title: A surface electromyography based objective method to identify patients with nonspecific chronic low back pain, presenting a flexion related movement control impairment.
abstract: Movement control impairments (MCI) are often present in patients with non-specific chronic low back pain (NS-CLBP). Therefore, movement control exercises are widely used to rehabilitate patients. However, the objective assessment remains difficult. The purpose of this study was to develop a statistical model, based on logistic regression analysis, to differentiate patients with NS-CLBP presenting a flexion-related MCI from healthy subjects. This model is based on trunk muscle activation patterns measured by surface electromyography (sEMG), during movement control exercises. Sixty-three healthy male subjects and 36 male patients with a flexion-related MCI participated in this study. Muscle activity of the internal obliques, the external obliques, the lumbar multifidus and the thoracic part of the iliocostalis was registered. Ratios of deep stabilizing to superficial torque producing muscle activity were calculated to examine trunk muscle recruitment patterns during 6 different exercises. Logistic regression analyses were performed (1) to define the ratios and exercises that were most discriminating between patients and non-patients, (2) to make a predictive model. K-Fold cross-validation was used to assess the performance of the predictive model. This study demonstrated that sEMG trunk muscle recruitment patterns during movement control tests, allows differentiating NSCLBP patients with a flexion-related MCI from healthy subjects.
authors.affiliation: Center for Musculoskeletal Medicine & Rehabilitation, Military Hospital Queen Astrid, Brussels, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium. Electronic address: Benedicte.VanDamme@mil.be.
authors.forename: Benedicte
authors.initials: B
authors.lastname: Van Damme
authors.affiliation: Center for Musculoskeletal Medicine & Rehabilitation, Military Hospital Queen Astrid, Brussels, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Veerle
authors.initials: V
authors.lastname: Stevens
authors.affiliation: Department of Mathematics, Royal Military Academy, Brussels, Belgium.
authors.forename: Christiaan
authors.initials: C
authors.lastname: Perneel
authors.affiliation: Center for Musculoskeletal Medicine & Rehabilitation, Military Hospital Queen Astrid, Brussels, Belgium; Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Damien
authors.initials: D
authors.lastname: Van Tiggelen
authors.affiliation: Center for Musculoskeletal Medicine & Rehabilitation, Military Hospital Queen Astrid, Brussels, Belgium.
authors.forename: Ellen
authors.initials: E
authors.lastname: Neyens
authors.affiliation: Center for Musculoskeletal Medicine & Rehabilitation, Military Hospital Queen Astrid, Brussels, Belgium.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Duvigneaud
authors.affiliation: Center for Musculoskeletal Medicine & Rehabilitation, Military Hospital Queen Astrid, Brussels, Belgium.
authors.forename: Luc
authors.initials: L
authors.lastname: Moerman
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.
authors.forename: Lieven
authors.initials: L
authors.lastname: Danneels
mesh_terms: D000009:Abdominal Muscles / Q000502:physiology; D000328:Adult; D002908:Chronic Disease; D004576:Electromyography / Q000379:methods*; D005081:Exercise Therapy / Q000379:methods*; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000503:physiopathology* / Q000534:rehabilitation; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D018482:Muscle, Skeletal / Q000502:physiology; D016059:Range of Motion, Articular / Q000502:physiology; D055815:Young Adult
keywords: Electromyography; Flexion; Movement control impairment; Ratios; Trunk muscle activity