Effects of Lumbopelvic Manipulation on Neuromuscular Activity of Back & Hip Muscles in Adults With Chronic Low Back Pain

Effects of Lumbopelvic Manipulation on Neuromuscular Activity of Back and Hip Muscles in Adults With Chronic Low Back Pain

The purposes of this study are:

1. To examine the within-day and between-day test-retest reliability of a testing protocol measuring the back and hip muscles fatigability using EMG median frequency
2. To examine the immediate and the carry-over effects of the lumbopelvic manipulation on the EMG median frequency of the lumbar multifidus (MULT), gluteus medius (GMED) and gluteus maximus (GMAX) muscles in patients with chronic low back pain (CLBP)
3. To compare the fatigability levels of the MULT, GMED and GMAX muscles by measuring the EMG median frequency between the participants who will receive lumbopelvic manipulation.

The research hypotheses are:

1. The testing protocol using EMG median frequency as a fatigue indicator for MULT,GMED and GMAX muscles will have good (ICC ≥ 0.80) within-day and between-day test-retest reliability.
2. The fatigability level of the MULT, GMED and GMAX muscles will significantly decrease immediately after the lumbopelvic manipulation and will be maintained over two to four days following the manipulation.
3. The fatigability of the MULT, GMED and GMAX muscles will significantly decrease after the intervention in the manipulation group while no change will occur in the placebo group.

Healthy subjects or the reliability phase:

Inclusion Criteria:

• Subjects without any history of back problems
• Subjects without any known pathology.

Exclusion Criteria:

• Any serious spinal condition such as tumor, fracture, or infection,
• Signs of nerve root compression (i.e. straight leg- raise ≤ 45° or diminished reflexes, sensation or lower extremity strength),
• Structural deformity,
• Spondylolithesis ,
• Ankylosing spondylitis
• Spinal stenosis,
• Osteoporosis,
• Previous surgery to the back or the hip, and
• Current pregnancy.

Subjects with Chronic low back pain for both the reliability and the manipulation phases:

Inclusion Criteria:

• Participants should be between the age of 20 to 60 years.
• Have had complaints of chronic low back pain for at least three months.

Exclusion Criteria:

• Any serious spinal condition such as tumor, fracture, or infection,
• Signs of nerve root compression (i.e. straight leg- raise ≤ 45° or diminished reflexes, sensation or lower extremity strength),
• Structural deformity,
• Spondylolithesis ,
• Ankylosing spondylitis
• Spinal stenosis,
• Osteoporosis,
• Previous surgery to the back or the hip, and
• Current pregnancy