Association between lumbopelvic motion and muscle activation in patients with non-specific low back pain during forward bending task: A cross-sectional study.
Peemongkon Wattananon, Komsak Sinsurin, Sirikarn Somprasong
PMID 32489238WHAT IT FOUND
During forward bending, people with low back pain did not show a clear lumbar motion difference, but pelvic motion appeared more dominant and gluteus maximus activity was lower than in healthy people.
Only eight per group were studied.
Key findings
01The pain group did not show a significant lumbar range difference from controls, but had a trend toward greater pelvic range and a within-group pattern of faster pelvic than lumbar motion.
02Both gluteus maximus muscles had lower activation in the pain group, though only the painful-side median exceeded the measurement-error threshold.
03In healthy controls, lumbar velocity was negatively associated with activation of several lumbopelvic muscles; in the pain group, ipsilateral erector spinae activation was strongly negatively associated with lumbar range of motion.
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How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 8 participants were in each group, and the authors said the association findings were under-powered. The sample size was pre-specified as part of an intervention study, not calculated for this cross-sectional comparison. Several motion differences were trends, and only the painful-side gluteus maximus median exceeded the measurement-error threshold. Submaximal reference contractions were used for lumbar multifidus and erector spinae, while maximal contractions were used for other muscles, so activation could not be compared across all lumbopelvic muscles. This was an observational comparison, not a treatment trial, so it cannot show that changing motion or muscle activation will improve pain.
Declared interests
The authors declare no conflict of interest. Funding was from the Thailand Research Fund (Grant No. TRG5880133, 2015).
The easy way to misread this
Do not conclude that low gluteus maximus activation causes non-specific low back pain or that exercising the gluteus maximus will change bending patterns. This was a small cross-sectional comparison of 8 patients and 8 healthy people, and several motion differences were trends rather than clear group differences.