title: Creation of an asymmetrical gradient of back muscle activity and spinal stiffness during asymmetrical hip extension.
abstract: BACKGROUND
  Low back pain is often associated with increased spinal stiffness which thought to arise from increased muscle activity. Unfortunately, the association between paraspinal muscle activity and paraspinal stiffness, as well as the spatial distribution of this relation, is unknown. The purpose of this investigation was to employ new technological developments to determine the relation between spinal muscle contraction and spinal stiffness over a large region of the lumbar spine.
  
  
  METHODS
  Thirty-two male subjects performed graded isometric prone right hip extension at four different exertion levels (0%, 10%, 25% and 50% of the maximum voluntary contraction) to induce asymmetric back muscle activity. The corresponding stiffness and muscle activity over bilateral paraspinal lumbar regions was measured by indentation loading and topography surface electromyography, respectively. Paraspinal stiffness and muscle activity were then plotted and their correlation was determined.
  
  
  RESULTS
  Data from this study demonstrated the existence of an asymmetrical gradient in muscle activation and paraspinal stiffness in the lumbar spine during isometric prone right hip extension. The magnitude and scale of the gradient increased with the contraction force. A positive correlation between paraspinal stiffness and paraspinal muscle activity existed irrespective of the hip extension effort (Pearson correlation coefficient, range 0.566-0.782 (P<0.001)).
  
  
  CONCLUSIONS
  Our results demonstrate the creation of an asymmetrical gradient of muscle activity and paraspinal stiffness during right hip extension. Future studies will determine if alterations in this gradient may possess diagnostic or prognostic value for patients with low back pain.
authors.affiliation: Department of Orthopaedics, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam Road, Hong Kong. yhud@hkusua.hku.hk
authors.forename: Y
authors.initials: Y
authors.lastname: Hu
authors.forename: Y L
authors.initials: YL
authors.lastname: Wong
authors.forename: William W
authors.initials: WW
authors.lastname: Lu
authors.forename: Gregory N
authors.initials: GN
authors.lastname: Kawchuk
mesh_terms: D000328:Adult; D001696:Biomechanical Phenomena; D004576:Electromyography / Q000379:methods; D004867:Equipment Design; D005081:Exercise Therapy / Q000379:methods*; D006615:Hip / Q000503:physiopathology; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology* / Q000534:rehabilitation*; D008159:Lumbar Vertebrae; D008161:Lumbosacral Region / Q000502:physiology; D008297:Male; D018763:Muscle Fatigue; D018482:Muscle, Skeletal / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D013131:Spine; D016474:Weight-Bearing