title: The potential use of spectral electromyographic fatigue as a screening and outcome monitoring tool of sarcopenic back muscle alterations.
abstract: BACKGROUND
  To examine whether or not median frequency surface electromyographic (MF-EMG) back muscle fatigue monitoring would be able to identify alterations in back muscle function in elderly muscles, if a protocol was used that allowed optimum standardization of the processes underlying electromyographic fatigue, and whether these tests were reliable from day to day.
  
  
  METHODS
  A total of 42 older (21 females; 67 (±10.5) years old) and 44 younger persons (19 females; 33 (±10) years) performed maximum isometric back extensions which were followed by one 30 s lasting 80% submaximum extension. Participants were seated on a dynamometer with their trunks 30° anteflexed, and they repeated all tests after 1-2 days and 6 weeks. SEMG was recorded bilaterally from the L1 (iliocostalis lumborum), L2 (longissimus), and L5 (multifidus) recording sites. Outcome variables included maximum back extension torque, initial MF-EMG (IMF-EMG), MF-EMG slope declines, and individual MF-EMG muscular imbalance scores. Two-factorial ANOVAs served to examine the age and gender-specific effects, and models from Generalizability Theory (G-Theory) were used for assessing retest-reliability.
  
  
  RESULTS
  Maximum back extension moment was non-significantly smaller in elders. IMF-EMG was overall higher in elders, with significant differences at the L5 recordings sites. In the elderly, MF-EMG fatigue declines were significantly smaller in L5, in the recording with the most negative slope, or if the slope of all electrodes was considered. Retest reliability was unanimous in young and older persons. ICC-type measurements from G-Theory of both the IMF and the fatigue slopes ranged from 0.7 to 0.85. Absolute SEM values were found clinically acceptable for the IMF-EMG, but relatively high for the fatigue slope declines.
  
  
  CONCLUSIONS
  The MF-EMG fatigue method is able to elucidate alterations of aging back muscles. This method, thus, might be suggested as a potential biomarker to objectively identify persons at risk for sarcopenia. Considering the clinical relevance of the IMF-EMG relative to the MF-EMG slope declines, spectral EMG may also be used as an outcome monitoring tool in elderly populations.
authors.affiliation: Karl-Landsteiner-Institute for outpatient rehabilitation research, Porschestraße 29, Vienna A-1230, Austria. kienbacher@rehabzentrum.at.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kienbacher
authors.forename: Richard
authors.initials: R
authors.lastname: Habenicht
authors.forename: Christian
authors.initials: C
authors.lastname: Starek
authors.forename: Patrick
authors.initials: P
authors.lastname: Mair
authors.forename: Markus
authors.initials: M
authors.lastname: Wolf
authors.forename: Birgit
authors.initials: B
authors.lastname: Paul
authors.forename: Sara
authors.initials: S
authors.lastname: Riegler
authors.forename: Josef
authors.initials: J
authors.lastname: Kollmitzer
authors.forename: Gerold
authors.initials: G
authors.lastname: Ebenbichler
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology* / Q000502:physiology; D064131:Back Muscles / Q000503:physiopathology*; D004576:Electromyography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology; D018763:Muscle Fatigue / Q000502:physiology*; D055948:Sarcopenia / Q000175:diagnosis*; D012815:Signal Processing, Computer-Assisted; D055815:Young Adult