CONTEXT: A neuromuscular relationship exists between the lumbar extensor and quadriceps muscles during fatiguing exercise. However, this relationship may be different for persons with low back pain (LBP). OBJECTIVE: To compare quadriceps inhibition after isometric, fatiguing lumbar extension exercise between persons with a history of LBP and control subjects. DESIGN: A 2 x 3 factorial, repeated-measures, time-series design with independent variables of group (persons with a history of LBP, controls) and time (baseline, postexercise set 1, postexercise set 2). SETTING: University research laboratory. PATIENTS OR OTHER PARTICIPANTS: Twenty-five subjects with a history of LBP were matched by sex, height, and mass to 25 healthy control subjects. INTERVENTION(S): Electromyography median frequency indexed lumbar paraspinal muscular fatigue while subjects performed 2 sets of isometric lumbar extension exercise. Subjects exercised until a 15% downward shift in median frequency for the first set and a 25% shift for the second set were demonstrated. MAIN OUTCOME MEASURE(S): Knee extension force was measured while subjects performed an isometric maximal quadriceps contraction. During this maximal effort, a percutaneous electric stimulus was applied to the quadriceps, causing a transient, supramaximal increase in force output. We used the ratio between the 2 forces to estimate quadriceps inhibition. Quadriceps electromyographic activity was recorded during the maximal contractions to compare median frequencies over time. RESULTS: Both groups exhibited significantly increased quadriceps inhibition after the first (12.6% +/- 10.0%, P < .001) and second (15.2% +/- 9.7%, P < .001) exercise sets compared with baseline (9.6% +/- 9.3%). However, quadriceps inhibition was not different between groups. CONCLUSIONS: Persons with a history of LBP do not appear to be any more or less vulnerable to quadriceps inhibition after fatiguing lumbar extension exercise.
CONTEXT: A neuromuscular relationship exists between the lumbar extensor and quadriceps muscles during fatiguing exercise. However, this relationship may be different for persons with low back pain (LBP). OBJECTIVE: To compare quadriceps inhibition after isometric, fatiguing lumbar extension exercise between persons with a history of LBP and control subjects. DESIGN: A 2 x 3 factorial, repeated-measures, time-series design with independent variables of group (persons with a history of LBP, controls) and time (baseline, postexercise set 1, postexercise set 2). SETTING: University research laboratory. PATIENTS OR OTHER PARTICIPANTS: Twenty-five subjects with a history of LBP were matched by sex, height, and mass to 25 healthy control subjects. INTERVENTION(S): Electromyography median frequency indexed lumbar paraspinal muscular fatigue while subjects performed 2 sets of isometric lumbar extension exercise. Subjects exercised until a 15% downward shift in median frequency for the first set and a 25% shift for the second set were demonstrated. MAIN OUTCOME MEASURE(S): Knee extension force was measured while subjects performed an isometric maximal quadriceps contraction. During this maximal effort, a percutaneous electric stimulus was applied to the quadriceps, causing a transient, supramaximal increase in force output. We used the ratio between the 2 forces to estimate quadriceps inhibition. Quadriceps electromyographic activity was recorded during the maximal contractions to compare median frequencies over time. RESULTS: Both groups exhibited significantly increased quadriceps inhibition after the first (12.6% +/- 10.0%, P < .001) and second (15.2% +/- 9.7%, P < .001) exercise sets compared with baseline (9.6% +/- 9.3%). However, quadriceps inhibition was not different between groups. CONCLUSIONS:Persons with a history of LBP do not appear to be any more or less vulnerable to quadriceps inhibition after fatiguing lumbar extension exercise.
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