Erector Spinae Muscle Activation During Forward Movement in Individuals With or Without Chronic Lower Back Pain: A Systematic Review and Meta-analysis.
Euan W Taylor, U Chris Ugbolue, Yang Gao and 3 others
PMID 37744192WHAT IT FOUND
Adults with chronic low back pain showed higher erector spinae muscle activity during forward walking or running than healthy adults.
Seven case-control studies found the same direction, but the studies do not show pain caused the change.
Key findings
01The pooled comparison found higher erector spinae activation in chronic low back pain than healthy controls (standardized mean difference 0.48, 95% confidence interval 0.21-0.74).
02The meta-analysis included 7 case-control studies with 241 participants: 135 had chronic low back pain and 106 were healthy controls.
03The included studies scored 4 to 8 on the PEDro scale.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 7 case-control studies were included, with 241 participants in total. Participants were grouped by whether they had chronic low back pain, not randomly assigned, so the review cannot show that pain caused the higher muscle activity. The studies used different EMG systems, speeds, and back muscles, and some did not report details such as treadmill incline, velocity or maximum voluntary contraction methods. Surface EMG was used in all 7 studies and can be affected by crosstalk from nearby muscles, especially when measuring deep back muscles. PEDro scores ranged from 4 to 8. Only English journal articles with full text were included, so other relevant studies may have been missed.
The easy way to misread this
Do not read the higher erector spinae activity as proof that chronic low back pain is caused by a specific muscle problem or that a particular exercise will fix it. The studies compared existing groups, used different EMG methods and walking speeds, and did not test treatment.