Muscle activation patterns in subjects with and without low back pain

Arch Phys Med Rehabil. 2002 Jun;83(6):816-21. doi: 10.1053/apmr.2002.32826.


Objective: To analyze muscle activation patterns during various footplate perturbations, used as proprioceptive challenges in patients with low back pain (LBP) and in controls.

Design: A prospective and controlled comparative study.

Setting: Outpatient clinic.

Participants: Twenty subjects with chronic LBP and 20 age- and sex-matched controls.

Interventions: The subjects underwent 5 sets of footplate perturbations in 3 directions with 16 perturbations for each set.

Main outcome measures: Latency, frequency, and asymmetry of muscle activation of the erector spinae, rectus abdominus, anterior tibialis, and gastrocnemius muscles were measured bilaterally with surface electromyography.

Results: In the toes-up movements, subjects with LBP were significantly less likely to activate their rectus abdominus muscles (P=.02), and they were more likely to exhibit asymmetric muscle activation in the smaller forward movements (odds ratio=4.1, P=.03). The latter result appears to be driven by asymmetric contraction of the erector spinae and rectus abdominus.

Conclusions: Significantly more subjects with LBP than control subjects exhibited absent firing of trunk muscles during 2 of the 5 footplate perturbations. These results suggest an abnormality of the neuromuscular loop and may represent altered proprioception.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Case-Control Studies
  • Chronic Disease
  • Electromyography
  • Female
  • Humans
  • Logistic Models
  • Low Back Pain / physiopathology*
  • Low Back Pain / rehabilitation*
  • Male
  • Middle Aged
  • Muscle, Skeletal / physiopathology*
  • Odds Ratio
  • Proprioception*
  • Prospective Studies