Electromyographic assessment of spinal stabilizing muscles activity in degenerative spondylolisthesis before and after a specific spinal stabilization rehabilitation program

الملخص EN

Objective : To assess the electrical activity of local spinal stabilizing muscles in chronic low back pain (CLBP) diagnosed radio logically as degenerative spondylolisthesis, before and after a specific spinal stabilization program.

Methodology : Subjects were 20 patients complaining of CLBP longer than 3 months with or without radiation to the lower limbs diagnosed radio logically as degenerative spondylolisthesis.

They were compared to matched 10 controls.

Patients underwent medical history, and thorough clinical and neurological examinations.

Pain was assessed with McGill pain questionnaire, functional disabilities with Oswestry functional disability questionnaire.

Flexion / extension plain x-rays were taken for spinal instability.

The electrical activity (mean number of turns per second (T / s) and mean amplitude per turn (A / T)) of both lumbar multifidi (LM) and internal oblique (IO) was examined using surface electrodes.

Group (I) of 10 patients received a specific spinal stabilization program and (II) received ordinary one.

Reassessment was done after 10 weeks.

Results : Group (1) showed a significant improvement (p < 0.05) in local spinal tenderness, lumbar par spinal muscles spasm, painful back movements and overall electrical activity after than before rehabilitation program.

The difference was highly statistically significant (p<0.001) for overall pain intensity, pain descriptor scores and functional disability scores.

Group (2) showed a significant improvement (p < 0.05) in spasm of lumbar par spinal muscles, pain descriptor scores and functional disability scores.

The difference was highly significant (p < 0.001) for overall pain intensity, but not significant (p > 0.05) for electrical activity of both LM and IO.

After rehabilitation, group (1) had a significant improvement (p < 0.05) in local tenderness and painful back movements as compared to group (II).

Group (1) had a highly significant improvement (p < 0.001) in overall pain intensity, pain descriptor scores and functional disability scores.

Group (1) had a significant improvement of overall electrical activity of the LM and IO (p < 0.05) compared to group (II).

Group (1) had a highly significant improvement in (A / T) of IO (p < 0.001).

Conclusions : Specific spinal stabilizing exercises are essential in any therapeutic exercise program advocated for treatment of CLBP patients.