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The Effect of Current Low Back Pain on Volitional Preemptive Abdominal Activation During a Loaded Forward Reach Activity
Author(s) -
Nagar Vittal R.,
Hooper Troy L.,
Dedrick Gregory S.,
Brismée JeanMichel,
McGalliard Michael K.,
Sizer Phillip S.
Publication year - 2017
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2016.05.019
Subject(s) - medicine , visual analogue scale , crossover study , trunk , contraction (grammar) , analysis of variance , physical medicine and rehabilitation , physical therapy , anesthesia , ecology , alternative medicine , pathology , biology , placebo
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.