OBJECTIVETo evaluate the reliability of flexion-extension ratio (FER) of lumbar erector muscle in surface EMG for the diagnosis of nonspecific chronic low back pain.

METHODSAccording to diagnostic study strategies, 73 patients with chronic low back pain and 86 controls were recruited in this study, FER of lumbar erector muscle were recorded in surface EMG for all the subjects. The critical value of FER for the diagnosis of nonspecific chronic low back pain was selected according to the receiver operator characteristic curve by SPSS. Sensitivity, specificity and accuracy were calculated and analyzed as well.

RESULTSThe FER in patients group was significantly higher than that in the control group. The critical value of FER was 0.68 with sensitivity, specificity and accuracy was 78.1%, 95.3% and 87.4% respectively.

CONCLUSIONFER of lumbar erector muscle might be practically applied as an objective indicator on the diagnosis of nonspecific chronic low back pain in surface EMG.

Chronic Disease ; Electromyography ; Humans ; Low Back Pain ; diagnosis ; physiopathology

EMG has been extensively used to study function of back muscle, which plays an important role in the objective assessment of occupational low back pain, yet the inherent large variability of EMG signals across subjects produced by reasons already known or unknown may mask true biological differences. Some useful parameters abstracted from 8-channel EMG signal in time-frequency domain are used or proposed and calculated in this paper to decrease this variability, when comparing the possible difference between low back pain patients and normal control group. The calculation of instantaneous median frequency is improved to decrease the interruption of background noise, and different power densities in EMG time-frequency spectrogram are observed in two tested groups.
Back ; Electromyography ; Fourier Analysis ; Humans ; Low Back Pain ; physiopathology ; Muscle, Skeletal ; physiopathology ; Spectrum Analysis

Dynamic stabilization system plays an important role in the treatment of the degenerative lumbar spine. Fusion of short movement segments has little influences on the motion of lumbar spine. Meanwhile, preservation of movements of segment can prevent the degeneration of adjacent segment and maintain the possibility of disc replacement even under the condition that facet joints need to be excised. While maintaining the normal lumbar motion, dynamic stabilization system can not only decrease the load of intervertebral disc of corresponding movement segments and provide a good environment for the recovery of intervertebral disc and soft tissues, but also delay the degeneration of small facet and reconstruct the biomechanical function of spine.
Biomechanical Phenomena ; Humans ; Intervertebral Disc Displacement ; surgery ; Low Back Pain ; physiopathology ; surgery

OBJECTIVETo evaluate the role of muscle fatigue in the pathogenesis of high prevalence of low back pain(LBP) in drivers who work at high altitude, in order to seek the effective measures for prevention and treatment of LBP.

METHODThe spectral electromyographic(EMG) changes during isometric contraction of erector spinalis to fatigue in 26 drivers in the field were consecutively recorded after daily driving for 5 days. The relationship between the decline of median frequency and the development of the back extensor fatigue were analyzed.

RESULTSThe decline rates of EMG median frequency of the erector spinalis on 1-5 working day [(-0.258 +/- 0.087), (-0.248 +/- 0.070), (-0.256 +/- 0.097), (-0.267 +/- 0.093), (-0.274 +/- 0.081)%/s respectively] were significantly different from that of baseline measured before work [(-0.175 +/- 0.114)%/s, P < 0.05 or P < 0.01]. A positive correlation was also found between the decline rate and the working time(r = -0.809, P < 0.05).

CONCLUSIONThe high prevalence of LBP in the drivers working at high altitude is due to acumulative fatigue of back extensor resulting from long-distance driving, lack of proper rest, decrease of muscle endurance and increase of liability to fatigue, consequently leading to the muscle dysfunction and finally LBP.

Altitude ; Automobile Driving ; Electromyography ; Humans ; Low Back Pain ; etiology ; physiopathology ; Muscle Fatigue ; physiology ; Occupational Diseases ; etiology

Spinal "Gucuofeng" mainly is considered as abnormalities of joint function. Manipulative maneuver have obviously effect in adjustment of spinal "Gucuofeng", and the technical key point is utilization of principle of lever to achieve safe, effective and labor-saving purpose. After clinical practice, the general principle of manipulative maneuver in adjustment of spinal "Gucuofeng" can be summed up as pull stretch traction, first-induced instability, reverse adjustment,withdraw along situation.
Adaptation, Psychological ; Exercise Therapy ; Humans ; Low Back Pain ; surgery ; Manipulation, Spinal ; methods ; Social Adjustment ; Spine ; physiopathology

OBJECTIVETo explore the morphometric abnormalities of brain gray matter (GM) in patients with chronic low back pain (CLBP).

METHODSThirty patients with CLBP and 30 healthy individuals were enrolled and examined with a 3.0 T magnetic resonance (MR) scanner. High-resolution T1 structural MR data were acquired and data analysis was performed using voxel-based morphometry (VBM) in FMRIB Software Library. The morphological differences were compared between the two groups.

RESULTSs Compared with the healthy control subjects, patients with CLBP showed decreased GM volumes in several brain cortical areas including the bilateral superior frontal gyrus, right frontal pole, left insular cortex, left middle and left inferior temporal gyrus (P<0.05, after TFCE correction). Increased GM volumes were found in the patients in the subcortical structures including the left thalamus, bilateral putamen, bilateral nucleus accumben and right caudate nucleus (P<0.05, after TFCE correction).

CONCLUSIONPatients with CLBP have different patterns of GM abnormalities in different brain regions, characterized by reduced GM volume in cerebral cortical regions and increased GM volume in the subcortical nuclei. Such changes might be associated with the maladaptation of the brain in chronic pain state.

Cerebral Cortex ; Frontal Lobe ; Gray Matter ; diagnostic imaging ; pathology ; Humans ; Low Back Pain ; physiopathology ; Magnetic Resonance Imaging ; Temporal Lobe ; Thalamus

Animals ; Humans ; Intervertebral Disc Degeneration ; physiopathology ; Low Back Pain ; etiology ; pathology ; Lumbar Vertebrae ; blood supply ; Risk Factors ; Smoking ; adverse effects

BACKGROUNDLow back pain (LBP) is a common clinical problem. Many researchers have demonstrated that LBP disorders have difference in sensory strategies for postural control. Optokinetic stimulation (OKS) of optic flow has been widely applied to study its effect on vision, but has not been applied to LBP. Here we used OKS on different surfaces to investigate the characteristics of chronic nonspecific LBP (CNLBP) posture control, so as to provide new theoretical and experimental data for further recognizing CNLBP and enriching its treatment.

METHODSFifteen individuals with CNLBP (age range 25-40 years) and 15 age and gender-matched control subjects were recruited. Each subject, while standing on a stable or soft surface, was exposed to random-dot patterns projected on a large screen, with the dots displaying expansion (+) and contraction (-) and velocities including 80°, 40°, and 20° per second. The visual stimulus used a "stimuli-interval" pattern. The peak velocity, different phases' standard deviation (SD) of the anterior-posterior centre of pressure (COP) displacements and the total length of the medial-lateral COP sway (LML) for stable surface and soft surface were recorded by force platform.

RESULTSThe main effect of surface on all parameters was significant, while the main effect of group and OKS showed no significance with the exception of peak velocity (F(3, 95) = 3.6, P = 0.01) and A2 (F(5, 140) = 9.34, P < 0.01) for which the effect of OKS was significant. The interactions of group by OKS of A2 (F(5, 140) = 3.65, P < 0.01) and group by surface by OKS (F(5,140) = 2.83, P = 0.02), and surface by OKS of A1 and A3 (P < 0.05) were significant. It was reported that significantly more SD in amplitude in the T2 phase was seen in persons with CNLBP when confronting the + 40 stimuli on the soft surface (P < 0.05) compared to healthy individuals.

CONCLUSIONSThere was no significance between persons with CNLBP and healthy people when using the stable surface. Subjects with LBP showed decreased efficiency of postural adjustment when exposed to more complicated tasks and environments, especially OKS in the expansion direction, and displayed a visual-dependent phenomenon. This result suggested that the treatment of abnormal motor patterns in people with LBP should take the properties of task and environment into account.

Adult ; Case-Control Studies ; Female ; Healthy Volunteers ; Humans ; Low Back Pain ; physiopathology ; Male ; Postural Balance ; physiology ; Posture ; physiology

OBJECTIVETo observe the difference of the clinical effects of different needle retention times for acute lumbar sprain treated with float needle.

METHODSOne hundred and twenty patients with acute lumbar sprain were randomly divided into a 6 h group, a 12 h group, a 24 h group and a western medication group, 30 cases in each one. In the three float needle groups, plastic hose was detained near the pressure pain point on the lumbar after subcutaneous scattering with float needle. The needle retention time was 6 h, 12 h and 24 h respectively. In the western medication group, 75 mg voltaren tablet was adopted orally every day and the treatment was given for four days. Visual analogue scale (VAS) and Oswestry dysfunction index (ODI) about low back pain were observed before and after treatment. Also, the comprehensive effect was assessed after treatment.

RESULTSAfter treatment, the VAS scores and the ODI scores were improved obviously than those before treatment in all groups (all P< 0. 05). In the three float needle groups, the VAS scores and the ODI scores were superior to those in the western medication group (all P<0. 05). The differences in VAS scores and ODI scores among the three float needle groups were not statistically significant after treatment (all P>0. 05). The effective rate in the 6 h, 12 h and 24 h group was 93. 3% (28/30), 90. 0% (27/30) and 93. 3% (28/30) respectively, which were better than 73. 3% (22/30) in the western medication group (all P<0. 05).

CONCLUSIONThe effect of float needle for acute lumbar sprain is better than voltaren, and there is no apparent difference in retention times.

Acupuncture Therapy ; Adult ; Aged ; Female ; Humans ; Low Back Pain ; physiopathology ; therapy ; Lumbar Vertebrae ; injuries ; physiopathology ; Male ; Middle Aged ; Needles ; Sprains and Strains ; physiopathology ; therapy ; Young Adult

OBJECTIVETo observe therapeutic effect of small needle-knife comprehensive therapy on pain and lumbar flexion range in the chronic nonspecific low back pain patient.

METHODSThree hundred and five cases were randomly divided into a needle-knife group of 153 cases and a physiotherapy group of 152 cases. The needle-knife group were treated with small needle-knife releasing therapy, blocking and functional training. The physiotherapy group were treated with ultra-short wave, modulated medium frequency current, massage and functional training. Pain was assessed by visual analogue scale (VAS) and the lumbar flexion range was determined before and after treatment.

RESULTSAfter treatment, the pain and the lumbar flexion range were significantly improved in the two groups; and after treatment, the VAS score and the lumbar flexion range were (1.60 +/- 0.38) points and (65.76 +/- 15.11) cm in the needle-knife group and (4.59 +/- 1.09) points and (53.74 +/- 15.13) cm in the physiotherapy group, respectively, the needle-knife group being significantly better than the physiotherapy group (P < 0.01). Follow-up survey of 6-36 months showed that the VAS score and the lumbar flexion range in the needle-knife group were superior to those in the physiotherapy group.

CONCLUSIONSmall needle-knife comprehensive therapy can significantly improve pain and lumbar flexion range in the chronic nonspecific low back pain patient, with a stable long-term therapeutic effect.

Acupuncture Therapy ; Adult ; Aged ; Chronic Disease ; therapy ; Combined Modality Therapy ; Female ; Humans ; Low Back Pain ; physiopathology ; rehabilitation ; therapy ; Lumbosacral Region ; physiopathology ; Male ; Massage ; Middle Aged ; Radiotherapy