Project Details
Projekt
SP4 Advancing Diagnosis and Treatment in Chronic Low Back Pain – Insights from Spatial Distribution and Modular Organization of Activation Patterns
Applicant
Professor Adamantios Arampatzis, Ph.D.
Subject Area
Orthopaedics, Traumatology, Reconstructive Surgery
Term
since 2021
Project identifier
Deutsche Forschungsgemeinschaft (DFG) - Project number 439742772
During the first funding period, we found that diagnostic variables such as lumbopelvic posture and coordination are primarily influenced by sex and are not associated with chronic low back pain (cLBP). Furthermore, reduced trunk muscle strength in participants with cLBP is not associated with degeneration of trunk muscle morphology. We found an inverse relationship between trunk extensor muscle strength and electromyographic (EMG) activity during a challenging task, indicating modifications in trunk muscle activation in cLBP. Finally, preliminary data show that the trunk plays a crucial role in controlling body stability during challenging locomotor tasks. These findings emphasize the importance of broadening our diagnostic approach to capture the underlying mechanisms of cLBP by incorporating challenging movement tasks. In the second funding period, we will address (i) the functional diversity of EMG activity among synergistic trunk muscles, (ii) pain-related compensatory adaptations in the activation patterns of trunk and adjacent muscles, as well as the contribution of the trunk to body stability during challenging locomotor tasks, (iii) the interplay between trunk kinematics, muscle activation patterns, and psychological factors, (iv) how improvements from perturbation-based training affect the aforementioned interplay, and (v) how EMG-guided visuomotor training recalibrates dysfunctional muscle activation patterns. We hypothesize (a) a scaled increase in the functional diversity of synergistic trunk muscle activity with increasing task difficulty, with smaller changes in cLBP, (b) increased compensatory effects in muscle activation and reduced contribution of the trunk to body stability control in cLBP, (c) influence of psychological factors on trunk kinematics and activation patterns, with greater effects in cLBP, (d) functional improvements in muscle activation and trunk movement for body stability control following perturbation-based treatment, and (e) recalibration of dysfunctional muscle activation patterns after EMG-guided visuomotor feedback. We will use high-density EMG to measure the spatial distribution of erector spinae activation in the lumbar and thoracic regions. Whole-body kinematics and EMG activity of 16 trunk and neighbouring muscles will be measured simultaneously, along with psychological factors, during different challenging locomotor tasks. We plan to use this approach to uncover neuromuscular drivers of cLBP and contribute to the overall project of establishing a robust, evidence-based diagnosis.
DFG Programme
Research Units
