Comparison of muscle activity timing during stance phase of gait cycle in chronic low back pain and healthy subjects

Low back pain (LBP) is the most common and expensive musculoskeletal problem in industrialized societies. One in ten people suffers from LBP once in his life. It is self-limited up to 90%, but it is common to repeat. By the way, sacroiliac joint (SIJ) is the origin of low back and pelvic pain in many cases and one of the most important elements in normal musculoskeletal function during gait cycle. Muscles are important to stabilize this joint plus to bones and ligaments. Some of the muscles (Gluteus Maximus, Biceps Femoris, Multi Fidus, Erector Spinae) contributing in gait cycle are important to transfer load through SIJ. The aim of this present study is to compare muscle activity timing during initial and mid stance phase of gait cycle. Methods and Materials: Sixteen low back pain cases and fifteen healthy subjects participated in this study. A footswitch is placed beneath foot at the suffered side in LBP cases and dominant foot in control group. Two markers were on the 5th metatarsal bone and lateral maleolus. Electrodes are placed on selected muscles according to SENIAM. Digital camera and EMG Datalink were turned on simultaneously and subject started to walk with his own favorite speed in a specific direction and path. Onset and time to peak of selected muscles were recorded during gait by Datalink and processed by its software. Low back pain cases showed delayed muscle onset, although it was not significant (P=0.4). Time to peak of all selected muscles in loading response event in LBP group was longer and significant (P=0.01). There was also significant difference in time to peak of all selected muscles during mid-stance event (P= 0.005) except biceps femoris muscle. Delayed onset and longer time to peak during initial and mid stance phase of gait can be interpreted as a compensatory strategy to control trunk movements effectively, provide sufficient stability and transfer load to lumbar area efficiently.