The value of electromyography of the lumbar paraspinal muscles in discriminating between chronic-low-back-pain sufferers and normal subjects

Abstract

The authors studied the surface electromyographic (EMG) spectrum of the paraspinal muscles of 350 subjects. They were classified by their history as normal (n=175), chronic low back pain (n=145), or past history (n=30). They pulled upwards on a floor-mounted load cell at two-thirds of their maximum voluntary contraction for 30 s, while the EMG was measured from the paraspinal muscles at the L4/L5 level. From the EMG signal the root-mean-square (RMS) was calculated. Power spectrum analysis allowed calculation of the median frequency slope, the initial median frequency (IMF), modal frequency, peak amplitude and spectral width at half peak amplitude (half-width). All of the variables of the chronic group were significantly different from the normal group, except the median frequency slope, RMS slope and mode. Half-width, age and maximum voluntary contraction were shown to be independent predictors of back pain classification. Half-width classified the subjects with a sensitivity of 0.65 and a specificity of 0.75.

Fig. 1

The half-width was taken as the width of the spectrum at half the maximum amplitude

Fig. 2

Sensitivity, specificity and accuracy of median slope discriminating between chronic-low-back-pain subjects and normal controls

Fig. 3

Sensitivity, specificity and accuracy of half-width discriminating between chronic-low-back-pain subjects and normal controls