Postural cueing increases multifidus activation during stabilization exercise in participants with chronic and recurrent low back pain: An electromyographic study.

Persons with low back pain (LBP) have demonstrated altered morphology and function of the deep multifidus (DM). This study examined the effects of postural cueing for increased lumbar lordosis on DM and longissimus thoracis (LT) activation during lumbar stabilization exercises (LSE) performed by persons with LBP. Nine adults with a history of chronic or recurrent LBP were recruited. Fine-wire EMG data was collected while participants performed 10 LSE's in neutral posture and with postural cueing. Percent maximum voluntary isometric contraction of L5 DM and T12 LT, and ratios of activation (DM/LT) were analyzed. There was a significant main effect for posture on DM activation (p < 0.001), indicating greater activation levels during exercises performed with postural cueing vs. neutral posture. LT activation did not increase significantly with postural cueing. Following a significant 1-way repeated measures ANOVA (p = 0.034) for the postural cueing condition, pairwise comparisons demonstrated significantly higher DM/LT activation ratios for prone leg lift, variable-angle Roman chair at 15°, bridging, and bilateral arm and leg lift. These results suggest postural cueing can be used across a range of LSE intensities to increase DM activation without a significant increase in LT activation in patients with chronic or recurrent LBP.