title: The Effects of Vibration and Muscle Fatigue on Trunk Sensorimotor Control in Low Back Pain Patients.
abstract: BACKGROUND
  Changes in sensorimotor function and increased trunk muscle fatigability have been identified in patients with chronic low back pain (cLBP). This study assessed the control of trunk force production in conditions with and without local erector spinae muscle vibration and evaluated the influence of muscle fatigue on trunk sensorimotor control.
  
  
  METHODS
  Twenty non-specific cLBP patients and 20 healthy participants were asked to perform submaximal isometric trunk extension torque with and without local vibration stimulation, before and after a trunk extensor muscle fatigue protocol. Constant error (CE), variable error (VE) as well as absolute error (AE) in peak torque were computed and compared across conditions. Trunk extensor muscle activation during isometric contractions and during the fatigue protocol was measured using surface electromyography (sEMG).
  
  
  RESULTS
  Force reproduction accuracy of the trunk was significantly lower in the patient group (CE = 9.81 ± 2.23 Nm; AE = 18.16 ± 3.97 Nm) than in healthy participants (CE = 4.44 ± 1.68 Nm; AE = 12.23 ± 2.44 Nm). Local erector spinae vibration induced a significant reduction in CE (4.33 ± 2.14 Nm) and AE (13.71 ± 3.45 Nm) mean scores in the patient group. Healthy participants conversely showed a significant increase in CE (8.17 ± 2.10 Nm) and AE (16.29 ± 2.82 Nm) mean scores under vibration conditions. The fatigue protocol induced erector spinae muscle fatigue as illustrated by a significant decrease in sEMG median time-frequency slopes. Following the fatigue protocol, patients with cLBP showed significant decrease in sEMG root mean square activity at L4-5 level and responded in similar manner with and without vibration stimulation in regard to CE mean scores.
  
  
  CONCLUSIONS
  Patients with cLBP have a less accurate force reproduction sense than healthy participants. Local muscle vibration led to significant trunk neuromuscular control improvements in the cLBP patients before and after a muscle fatigue protocol. Muscle vibration stimulation during motor control exercises is likely to influence motor adaptation and could be considered in the treatment of cLBP. Further work is needed to clearly identify at what levels of the sensorimotor system these gains are achievable.
authors: Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada.
authors: Jean-Alexandre
authors: JA
authors: Boucher
authors: Département d'anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada.
authors: Jacques
authors: J
authors: Abboud
authors: Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada.
authors: François
authors: F
authors: Nougarou
authors: Département de chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada.
authors: Martin C
authors: MC
authors: Normand
authors: Département des sciences de l'activité physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada.
authors: Martin
authors: M
authors: Descarreaux
mesh_terms: D000328:Adult; D004576:Electromyography; D005260:Female; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology; D017116:Low Back Pain / Q000503:physiopathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D018763:Muscle Fatigue / Q000502:physiology*; D052580:Muscle Stretching Exercises; D018482:Muscle, Skeletal / Q000503:physiopathology; D026741:Physical Therapy Modalities; D066191:Sensorimotor Cortex / Q000502:physiology; D019415:Torque; D060726:Torso / Q000503:physiopathology; D014732:Vibration / Q000627:therapeutic use*; D055815:Young Adult