title: Influence of chronic low back pain and fear of movement on the activation of the transversely oriented abdominal muscles during forward bending.
abstract: BACKGROUND
  Chronic low back pain (CLBP) and fear of movement (kinesiophobia) are associated with an overactivation of paravertebral muscles during forward bending. This impairs spine motor control and contributes to pain perpetuation. However, the abdominal muscles activation is engaged too in spine stabilization but its modulation with kinesiophobia remains unknown. Our study tested whether CLBP and kinesiophobia affected the activation pattern of abdominal muscles during trunk flexion/extension.
  
  
  METHODS
  Surface electromyographical recordings of the internal oblique/transversus abdominis (IO/TrA) and external oblique (EO) muscles were analyzed in 12 people with CLBP and 13 pain-free subjects during low-velocity forward bending back and forth from erected posture. Tampa Scale of Kinesiophobia was also administrated.
  
  
  RESULTS
  IO/TrA activation, but not EO, was modulated across the phases of movement in both groups, i.e. maximal at onset of flexion and end of extension, and minimal at full flexion. In CLBP group only, IO/TrA activation was increased near to full trunk flexion and in correlation with kinesiophobia.
  
  
  CONCLUSIONS
  The phase-dependence of IO/TrA activation during trunk flexion/extension in standing may have a role in spine motor control. The influence of kinesiophobia in CLBP should be further investigated as an important target in CLBP management.
authors.affiliation: Université Laval, Centre de recherche du CHU de Québec, Clinical Neuroscience and Neurostimulation Laboratory, Quebec City, Qc, Canada. Electronic address: hugo.masse-alarie.1@ulaval.ca.
authors.forename: Hugo
authors.initials: H
authors.lastname: Massé-Alarie
authors.affiliation: Université Laval, Centre de recherche du CHU de Québec, Clinical Neuroscience and Neurostimulation Laboratory, Quebec City, Qc, Canada. Electronic address: louis-david.beaulieu.1@ulaval.ca.
authors.forename: Louis-David
authors.initials: LD
authors.lastname: Beaulieu
authors.affiliation: McGill University, Constance-Lethbridge Rehabilitation Center - CRIR, Montreal, Qc, Canada. Electronic address: richard.preuss@mcgill.ca.
authors.forename: Richard
authors.initials: R
authors.lastname: Preuss
authors.affiliation: Université Laval, Centre de recherche du CHU de Québec, Clinical Neuroscience and Neurostimulation Laboratory, Quebec City, Qc, Canada. Electronic address: cyril.schneider@rea.ulaval.ca.
authors.forename: Cyril
authors.initials: C
authors.lastname: Schneider
mesh_terms: D000009:Abdominal Muscles / Q000502:physiology*; D000328:Adult; D064131:Back Muscles / Q000502:physiology; D059350:Chronic Pain / Q000503:physiopathology / Q000523:psychology*; D004576:Electromyography / Q000379:methods; D005239:Fear / Q000502:physiology* / Q000523:psychology*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009068:Movement / Q000502:physiology*; D011187:Posture / Q000502:physiology*; D016059:Range of Motion, Articular / Q000502:physiology; D055815:Young Adult
keywords: Abdominal muscles; Chronic low back pain; Kinesiophobia; Lumbar spine; Motor control; Trunk movement