ORIGINAL PAPER
Correlations of back muscle electromyography and gait analysis data as a basis for exercise prescription in patients with lumbar disc herniation
 
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1
Department of Sports Medicine and Adaptive Sports, Yerevan State Medical University, Yerevan, Armenia
 
2
Department of Kinesiology, Armenian State Institute of Physical Culture and Sport, Yerevan, Armenia
 
3
‘Armbiotechnology’ Scientific and Production Centre SNPO NAS RA, Yerevan, Armenia
 
4
Department of General Medicine, Gorgan University of Medical Science, Gorgan, Iran
 
 
Submission date: 2020-07-18
 
 
Acceptance date: 2020-08-19
 
 
Publication date: 2021-11-30
 
 
Physiother Quart. 2021;29(4):49-59
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The principles and practice of physical rehabilitation in patients with lumbar disc herniation still remain controversial. The objective of the study was to reveal the correlations of gait pattern changes and muscle (spinal and leg muscles) electromyographic recordings in patients with lumbar disc herniation

Methods:
A motion capture system was used to analyse gait parameters, including angular measurements of hip, knee, and ankle joints, foot support time, pace rate, and speed. A targeted exercise program with exercises in a shortened position of muscles without exceeding the internal range of contraction was applied to level the values of goniometric data and pace parameters obtained by motion capture.

Results:
The gait restored owing to the reconditioning of spine and leg muscles, confirmed by the recorded changes in electromyographic data, ensures the irreversible nature of gait improvement. The changes in H-reflex expression and muscle baseline electromyography of spine and leg muscles make up a proper tool that provides a system for periodic evaluation of gait recovery.

Conclusions:
Targeting the weak muscles helped to identify the causes of gait deviations, revealing an expressed positive (negative) correlation between the targeted muscle strengthening and gait restoration. This confirms the importance of selective targeting and strengthening of the muscles to restore the deviated angles and other gait parameters.

REFERENCES (26)
1.
van Middelkoop M, Rubinstein SM, Verhagen AP, Ostelo RW, Koes BW, van Tulder MW. Exercise therapy for chronic nonspecific low-back pain. Best Pract Res Clin Rheumatol. 2010;24(2):193–204; doi: 10.1016/j.berh.2010.01.002.
 
2.
Mayor S. Targeted exercise for muscles that support the spine reduces low back pain, Cochrane review shows. BMJ. 2016;352:i84; doi: 10.1136/bmj.i84.
 
3.
Janda V, Schmid HJA. Muscles as a pathogenic factor in back pain. In: Proceedings of the Fourth Conference of the International Federation of Orthopaedic Manipulative Therapists. Christchurch; 1980; 17–18.
 
4.
Kendall FP, McCreary EK, Provance PG. Muscles: testing and function, 4th ed. Baltimore: Lippincott Williams and Wilkins; 1993.
 
5.
Sahrmann SA. Muscle imbalances in the orthopaedic and neurological patients. In: Proceedings of the 10th International Congress of the World Confederation of Physical Therapy. Sydney; 1987.
 
6.
Sahrmann SA. Posture and muscle imbalance: faulty lumbar-pelvic alignment and associated musculoskeletal pain syndromes. Postgraduate Advances in Physical Therapy. Berryville: Forum Medicum Incorporated; 1987.
 
7.
Stokes M, Young A. The contribution of reflex inhibition to arthrogenous muscle weakness. Clin Sci. 1984;67(1):7–14; doi: 10.1042/cs0670007.
 
8.
Albeck MJ, Taher G, Lauritzen M, Trojaborg W. Diagnostic value of electrophysiological tests in patients with sciatica. Acta Neurol Scand. 2000;101(4):249–254; doi: 10.1034/j.1600-0404.2000.101004249.x.
 
9.
Koceja DM, Trimble MH, Earles DR. Inhibition of the soleus H-reflex in standing man. Brain Res. 1993;629(1):155–158; doi: 10.1016/0006-8993(93)90495-9.
 
10.
Aagaard P, Simonsen EB, Andersen JL, Magnusson P, Dyhre-Poulsen P. Neural adaptation to resistance training: changes in evoked V-wave and H-reflex responses. J Appl Physiol. 2002;92(6):2309–2318; doi: 10.1152/japplphysiol.01185.2001.
 
11.
Angulo-Kinzler RM, Mynark RG, Koceja DM. Soleus H-reflex gain in elderly and young adults: modulation due to body position. J Gerontol A Biol Sci Med Sci. 1998;53(2):120–125; doi: 10.1093/gerona/53a.2.m120.
 
12.
Capaday C, Stein RB. Amplitude modulation of the soleus H-reflex in the human during walking and standing. J Neurosci. 1986;6(5):1308–1313; doi: 10.1523/JNEUROSCI.06-05-01308.1986.
 
13.
Cheng J, Brooke JD, Misiaszek JE, Staines WR. The relationship between the kinematics of passive movement, the stretch of extensor muscles of the leg and the change induced in the gain of the soleus H reflex in humans. Brain Res. 1995;672(1):89–96; doi: 10.1016/0006-8993(94)01321-8.
 
14.
Gruber M, Taube W, Gollhofer A, Beck S, Amtage F, Schu­bert M. Training-specific adaptations of H- and stretch reflexes in human soleus muscle. J Motor Behav. 2007;39(1):68–78; doi: 10.3200/JMBR.39.1.68-78.
 
15.
Misiaszek JE, Cheng J, Brooke JD, Staines WR. Movement-induced modulation of soleus H reflexes with altered length of biarticular muscles. Brain Res. 1998;795(1–2):25–36; doi: 10.1016/s0006-8993(98)00246-7.
 
16.
Larsen B, Mrachacz-Kersting N, Lavoie BA, Voigt M. The amplitude modulation of the quadriceps H-reflex in relation to the knee joint action during walking. Exp Brain Res. 2006;170(4):555–566; doi: 10.1007/s00221-005-0237-1.
 
17.
Morag E, Hurwitz DE, Andriacchi TP, Hickey M, Andersson GB. Abnormalities in muscle function during gait in relation to the level of lumbar disc herniation. Spine. 2000;25(7):829–833; doi: 10.1097/00007632-200004010-00011.
 
18.
Simonsen EB, Dyhre-Poulsen P. Amplitude of the human soleus H reflex during walking and running. J Physiol. 1999;515(Pt 3):929–939; doi: 10.1111/j.1469-7793.1999.929ab.x.
 
19.
Kyröläinen H, Avela J, Komi PV. Changes in muscle activity with increasing running speed. J Sports Sci. 2005;23(10):1101–1109; doi: 10.1080/02640410400021575.
 
20.
Simonsen EB, Alkjær T, Raffalt PC. Reflex response and control of the human soleus and gastrocnemius muscles during walking and running at increasing velocity. Exp Brain Res. 2012;219(2):163–174; doi: 10.1007/s00221-012-3075-y.
 
21.
Racic V, Brownjohn JMW, Pavic A. Reproduction and application of pedestrian forces from visual marker data. In: Proceedings of the IUTAM symposium on analysis and simulation of human motion. Leuven, 13–15 Sep 2010.
 
22.
Groll DL, To T, Bombardier C, Wright JG. The development of a comorbidity index with physical function as the outcome. J Clin Epidemiol. 2005;58(6):595–602; doi: 10.1016/j.jclinepi.2004.10.018.
 
23.
Burke GL. Backache from occiput to coccyx. Vancouver: W.E.G. Macdonald; 1964.
 
24.
Ogwumike OO, Musa SB. Relationships among walking speed, selected clinical symptoms, and exercise self-efficacy in individuals with knee osteoarthritis. Hum Mov. 2019;20(2):79–84; doi: 10.5114/hm.2019.81023.
 
25.
Łozińska P, Wójtowicz D, Wdowiak P, Dziuba-Słonina A. Changes in kinematic parameters during walking in adults with low back pain subjected to Vojta therapy. A pilot study. Physiother Quart. 2019;27(2):22–28; doi: 10.5114/pq.2019.84273.
 
26.
Bennett HJ, Valenzuela KA, Fleenor K, Morrison S, Hae­gele JA. Walking biomechanics and energetics of individuals with a visual impairment: a preliminary report. Hum Mov. 2019;20(4):8–18; doi: 10.5114/hm.2019.85094.
 
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