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      Influence of pain in strength, resistance and recruitment of trunk muscles Translated title: Influência da dor na força, resistência e recrutamento dos músculos do tronco

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          Abstract

          ABSTRACT BACKGROUND AND OBJECTIVES: Changes in motor control may contribute to muscle recruitment deficits. The objective of this study was to evaluate strength, endurance, and recruitment of the torso muscles. METHODS: We evaluated 35 women, divided into two groups: chronic low back pain (LBPG, n=20) and control (CG, n=15). The clinical conditions, incapacity, level of pain, strength, endurance and the muscles recruitment: internal oblique (IO) and external oblique (EO), rectus abdominis (RA), lumbar iliocostal (LI) and lumbar multifidus (LM) were evaluated. MANOVA, MANCOVA and Kruskal-Wallis were used. RESULTS: There was no significant difference between groups in the muscle strength test (p<0.172). The control group showed the greater capacity for muscle endurance in the muscle endurance test (p<0.001). In muscle recruitment, the chronic low back pain group presented greater muscle activation, which was evident in the global stabilizing muscles EO and RA (p<0.05). CONCLUSION: Women with back pain had reduced muscular endurance and greater recruitment of the global muscles when compared to women with no back pain.

          Translated abstract

          RESUMO JUSTIFICATIVA E OBJETIVOS: Alterações no controle motor podem contribuir para déficits no recrutamento muscular. Sendo assim o objetivo deste estudo foi avaliar a força, resistência e o recrutamento dos músculos do tronco. MÉTODOS: Foram avaliadas 35 mulheres, divididas em dois grupos: dor lombar crônica (GDL, n=20) e controle (GC, n=15). Avaliou-se as condições clínicas, incapacidade, nível da dor, força, resistência e recrutamento dos músculos: oblíquo externo (OE) e interno (OI), reto abdominal (RA), iliocostal lombar (ICL) e multífido lombar (MUL). Utilizou-se MANOVA, MANCOVA e Kruskal-Wallis. RESULTADOS: No teste de força muscular não houve diferença significativa entre os grupos (p=0,172). O grupo controle demonstrou maior capacidade de resistência no teste de resistência muscular (p<0,001). No recrutamento muscular, o grupo dor lombar crônica apresentou ativação muscular maior, que ficou evidente nos músculos estabilizadores globais, OE e RA (p<0,05). CONCLUSÃO: Mulheres com dor lombar apresentaram resistência muscular diminuída e maior recrutamento nos músculos globais, quando comparadas às mulheres sem dor lombar.

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          Experimental muscle pain changes feedforward postural responses of the trunk muscles.

          Many studies have identified changes in trunk muscle recruitment in clinical low back pain (LBP). However, due to the heterogeneity of the LBP population these changes have been variable and it has been impossible to identify a cause-effect relationship. Several studies have identified a consistent change in the feedforward postural response of transversus abdominis (TrA), the deepest abdominal muscle, in association with arm movements in chronic LBP. This study aimed to determine whether the feedforward recruitment of the trunk muscles in a postural task could be altered by acute experimentally induced LBP. Electromyographic (EMG) recordings of the abdominal and paraspinal muscles were made during arm movements in a control trial, following the injection of isotonic (non-painful) and hypertonic (painful) saline into the longissimus muscle at L4, and during a 1-h follow-up. Movements included rapid arm flexion in response to a light and repetitive arm flexion-extension. Temporal and spatial EMG parameters were measured. The onset and amplitude of EMG of most muscles was changed in a variable manner during the period of experimentally induced pain. However, across movement trials and subjects the activation of TrA was consistently reduced in amplitude or delayed. Analyses in the time and frequency domain were used to confirm these findings. The results suggest that acute experimentally induced pain may affect feedforward postural activity of the trunk muscles. Although the response was variable, pain produced differential changes in the motor control of the trunk muscles, with consistent impairment of TrA activity.
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            Translation, adaptation and validation of the Roland-Morris questionnaire--Brazil Roland-Morris.

            The purpose of the present study was to translate the Roland-Morris (RM) questionnaire into Brazilian-Portuguese and adapt and validate it. First 3 English teachers independently translated the original questionnaire into Brazilian-Portuguese and a consensus version was generated. Later, 3 other translators, blind to the original questionnaire, performed a back translation. This version was then compared with the original English questionnaire. Discrepancies were discussed and solved by a panel of 3 rheumatologists and the final Brazilian version was established (Brazil-RM). This version was then pretested on 30 chronic low back pain patients consecutively selected from the spine disorders outpatient clinic. In addition to the traditional clinical outcome measures, the Brazil-RM, a 6-point pain scale (from no pain to unbearable pain), and its numerical pain rating scale (PS) (0 to 5) and a visual analog scale (VAS) (0 to 10) were administered twice by one interviewer (1 week apart) and once by one independent interviewer. Spearman's correlation coefficient (SCC) and intraclass correlation coefficient (ICC) were computed to assess test-retest and interobserver reliability. Cross-sectional construct validity was evaluated using the SCC. In the pretesting session, all questions were well understood by the patients. The mean time of questionnaire administration was 4 min and 53 s. The SCC and ICC were 0.88 (P<0.01) and 0.94, respectively, for the test-retest reliability and 0.86 (P<0.01) and 0.95, respectively, for interobserver reliability. The correlation coefficient was 0.80 (P<0.01) between the PS and Brazil-RM score and 0.79 (P<0.01) between the VAS and Brazil-RM score. We conclude that the Brazil-RM was successfully translated and adapted for application to Brazilian patients, with satisfactory reliability and cross-sectional construct validity.
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              Driving plasticity in the motor cortex in recurrent low back pain.

              The sensory and motor systems can reorganise following injury and learning of new motor skills. Recently we observed adaptive changes in motor cortical organisation in patients with recurrent low back pain (LBP), which are linked to altered motor coordination. Although changes in motor coordination can be trained and are associated with improved symptoms and function, it remains unclear whether these training-induced changes are related to reorganisation of the motor cortex. This was investigated using the model of a delay in postural activation of the deep abdominal muscle, transversus abdominis (TrA) in 20 individuals with recurrent LBP. Subjects were allocated to either motor skill training that involved isolated voluntary contractions of TrA, or a control intervention of self-paced walking exercise for 2 weeks. Electromyographic (EMG) activity was recorded from TrA bilaterally using intramuscular fine-wire electrodes. Motor cortical organisation using transcranial magnetic stimulation (TMS) and postural activation associated with single rapid arm movements were investigated before and after training. Motor skill training induced an anterior and medial shift in motor cortical representation of TrA, towards that observed in healthy individuals from our previous study. This shift was associated with earlier postural activation of TrA. Changes were not observed following unskilled walking exercise. This is the first observation that motor training can reverse reorganisation of neuronal networks of the motor cortex in people with recurrent pain. The observed relationship between cortical reorganisation and changes in motor coordination following motor training provides unique insight into potential mechanisms that underlie recovery. Copyright 2010 European Federation of International Association for the Study of Pain Chapters. All rights reserved.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                brjp
                BrJP
                BrJP
                Sociedade Brasileira para o Estudo da Dor (São Paulo, SP, Brazil )
                2595-0118
                2595-3192
                December 2018
                : 1
                : 4
                : 310-315
                Affiliations
                [1] Rio Claro orgnameUniversidade Estadual Paulista orgdiv1Instituto de Biociências orgdiv2Departamento de Educação Física Brazil
                [2] Marília orgnameUniversidade Estadual Paulista orgdiv1Faculdade de Filosofia e Ciências orgdiv2Departamento de Fisioterapia e Terapia Ocupacional Brazil
                Article
                S2595-31922018000400310
                10.5935/2595-0118.20180059
                3b5a5494-1989-4e17-a984-1e9bc70523dc

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 11 March 2018
                : 20 August 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 27, Pages: 6
                Product

                SciELO Brazil


                Dor lombar,Eletromiografia,Força muscular,Resistência física,Electromyography,Lumbar pain,Muscle strength,Physical resistance

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