The Effect of Current Low Back Pain on Volitional Preemptive Abdominal Activation During a Loaded Forward Reach Activity

• Published in: PM & R 2017-02, Vol.9 (2), p.127-135
• Main Authors: Nagar, Vittal R., MD, Hooper, Troy L., PT, PhD, Dedrick, Gregory S., PT, ScD, Brismée, Jean-Michel, PT, ScD, McGalliard, Michael K., ScD, Sizer, Phillip S., PT, PhD
• Format: Article
• Language: English
• Subjects: Abdominal Muscles - diagnostic imaging; Abdominal Muscles - physiopathology; Adult; Cross-Over Studies; Female; Humans; Low Back Pain - physiopathology; Male; Muscle Contraction - physiology; Physical Medicine and Rehabilitation; Ultrasonography - methods
• ISSN: 1934-1482; 1934-1563
• DOI: 10.1016/j.pmrj.2016.05.019

Abstract Background A volitional preemptive abdominal contraction (VPAC) supports trunk stability during functional activity. Pain-free individuals can sustain VPAC during function, but such has not been reported for individuals with current low back pain (cLBP). Objective To examine whether cLBP affects VPAC performance during a loaded forward reach (LFR) task. Design Observational crossover study. Setting Laboratory. Participants A total of 18 controls and 17 subjects with cLBP with pain ratings of 1/10 to 4/10 on a visual analog scale. Interventions Transverse abdominis (TrA) thickness measurements were recorded by blinded researchers from M-mode ultrasound imaging during 4 conditions: (1) quiet standing without abdominal drawing-in maneuver (ADIM); (2) quiet standing with ADIM; (3) LFR without ADIM; and (4) LFR with ADIM. A physical therapist with 29 years of experience collected historical and examination data. Main Outcome Measures TrA muscle thickness (mm). Results A 2 (group) × 2 (contraction) × 2 (reach) analysis of variance demonstrated a significant group × contraction interaction (F [1, 31] = 4.499, P = .04) where ADIM produced greater TrA thickness increases in PLBP subjects (2.18 mm) versus controls (1.36 mm). We observed a significant main effect for reach (F [1, 31] = 14.989, P < .001), where LFR activity produced a greater TrA thickness (6.15 ± 2.48 mm) versus quiet standing (5.30 ± 2.12 mm). Conclusions Subjects with cLBP demonstrated a greater increase in TrA activation during ADIM versus controls.