Trunk muscle activation patterns during active hip abduction test during remission from recurrent low back pain: an observational study

Background The active hip abduction test (AHAbd) is widely used to evaluate lumbopelvic stability, but the onset of trunk muscle activation during the test in individuals with recurrent low back pain (rLBP) has not been investigated so far. It is important to investigate the pattern of trunk muscle activation during the AHAbd test to provide insight into the interpretation of observation-based assessment results; this may help to create exercise therapy interventions, from a movement control perspective, for people seeking treatment for rLBP. The purpose of this study was to compare the timing of trunk muscle activation between individuals with and without rLBP and to assess potential differences. Methods Seventeen subjects in remission from rLBP and 17 subjects without rLBP were recruited. We performed surface electromyography of the transversus abdominis/internal abdominal oblique, external oblique, erector spinae, and gluteus medius muscles during the AHAbd test on both sides. The onset of trunk muscle activation was calculated relative to the prime mover gluteus medius. The independent-samples t- and Mann-Whitney U tests were used to compare the onset of trunk muscle activation between the two groups. Results The onset of transversus abdominis/internal abdominal oblique activation on the ipsilateral (right AHAbd: -3.0 +/- 16.2 vs. 36.3 +/- 20.0 msec, left AHAbd: -7.2 +/- 18.6 vs. 29.6 +/- 44.3 ms) and contralateral sides (right AHAbd: -11.5 +/- 13.9 vs. 24.4 +/- 32.3 ms, left AHAbd: -10.1 +/- 12.5 vs. 23.3 +/- 17.2 ms) and erector spinae on the contralateral side (right AHAbd: 76.1 +/- 84.9 vs. 183.9 +/- 114.6 ms, left AHAbd: 60.7 +/- 70.5 vs. 133.9 +/- 98.6 ms) occurred significantly later in individuals with rLBP than in individuals without rLBP (p < 0.01). During the left AHAbd test, the ipsilateral erector spinae was also activated significantly later in individuals with rLBP than in individuals without rLBP (71.1 +/- 80.1 vs. 163.8 +/- 120.1 ms, p < 0.05). No significant difference was observed in the onset of the external oblique activation on the right and left AHAbd tests (p > 0.05). Conclusions Our results suggest that individuals with rLBP possess a trunk muscle activation pattern that is different from that of individuals without rLBP. These findings provide an insight into the underlying muscle activation patterns during the AHAbd test for people with rLBP and may support aggressive early intervention for neuromuscular control.