Electromyography in muscle activation lumbar region in a comparison between manual therapy and photobiomodulation associated with kinesiotherapy in individuals with low back pain

INTRODUCTION: About 10 million people have low back pain (LBP) disability in Brazil. Several therapies are used to treat this condition, such as kinesiotherapy, manual therapy (MT), and photobiomodulation (PBM). Although the use of these methods in LBP has been investigated, studies evaluating the efficacy of the association between these techniques are still needed. OBJECTIVE: To evaluate the activation of the lumbar region muscles by PBM or MT associated with kinesiotherapy for the treatment of LBP. METHODS: Twenty individuals with chronic LBP were randomlydivided into two groups. The first group (MT) received vertebral mobilization associated with a kinesiotherapy exercise program. The second group (830nm-PBM) received PBM associated with the exercise program, twice a week for 8 weeks. Evaluation of pain perceived was performed by the visual analogic scale (VAS), lumbar disability by the Oswestry questionnaire, muscle strength by strain gauge, and activation through surface electromyography (EMG). Data were collected before and after the treatment. EMG data was analyzed by MatLab®. The ANOVA two-way test was used (degree of significance p≤0.05), and the size of the effect by the Hedge test. RESULTS: Considering pain, the two groups presented a significant result (p<0.05). In muscle activation, only the multifidus was different during the side bridge (p<0.05) when compared intragroup. None of the variables were different when evaluating intergroup. CONCLUSION: Both MT and PBM associated with kinesiotherapy for 8 weeks are effective in reducing pain, and improving motor control and stability of the lumbar spine in patients with chronic LBP.

Análise da influência da mecanosensibilidade neural na extensão de joelho durante o teste de flexibilidade dos isquiotibiais / Analysis of neural mechanosensitivity influence in the knee extension during the hamstrings flexibility test

Objetivo - Analisar a influência da mecanosensibilidade neural na mobilidade de extensão do joelho através do teste de flexibilidade dos isquiotibiais e teste de slump por meio de goniometria. Métodos - Foram avaliados 19 voluntários bilateralmente (38 membros inferiores) através do teste de slump para mecanosensibilidade neural e teste de flexibilidade dos isquiotibiais com um goniômetro. De acordo com o teste de slump os MMII foram divididos em 2 grupos: GSP (slump positivo, n = 28) e GSN (slump negativo, n = 10). Posteriormente os participantes foram avaliados através do teste de flexibilidade dos isquiotibiais com dorsiflexão e flexão plantar com mensuração da ADM de joelho. Resultados - Os resultados referentes ao teste de slump revelaram um aumento significativo na ADM de joelho pós-extensão de cabeça nos MMII que compõe o grupo GSP (t=10.56; p<0,0001) e não foi evidenciado modificação da ADM de joelho durante o mesmo teste nos MMII que compõe o grupo GSN (t=0.000; p=0,5). Os resultados referentes ao teste de flexibilidade dos isquiotibiais no grupo GSP revelaram um aumento significativo na ADM de joelho com o tornozelo em flexão plantar quando comparado com o tornozelo em dorsiflexão(t=8.911; p<0,0001). Já no grupo GSN, não foi evidenciado diferença significativa na ADM de joelho com tornozelo em dorsiflexão ou flexão plantar (t=1.470; p=0.08). Conclusão - Os resultados sugerem que a dorsiflexão de tornozelo em sujeitos com perda de mecanosensibilidade neural detectada pelo teste de slump pode influenciar na ADM de extensão de joelho durante o teste de flexibilidade dos isquiotibiais.

Objective - To analyze the neural mechanosensitivity influence in the knee extension mobility through the hamstrings flexibility test and slump test by goniometry means. Methods - Nineteen subjects were bilaterally assessment (38 lower limbs) with slump test for neural mechanosensitivity and hamstrings flexibility test by goniometer. In agreement with the slump test the lower limbs were divided in 2 groups: GSP (positive slump, n = 28) e GSN (negative slump, n = 10). After the groups formation the subjects were assessment by hamstrings flexibility test with dorsiflexion and plantar flexion. The knee range of motion (ROM) was assessment. Results - The results of the slump test show significant increase in the knee ROM post neck extension in the GSP (t=10.56; p<0,0001) and modification of knee ROM was not evidenced during the same test in the GSN (t=0.000; p=0,5). The results of the hamstrings flexibility test in the GSP show significant increase in knee ROM with plantar flexion ankle when compared with dorsiflexion (t=8.911; p<0,0001). In the GSN, modification of knee ROM was not evidenced during the same test (t=1.470; p=0.08). Conclusion - Our results suggest that ankle dorsiflexion in subjects with neural mechanosensitivity decrease detected by slump test it can influence in the knee extension ROM during the hamstrings flexibility test.