The adaptive changes in muscle coordination following lumbar spinal fusion
Journal
Human Movement Science
Journal Volume
40
Pages
284-297
Date Issued
2015
Author(s)
Abstract
Limited back motion and damage of paraspinal muscles after spinal fusion surgery may lead to abnormal compensatory movements of the body. Whether neuromuscular control changes after surgery remains unclear. The purpose of the study was to identify the muscle activation patterns employed before and after lumbar spinal fusion. Nineteen patients having low back pain and undergoing minimally invasive lumbar spinal fusion were evaluated at 1. day before and 1. month after fusion surgery. Nineteen matched healthy participants were recruited as controls. Patients' pain severity and daily activity functioning were recorded. All participants were instructed to perform forward reaching, and the muscle activities were monitored using surface electromyography (EMG) with sensors placed on both sides of their trunk and lower limbs. The muscle activation patterns were identified using the principal component analysis (PCA). All patients had significant improvements in pain intensity and daily activity functioning after surgery, but exhibited an adaptive muscle activation pattern during forward reaching movement compared with the controls. Significant loading coefficients in the dominant movement pattern (reflected in the first principal component) were observed in back muscles for controls whereas in leg muscles for patients, both pre- and postoperatively. Despite substantial improvements in pain intensity and daily activity functioning after surgery, the patients exhibited decreased paraspinal muscle activities and adaptive muscle coordination patterns during forward reaching. They appeared to rely mainly on their leg muscles to compensate for their insufficient paraspinal muscle function. Early intervention focusing on training paraspinal muscles should be considered after spinal fusion surgery. ? 2015 Elsevier B.V.
SDGs
Other Subjects
adult; aged; Article; back muscle; biceps brachii muscle; biceps femoris muscle; body movement; clinical article; clinical evaluation; controlled study; daily activity functioning; daily life activity; electromyography; erector spinae muscle; female; gastrocnemius muscle; gluteus maximus muscle; human; leg muscle; low back pain; lumbar spine; male; medial head of the gastrocnemius muscle; minimally invasive surgery; multifidus muscle; muscle contraction; muscle coordination; muscle function; muscle strength; pain intensity; pain severity; paraspinal muscle; reaching movement; rectus abdominis muscle; rectus femoris muscle; spine fusion; tibialis anterior muscle; visual analog scale; adaptation; back; case control study; electromyography; joint characteristics and functions; low back pain; lumbar vertebra; middle aged; motor performance; movement (physiology); pain measurement; pathophysiology; physiology; principal component analysis; skeletal muscle; Adaptation, Physiological; Aged; Back; Case-Control Studies; Electromyography; Female; Humans; Low Back Pain; Lumbar Vertebrae; Male; Middle Aged; Motor Skills; Movement; Muscle, Skeletal; Pain Measurement; Principal Component Analysis; Range of Motion, Articular; Spinal Fusion
Publisher
Elsevier B.V.
Type
journal article