People with recurrent low back pain respond differently to trunk loading despite remission from symptoms.
METHODS
Cross-sectional design.


OBJECTIVE
To compare lumbar multifidus electromyographic activity (EMG) during predictable and unpredictable trunk loading between people with and without recurrent unilateral low back pain (LBP) during symptom remission.


BACKGROUND
Unpredictable loading is a common injury mechanism for LBP. Paraspinal muscle responses to trunk loading differ between people with and without a history of LBP, but whether the response differs between specific regions within the paraspinal muscles is unclear. Differences between deep (DM) and superficial fibers (SM) of multifidus have been implicated in other tasks. It is unknown whether DM and SM EMG differ between people in remission from recurrent LBP and healthy people during trunk loading.


METHODS
DM and SM EMG was recorded bilaterally at L5 with intramuscular electrodes during predictable and unpredictable trunk loading and compared during 10 milliseconds epochs (250 milliseconds before to 150 milliseconds after loading) between sides, loading conditions, and groups.


RESULTS
DM EMG increased above baseline before and after predictable load onset, but returned to baseline at the time of impact. Both DM EMG bursts were less in the remission group and less on the non-painful side. Peak SM EMG amplitude on the previously painful side was earlier in the remission group than healthy participants. DM and SM EMG were less after unpredictable load onset in the remission group than healthy participants.


CONCLUSIONS
Despite symptom remission, DM EMG during predictable loading and DM and SM EMG during unpredictable loading were less in people with recurrent LBP than healthy participants.
NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
David
D
MacDonald
G Lorimer
GL
Moseley
Paul W
PW
Hodges
D000328:Adult; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D004576:Electromyography; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology*; D008161:Lumbosacral Region; D008297:Male; D009119:Muscle Contraction / Q000502:physiology*; D018482:Muscle, Skeletal / Q000503:physiopathology*; D016474:Weight-Bearing