with cervical spine radiculopathy. In our patients, rotary manipulation was associated with a different outcome depending on the direction of neck rotation. Prospective time-series studies and randomized, blind trials are needed to identify the efficacy and effectiveness of different manipulation techniques for this condition.