Paraspinal strength and electromyographic fatigue in patients with sub-acute back pain and controls: Reliability, clinical applicability and between-group differences

doi:10.5312/wjo.v12.i11.816

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Nov 18, 2021 (publication date) through Feb 21, 2025

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World Journal of Orthopedics

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World J Orthop. Nov 18, 2021; 12(11): 816-832
Published online Nov 18, 2021. doi: 10.5312/wjo.v12.i11.816

Table 1 Anthropometric measures (mean ± SD) of participants

	Age (yr)	Height (cm)	Body mass (kg)	BMI (kg/m²)
Healthy
Male (n = 13)	27.0 ± 6.8^a	178.4 ± 5.5	78.9 ± 8.7	24.7 ± 2.3
Female (n = 13)	24.6 ± 5.3^b	163.0 ± 8.0	56.8 ± 5.7^b	21.5 ± 3.5^b
Total (n = 26)	25.8 ± 6.1^b	170.7 ± 10.4	67.8 ± 13.4^b	23.1 ± 3.3^b
Patients
Male (n = 34)	35.7 ± 10.2	177.5 ± 6.4	81.1 ± 10.6	25.7 ± 2.6
Female (n = 32)	39.2 ± 10.9	166.2 ± 5.8	74.5 ± 13.6	26.9 ± 4.4
Total (n = 66)	37.4 ± 10.6	172.1 ± 8.4	77.9 ± 12.5	26.3 ± 3.6

Significantly different to patients’ corresponding data:

^aP = 0.01.

^bP < 0.01.

BMI: Body mass index.

Table 2 Maximum strength (mean ± SD) values in controls and patients

	Non-LBP (n = 26)			LBP (n = 66)
MVIC (kg)	Day 1 (practice)	Day 2	P value	Day 1 (practice)	Day 2	P value
Maximum	85.8 ± 23.7	91.4 ± 26.7	0.005^b	58.7 ± 24.8	63.5 ± 26.5	0.0005^b
		Mean increase: 6.5%			Mean increase: 9.4%
Mean	82.6 ± 22.7	88.5 ± 25.5	0.002^b	56.0 ± 24.1	61.1 ± 26.0	0.0005^b
		Mean increase: 7.2%			Mean increase: 9.7%

^bP < 0.01.

MVIC: Maximum/mean voluntary isometric contraction.

Table 3 Mean ± SD values on 2 separate days for initial median frequency, median frequency-slope and root mean square for the isometric endurance test in both groups

	Healthy (n = 26)			LBP (n = 66)
Parameter	Day 1	Day 2	P value	Day 1	Day 2	P value
IMF (Hz)
L2/3 R	60.3 ± 10.9	61.0 ± 11.1	0.48	66.5 ± 17.6	66.1 ± 15.8	0.82
L2/3 L	58.2 ± 9.0	59.1 ± 12.3	0.52	63.5 ± 17.2	61.9 ± 13.2	0.18
L4/5 R	89.3 ± 20.3	91.0 ± 16.4	0.49	83.2 ± 24.3	83.0 ± 21.3	0.89
L4/5 L	90.9 ± 20.1	92.3 ± 17.3	0.59	82.7 ± 26.0	83.5 ± 20.8	0.59
L2/3	59.24 ± 9.7	60.1 ± 11.4	0.44	65.0 ± 16.4	64.0 ± 13.8	0.39
L4/5	90.1 ± 19.4	91.6 ± 15.9	0.49	82.9 ± 24.3	83.2 ± 20.0	0.83
MF slopes (raw, Hz/s)
L2/3 R	-0.30 ± 0.14	-0.35 ± 0.12	0.02^a	-0.12 ± 0.16	-0.12 ± 0.17	0.77
L2/3 L	-0.30 ± 0.11	-0.31 ± 0.10	0.52	-0.10 ± 0.18	-0.11 ± 0.14	0.41
L4/5 R	-0.48 ± 0.16	-0.54 ± 0.22	0.19	-0.23 ± 0.25	-0.22 ± 0.20	0.62
L4/5 L	-0.56 ± 0.21	-0.61 ± 0.19	0.19	-0.21 ± 0.25	-0.23 ± 0.25	0.53
L2/3	-0.30 ± 0.11	-0.33 ± 0.10	0.08	-0.11 ± 0.16	-0.11 ± 0.15	0.51
L4/5	-0.52 ± 0.17	-0.57 ± 0.19	0.13	-0.22 ± 0.23	-0.22 ± 0.20	0.84
MF slopes (normalised, %/min)
L2/3 R	-28.8 ± 11.5	-31.5 ± 9.0	0.14	-9.0 ± 15.2	-9.9 ± 15.8	0.55
L2/3 L	-29.9 ± 9.3	-29.8 ± 8.4	0.95	-8.1 ± 15.9	-10.5 ± 14.8	0.11
L4/5 R	-34.0 ± 11.3	-34.2 ± 11.9	0.90	-15.0 ± 15.7	-15.0 ± 12.0	0.98
L4/5 L	-36.4 ± 10.7	-37.7 ± 10.4	0.58	-13.2 ± 14.0	-17.1 ± 13.3	0.01^a
L2/3	-29.3 ± 9.8	-30.6 ± 7.9	0.39	-8.6 ± 14.8	-10.2 ± 14.5	0.21
L4/5	-35.2 ± 9.6	-36.0 ± 10.2	0.67	-14.1 ± 13.7	-16.1 ± 11.7	0.10
RMS slopes (normalised, %/min)
L2/3 R	43.4 ± 45.0	37.4 ± 35.2	0.35	10.4 ± 21.4	11.3 ± 18.5	0.72
L2/3 L	27.4 ± 30.8	29.0 ± 28.3	0.73	11.3 ± 17.3	13.9 ± 22.8	0.17
L4-5 R	42.6 ± 35.9	32.7 ± 29.2	0.19	14.3 ± 21.2	12.6 ± 22.2	0.43
L4/5 L	37.1 ± 36.2	38.4 ± 34.1	0.85	10.3 ± 19.3	13.9 ± 21.2	0.07

^aP < 0.05.

Hz: Hertz; IMF: Initial median frequency; MF: Median frequency; RMS: Root mean square.

Table 4 Maximum strength reliability indices in controls and patients

	Controls (n = 26)			Patients (n = 66)
Parameter	ICC_3,1	SEM	SDD%	ICC_3,1	SEM	SDD%
MVIC (kg)
Maximum	0.92 (0.83-0.97)	5.94	18.57	0.91 (0.86-0.94)	6.96	31.61
Mean	0.96 (0.90-0.98)	5.72	18.51	0.96 (0.93-0.97)	6.49	30.75

ICC: Intraclass correlation coefficient; SEM: Standard error of the measurement; SDD: Smallest detectable difference; MVIC: Maximum/mean voluntary isometric contraction.

Table 5 Reliability of initial median frequency, median frequency-slope and root mean square for the isometric endurance test in both groups

	Controls (n = 26)			Patients (n = 66)
Parameter	ICC_3,1	SEM	SDD	ICC_3,1	SEM	SDD
IMF (Hz)
L2/3 R	0.91 (0.80-0.96)	3.32	9.19	0.80 (0.69-0.87)	7.56	20.95
L2/3 L	0.82 (0.63-0.92)	4.57	12.66	0.80 (0.69-0.87)	6.88	19.06
L4/5 R	0.82 (0.61-0.92)	7.99	22.13	0.82 (0.73-0.89)	9.64	26.70
L4/5 L	0.81 (0.60-0.91)	8.31	23.02	0.86 (0.79-0.92)	8.61	23.85
L 2/3	0.94 (0.87-0.98)	3.45	9.56	0.90 (0.84-0.94)	6.41	17.75
L 4/5	0.91 (0.79-0.96)	7.27	20.14	0.94 (0.90-0.96)	7.59	21.02
MF slopes (raw, Hz/s)
L2/3 R	0.61 (0.27-0.81)	0.07	0.19	0.75 (0.62-0.84)	0.08	0.22
L2/3 L	0.67 (0.36-0.85)	0.06	0.17	0.66 (0.50-0.78)	0.09	0.25
L4/5 R	0.52 (0.14-0.77)	0.13	0.36	0.73 (0.60-0.83)	0.12	0.33
L4/5 L	0.55 (0.18-0.78)	0.13	0.36	0.62 (0.45-0.75)	0.15	0.41
L 2/3	0.77 (0.46-0.90)	0.06	0.17	0.86 (0.77-0.91)	0.08	0.22
L 4/5	0.73 (0.35-0.89)	0.11	0.30	0.88 (0.80-0.92)	0.10	0.28
MF slopes (normalised, %/min)
L2/3 R	0.67 (0.36-0.85)	5.79	16.03	0.69 (0.55-0.80)	8.59	23.79
L2/3 L	0.65 (0.33-0.84)	5.36	14.85	0.69 (0.54-0.80)	8.44	23.38
L4/5 R	0.64 (0.31-0.83)	7.11	19.69	0.62 (0.45-0.75)	8.59	23.79
L4/5 L	0.50 (0.11-0.75)	7.60	21.05	0.57 (0.38-0.71)	8.66	23.99
L 2/3	0.82 (0.57-0.92)	4.93	13.66	0.85 (0.75-0.91)	7.47	20.69
L 4/5	0.78 (0.49-0.91)	6.02	16.67	0.83 (0.73-0.90)	6.75	18.69
RMS slopes (normalised, %/min)
L2/3 R	0.73 (0.46-0.88)	21.00	58.17	0.48 (0.27-0.65)	14.48	40.11
L2/3 L	0.76 (0.51-0.89)	14.83	41.08	0.71 (0.56-0.81)	10.83	30.00
L4/5 R	0.44 (0.04-0.72)	24.07	66.67	0.73 (0.60-0.83)	11.26	31.19
L4/5 L	0.54 (0.17-0.78)	24.20	67.03	0.61 (0.44-0.74)	12.44	34.46

Hz: Hertz; ICC: Intraclass correlation coefficient; SEM: Standard error of the measurement; SDD: Smallest detectable difference; IMF: Initial median frequency; MF: Median frequency; RMS: Root mean square.

Table 6 Adjusted between-group median frequency-slope differences in the isometric endurance test at 60% of maximum voluntary isometric contraction

		Healthy (n = 26)		LBP (n = 66)		Mean difference	P value
Parameter		Mean	SE	Mean	SE	Mean difference	P value
MF slopes (raw, Hz/s)
L2/3	-0.25		0.03	-0.14	0.02	0.12	0.002^b
L4/5	-0.44		0.05	-0.26	0.02	0.18	0.002^b
MF slopes (normalised, %/min)
L2/3	-22.4		2.9	-13.0	1.4	9.4	0.009^b
L4/5	-29.4		2.5	-18.4	1.2	11.0	0.000^b

^bP < 0.01.

Hz: Hertz; LBP: Low back pain; MF: Median frequency.

Citation: Koumantakis GA, Oldham JA. Paraspinal strength and electromyographic fatigue in patients with sub-acute back pain and controls: Reliability, clinical applicability and between-group differences. World J Orthop 2021; 12(11): 816-832
URL: https://www.wjgnet.com/2218-5836/full/v12/i11/816.htm
DOI: https://dx.doi.org/10.5312/wjo.v12.i11.816