title: Are lumbar multifidus fatigue and transversus abdominis activation similar in patients with lumbar disc herniation and healthy controls? A case control study.
abstract: The aims of this study were to assess lumbar multifidus fatigue (LM) and transversus abdominis activation (TrA) in individuals with lumbar disc herniation associated with low back pain.
  
  
  
  Sixty individuals were divided into the lumbar herniation (LHG, n = 30) and control groups (CG, n = 30). Fatigue of the LM was assessed using surface electromyography during the Sorensen effort test, and activation of the TrA with a pressure biofeedback unit. Pain intensity was determined using a visual analog scale and the McGill pain questionnaire. The Oswestry disability questionnaire and the Borg scale for self-evaluating exertion were used to assess functional disability.
  
  
  
  Fatigue was significantly more intense and the TrA activation was insufficient (p < 0.01) in individuals with disc herniation relative to the control group. The LHG had mild functional disability and moderate pain. There were differences in the initial exertion self-evaluation between groups, which were not observed in the final exertion evaluation.
  
  
  
  Individuals with lumbar disc herniation associated with low back pain have increased fatigue of the LM and decreased activation of the TrA, when compared to the control group.
authors.affiliation: Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil. luiz.armando@usp.br.|FMUSP, Street Cipotânia, 51, University City, Sao Paulo (SP), 05360-160, Brazil. luiz.armando@usp.br.
authors.forename: Luiz Armando Vidal
authors.initials: LAV
authors.lastname: Ramos
authors.affiliation: Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Fábio Jorge Renovato
authors.initials: FJR
authors.lastname: França
authors.affiliation: Department of Physical Therapy and Occupational Therapy, Institute of Health Sciences, Federal University of Pará, Belém, Brazil.
authors.forename: Bianca
authors.initials: B
authors.lastname: Callegari
authors.affiliation: Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Thomaz Nogueira
authors.initials: TN
authors.lastname: Burke
authors.affiliation: Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Maurício Oliveira
authors.initials: MO
authors.lastname: Magalhães
authors.affiliation: Department of Physical Therapy, Speech and Occupational Therapy, School of Medicine of University of Sao Paulo, Sao Paulo, Brazil.
authors.forename: Amélia Pasqual
authors.initials: AP
authors.lastname: Marques
mesh_terms: D000009:Abdominal Muscles / Q000502:physiology*; D000328:Adult; D016022:Case-Control Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000453:epidemiology / Q000503:physiopathology; D017116:Low Back Pain / Q000453:epidemiology / Q000503:physiopathology; D008161:Lumbosacral Region / Q000503:physiopathology*; D008875:Middle Aged; D018763:Muscle Fatigue; D064170:Paraspinal Muscles / Q000503:physiopathology*; D055815:Young Adult
keywords: Intervertebral disc displacement; Low back pain; Muscle fatigue