Rehabilitation and Therapy Commons^™

Botulinum Toxin Type A Injections For Refractory Abdominal Dystonia: A Case Report, William J. Naber Ii, Jodi M. Wilhelm, Kurt A. Kuhlman, Gabriel Howard

Graduate Medical Education Research Journal

Background: A 58-year-old male with chronic bilateral treatment resistant abdominal spasms secondary complications of ascites/ alcoholic cirrhosis. Spasms would occur 4-5 times/day, lasting minutes to hours despite a 2-year course of therapeutic and pharmacological interventions. Due to treatment refraction, 6 uniformly spaced botulinum toxin type A (BTX-A) injections were placed per side, using electromyography for audible intramuscular syringe placement confirmation, while visual confirmation was made via ultrasound. During the initial trial, 6 evenly spaced injections were performed bilaterally, uniformly distributing 80U/side. Injections began bilaterally just medial to the junction of the inferior rib cage border/ anterior axillary line and progressed …

The Effectiveness Of Temporary Deafferentation For Upper Limb Rehabilitation, Chelsea Erazo Macias, Daniel Salinas, Monica Lozano Garcia, Victoria Cuello, Kelsey Baker

Research Symposium

Background: Temporary deafferentation (TD) is an approach that has been investigated in rehabilitation practices to improve motor function in people with spinal cord injuries. The overall goal of temporary deafferentation is to voluntarily reduce sensory input into the nervous system to improve efferent output. Temporary deafferentation is typically achieved using either topical or injectable anesthetics. Recently, our group sought to optimize a protocol for temporary deafferentation using topical anesthetic cream, and results suggested that temporary deafferentation was achieved 50 minutes after anesthetic cream application. Here, we aimed to determine if our optimized protocol impacted limb electromyography (EMG) after the intervention. …

Application Of Ultrasonography In The Diagnosis And Treatment (5% Dextrose Hydrodissection) For Entrapment Of Spinal Accessory Nerve: A Casereport, Tien-Lee Hsieh, Wei-Ting Wu, Chun-Ping Wang, Liang-Chun Chien, Lin-Fen Hsieh

Rehabilitation Practice and Science

The anatomical structure of the neck area is exceedingly complex; thus, cervical nerve damage during surgical procedures is not uncommon. A 25-year-old woman underwent excisional biopsy for neck lymphadenopathy. The patient reported left upper back pain and left shoulder weakness 1 day after the surgery. Physical examination revealed weakness of the left upper trapezius muscle and winging of the left scapula. A nerve conduction study indicated decreased compound muscle action potential amplitude on stimulation of the left spinal accessory nerve (SAN); electromyography also revealed denervation changes with the presence of voluntary motor unit action potentials in the left upper trapezius …

Bone–Patellar Tendon–Bone Autograft Harvest Prolongs Extensor Latency During Gait 2 Yr After Aclr, Naoaki Ito, Jacob J. Capin, Ashutosh Khandha, Thomas S. Buchanan, Karin Grävare Silbernagel, Lynn Snyder-Mackler

Physical Therapy Faculty Research and Publications

Purpose

Bone–patellar tendon–bone (BPTB) graft harvest for anterior cruciate ligament reconstruction alters patellar tendon properties, which inflict poor quadriceps neuromuscular function. BPTB autografts are associated with higher rates of posttraumatic osteoarthritis, which in turn is associated with pathological gait. The purpose of this study was to investigate the latency between the time of peak quadriceps activity and the peak knee flexion moment during gait, between those with BPTB grafts (n = 23) and other graft types (hamstring autograft or allografts, n = 54), 5 ± 2 months and 2 yr (25 ± 3 months) after anterior cruciate ligament reconstruction. …

An Exploratory Analysis Of Gait Biomechanics And Muscle Activation In Pregnant Females With High And Low Scores For Low Back Or Pelvic Girdle Pain During And After Pregnancy, Jennifer J. Bagwell, Nicholas Reynolds, Jo Armour Smith, Michelle Walaszek, Hannah Runez, Kristina Lam, Julie Peterson, Dimitrios Katsavelis

Physical Therapy Faculty Articles and Research

Background

The purpose of this study was to compare gait kinematics, kinetics, and muscle activation between pregnant females with high and low scores for low back and/or pelvic girdle pain during and after pregnancy.

Methods

Twenty participants tested during second trimester, third trimester, and again post-partum. At each session, motion capture, force plates, and surface electromyography data were captured during self-selected velocity over-ground walking. Participants completed the Quebec Back Pain Disability Scale (QBPDS) and were assigned to high (QBPDS ≥15) or low pain groups (QBPDS

Findings

Nine participants met the high pain group criteria and 11 were low pain. During …

Identifying Gait Pathology After Acl Reconstruction Using Temporal Characteristics Of Kinetics And Electromyography, Naoaki Ito, Jacob J. Capin, Ashutosh Khandha, Thomas S. Buchanan, Lynn Snyder-Mackler

Physical Therapy Faculty Research and Publications

Purpose

Asymmetrical gait mechanics after anterior cruciate ligament reconstruction (ACLR) are associated with the development of posttraumatic knee osteoarthritis. Current measures of gait mechanics have focused heavily on peak magnitudes of knee kinematics, kinetics, and joint contact forces but have seldom considered the rate of knee loading, cumulative knee load, or the timing of motor input surrounding peaks. The purpose of this study was to introduce and describe novel metrics of gait using temporal characteristics of kinetics and EMG to identify neuromuscular deficits of the quadriceps in patients after ACLR.

Methods

Gait mechanics were assessed 6 months (n = …

Lower Extremity And Trunk Electromyographic Muscle Activity During Performance Of The Y-Balance Test On Stable And Unstable Surfaces., Navpreet Kaur, Kunal Bhanot, Germaine Ferreira

Physical Therapy Collection

Background: The Star Excursion Balance Test (SEBT) has been used as a rehabilitation exercise. To improve its efficacy, efficiency, and method variations, the Y-Balance Test (YBT) with anterior (A), posterolateral (PL), and posteromedial (PM) directions of the SEBT has been recommended. Electromyographic activity has been reported to change when the same task is performed on various surfaces.

Hypothesis/Purpose: To compare the EMG activity of trunk and LE muscles during the performance of the YBT on stable and unstable surfaces.

Study Design: Cross-Sectional study.

Methods: Healthy adults with no history of chronic ankle instability were recruited for the study. …

Tibial Neuropathy After Revision Total Knee Prosthesis: A Casereport, Chun-Ping Wang, Wei-Ting Wu, Lin-Fen Hsieh

Rehabilitation Practice and Science

We describe a 74-year-old woman with right knee osteoarthritis experiencing right tibial neuropathy because of complications of total knee arthroplasty revision. Weakness in the right toe flexors and paresthesia over the sole of the right foot were observed after operation. A nerve conduction study and electromyographic examination indicated right tibial neuropathy. Radiography indicated a prosthesis fragment in the right popliteal fossa, and its location was different before and after surgery. Prosthesis fragment dislodgement was also confirmed through ultrasonography, and the nearby tibial nerve may have been entrapped because of the dislocation process and surrounding tissue fibrosis. Ultrasonography confirmed the prosthesis …

Hip Muscle Function In Individuals With Chronic Ankle Instability, Lindsay Carroll

Electronic Theses and Dissertations

Purpose: Hip muscle function has been reported to be altered in individuals with chronic ankle instability (CAI). The purpose of this study was (1) to determine whether the single leg squat test (SLST) could be used to detect differences in proximal muscle activation between individuals with and without CAI and (2) to determine if there was a difference in maximum isometric body weight normalized torque output of the hip lateral rotators, extensors, and abductors between individuals with and without CAI.

Subjects: Forty-eight subjects (14 males, 34 females; median age = 22.00 years, interquartile range (IQR) = 1.00; median height = …

Co-Contraction Of Ankle Muscle Activity During Quiet Standing In Individuals With Incomplete Spinal Cord Injury Is Associated With Postural Instability, Kai Lon Fok, Jae W Lee, Janelle Unger, Katherine Chan, Kristin E Musselman, Kei Masani

Physical Therapy Publications

Previous findings indicate that co-contractions of plantarflexors and dorsiflexors during quiet standing increase the ankle mechanical joint stiffness, resulting in increased postural sway. Balance impairments in individuals with incomplete spinal cord injury (iSCI) may be due to co-contractions like in other individuals with reduced balance ability. Here we investigated the effect of co-contraction between plantar- and dorsiflexors on postural balance in individuals with iSCI (iSCI-group) and able-bodied individuals (AB-group). Thirteen able-bodied individuals and 13 individuals with iSCI were asked to perform quiet standing with their eyes open (EO) and eyes closed (EC). Kinetics and electromyograms from the tibialis anterior (TA), …

Ankle Muscle Activation And Mechanics During The Ebbet's Foot Drills, Quentin Adam Archuleta

Theses, Dissertations and Capstones

Introduction: The ankle is a complex structure of three joints that allow multiplanar motion (Brockett & Chapman, 2016). Lateral ankle sprains (LAS) are the most common injury seen today in both the general and athletic populations and have a high recurrence rate. When left untreated or mistreated, it often leads to developing chronic ankle instability or osteoarthritis, which a lower quality of life. Dr. Russ Ebbets created a set of foot drills with the claim that they can strengthen the muscles of the lower leg, lessen lower leg aliments, and the chances of a severe ankle sprain (Ebbets, 2011a). …

Electromyographical Assessments Of Recommended Neck And Trunk Positions For Dental Hygienists, Margaret F. Lemaster, Kyle J. Kelleran, Maryam Moeini, Daniel M. Russell

Rehabilitation Sciences Faculty Publications

Purpose: Dental professionals are recommended to limit neck and trunk flexion to within 20° of a neutral (0°) body posture, however empirical support for the recommendations is lacking. The purpose of this study was to determine whether there are differences in muscle workload between a range of neck and trunk postures in a population of dental hygiene students.

Methods: Fifteen first semester senior dental hygiene students with no history of neck and trunk injury volunteered to participate. Surface electromyography was used to record muscle activity from two neck extensors muscles, cervical erector spinae (CES) and upper trapezius (UT), and two …

Neuromuscular Response To A Single Session Of Whole-Body Vibration In Children With Cerebral Palsy: A Pilot Study, Huaqing (Virginia) Liang, Gena Henderson, Jianhua Wu

Physical Therapy Faculty Research

Background Whole-body vibration (WBV) is a relative new intervention paradigm that could reduce spasticity and improve motor function in children with cerebral palsy (CP). We investigated neuromuscular response to a single session of side-alternating WBV with different amplitudes in children with CP.

Methods Ten children with spastic CP aged 7–17 years at GMFCS level I-III participated in this pilot study. Participants received two sessions of side-alternating WBV with the same frequency (20 Hz) but different amplitudes (low-amplitude: 1 mm and high-amplitude: 2 mm). Each session included six sets of 90 s of WBV and 90 s of rest. Before and …

Biomechanical Properties Of Land Based And Shallow Water Wait: A Comparative Review Of Literature, Mostafa Yaghoubi, Philip Fink, Wyatt H. Page, Sarah P. Shultz

International Journal of Aquatic Research and Education

Aquatic locomotion exercises are frequently used in rehabilitation and cross-training for land-based athletes. Hydrostatic pressure, thermal conductivity and drag force affect a person's ability to move; therefore, it is important to understand differences of biomechanical gait in water vs land. This review investigated biomechanical differences between shallow water and land-based exercises. PubMed, Google Scholar, SPORTDiscus and Scopus were searched; 33 studies included walking forward (27), backward (6) and running (6). Electromyographic amplitude was similar or less in submaximal intensity during aquatic gait, in comparison to on land. At maximal intensities, however, the amplitude was similar (n=5) or higher (n=4) in …

A Critical Review Of The Abductor Pollicis Longus Electromyographic Activity, Hisham Arabkabeya

Journal of the Arab American University مجلة الجامعة العربية الامريكية للبحوث

The aim of this study was to review the current evidence of the abductor pollicis longus electromyographic activity during thumb movements. The author performed an electronic thorough search for EMBASE, MEDLINE, CINAHL, and Web of Knowledge articles. Nine pieces in particular were found to explore the electromyographic activity of the abductor pollicis longus during thumb functional and non-functional movements. Consistent results were noticed, all emphasizing the key role of abductor pollicis longus in stabilizing the thumb's carpometacarpal joint. All target studies provided useful information about the abductor pollicis longus electromyographic activity. However, none of them examined the relationship between abductor …

Clinical And Surface Electromyography Evaluation Pre And Post Orofacial Myology Therapy, Luiza Junqeira Ferrer, Adriana Tessitore, Almiro J. Machado Júnior, Eulalia Sakano

International Journal of Orofacial Myology and Myofunctional Therapy

Purpose: The objective of this study is to observe the efficacy of orofacial myofunctional therapy in children who breathe through their mouths “mouth breathers” using a clinical assessment and surface electromyography. Method: 30 nasal breath (control group) and 30 mouth breathers (study group) were evaluated initially, and the study group was re-evaluated after 12 sessions of orofacial myofunctional therapy. Assessments involved the MBGR protocol and surface electromyography. Results: The control group had significantly better scores on all nasal breathing tests compared to mouth breathers both before and after therapy. However, mouth breathers demonstrated statistically significant improvements over time with therapy. …

Assessment Of Intrinsic Hand Neuromuscular Physiology, Philemon Tsang

Electronic Thesis and Dissertation Repository

Alterations to the peripheral nervous system and neuromuscular physiology may impact hand function in a typical or clinical population, such as individuals with ulnar neuropathy. The mechanisms that influence these positive and negative changes are still not well understood. The three studies within my thesis aim to validate the reliability of decomposition-based quantitative electromyography (DQEMG) measurements and explore the changes in intrinsic hand neuromuscular physiology in a typical aging population and individuals recovering from a surgical intervention for severe ulnar neuropathy.

The purpose of the first study was to determine the test-retest reliability of near-fibre (NF) jiggle, a measure of …

Comparison Of Pre- And Post-Operative Shoulder Muscle Emg Profiles In Reverse Total Shoulder Arthroplasty Patients, Emily Lau, Sreten Franovic, Noah Kuhlmann, Eric C. Makhni Md, Stephanie Muh Md

Medical Student Research Symposium

Background: Deltoid muscle function is central in reverse total shoulder arthroplasty (RTSA) function; however, there is limited information available regarding changes in deltoid activity before and after surgery. Few tests exist to evaluate specific muscle metrics pre and post operatively. Surface Electromyographic (EMG) is non-invasive and allows for observation of motions with multifaceted analysis of movement with minimal patient demand. Understanding the changes in shoulder muscle activation, namely in the deltoid, in patients pre and post-RTSA can further advance understanding of the procedure and rehabilitation efforts.

Methods: Nine individuals were recruited for this study: all patients underwent RTSA by a …

Reactive Stepping After A Forward Fall In People Living With Incomplete Spinal Cord Injury Or Disease, Katherine Chan, Jae Woung Lee, Janelle Unger, Jaeeun Yoo, Kei Masani, Kristin E Musselman

Physical Therapy Publications

STUDY DESIGN: Cross sectional.

OBJECTIVES: To compare the reactive stepping ability of individuals living with incomplete spinal cord injury or disease (SCI/D) to that of sex- and age-matched able-bodied adults.

SETTING: A tertiary SCI/D rehabilitation center in Canada.

METHODS: Thirty-three individuals (20 with incomplete SCI/D) participated. Participants assumed a forward lean position in standing whilst 8-12% of their body weight was supported by a horizontal cable at waist height affixed to a rigid structure. The cable was released unexpectedly, simulating a forward fall and eliciting one or more reactive steps. Behavioral responses (i.e., single step versus non-single step) were compared …

Task-Invariance And Reliability Of Anticipatory Postural Adjustments In Healthy Young Adults, Jo Armour Smith, Niklas König Ignasiak, Jesse V. Jacobs

Physical Therapy Faculty Articles and Research

Background

Anticipatory postural adjustments (APAs) occur in the trunk during tasks such as rapid limb movement and are impaired in individuals with musculoskeletal and neurological dysfunction. To understand APA impairment, it is important to first determine if APAs can be measured reliably and which characteristics of APAs are task-invariant.

Research question

What is the test-retest reliability of latency, amplitude and muscle activation patterns (synergies) of trunk APAs during arm-raise and leg-raise tasks, and to what extent are these APA characteristics invariant across tasks at the individual and group levels?

Methods

15 young adults (mean age: 23.7 (±3.2) years) performed six …

Muscle Activation Patterns During Movement Attempts In Children With Acquired Spinal Cord Injury: Neurophysiological Assessment Of Residual Motor Function Below The Level Of Lesion., Darryn A Atkinson, Laura Mendez, Natalie Goodrich, Sevda C Aslan, Beatrice Ugiliweneza, Andrea L Behrman

Physical Therapy Collection

Introduction: Characterization of residual neuromotor capacity after spinal cord injury (SCI) is challenging. The current gold standard for measurement of sensorimotor function after SCI, the International Society for Neurological Classification of Spinal Cord Injury (ISNCSCI) exam, seeks to determine isolated intentional muscle activation, however many individuals with SCI exhibit intentional movements and muscle activation patterns which are not confined to specific joint or muscle. Further, isolated muscle activation is a feature of the neuromuscular system that emerges during development, and thus may not be an appropriate measurement standard for children younger than 6.

Methods: We utilized neurophysiological assessment …

Individuals With Recurrent Low Back Pain Exhibit Significant Changes In Paraspinal Muscle Strength After Intramuscular Fine Wire Electrode Insertion, Szu-Ping Lee, Vincent Dinglasan, Anthony Duong, Russell Totten, Jo Armour Smith

Physical Therapy Faculty Articles and Research

Objective

To examine how insertion and presence of intramuscular fine‐wire electromyography electrodes (IFWE) in lumbar multifidus affect paraspinal muscle strength, endurance, and activation in persons with and without recurrent lower back pain (RLBP) during activities that require high levels of muscle contraction.

Design

Case‐control with randomization of conditions.

Setting

Clinical Research Laboratory.

Participants

Forty participants age 18‐40 were recruited (18 female; mean age = 25.5 yr); 20 with a history of RLBP were compared to a matching control group of 20 without RLBP.

Interventions

Each participant was tested under three conditions over three sessions. On Session 1, the baseline condition, …

Hip And Trunk Muscle Activity During The Star Excursion Balance Test In Healthy Adults, Kunal Bhanot, Navpreet Kaur, Lori Thein Brody, Jennifer Bridges, David C. Berry, Joshua J. Ode

Physical Therapy Collection

CONTEXT: Dynamic balance is a measure of core stability. Deficits in the dynamic balance have been related to injuries in the athletic populations. The Star Excursion Balance Test (SEBT) is suggested to measure and improve dynamic balance when used as a rehabilitative tool.

OBJECTIVE: To determine the electromyographic activity of the hip and the trunk muscles during the SEBT.

DESIGN: Descriptive.

SETTING: University campus.

PARTICIPANTS: Twenty-two healthy adults (11 males and 11 females; 23.3 [3.8] y, 170.3 [7.6] cm, 67.8 [10.3] kg, and 15.1% [5.0%] body fat).

INTERVENTION: Surface electromyographic data were collected on …

Neuromuscular Adaptions Following A Daily Strengthening Exercise In Individuals With Rotator Cuff Related Shoulder Pain: A Pilot Case-Control Study, Amee L. Seitz, Lisa A. Podlecki, Emily R. Melton, Timothy L. Uhl

Physical Therapy Faculty Publications

Background: The goal of therapeutic exercise is to facilitate a neuromuscular response by increasing or decreasing muscular activity in order to reduce pain and improve function. It is not clear what dosage of exercise will create a neuromuscular response.

Purpose: The purpose of this study was to assess the effects following a three-week home program of a daily single exercise, the prone horizontal abduction exercise (PHA), on neuromuscular impairments of motor control as measured by scapular muscle EMG amplitudes, strength, and secondarily outcomes of self-reported pain and function between individuals with and without subacromial pain syndrome.

Study Design: Prospective Case-Control, …

The Effects Of Cryotherapy On Quadriceps Electromyographic Activity And Isometric Strength In Patient In The Early Phases Following Knee Surgery, William Loro, Mark Thelen, Michael Rosenthal, Paul Stoneman, Michael Ross

Articles & Book Chapters

Purpose: To determine the effects of cryotherapy on quadriceps electromyographic (EMG) activity and isometric strength in early postoperative knee surgery patients.

Methods: Twenty-two volunteers with recent knee surgeries were included. EMG readings of the vastus medialis (VM), rectus femoris (RF), and vastus lateralis (VL) from the surgical leg were collected during a maximal voluntary quadriceps setting (QS) activity. Maximum isometric knee extension force measurements were also recorded. Subjects were randomly assigned to receive an ice bag or a sham room-temperature bag to the front of their postsurgical knee for 20 min. After treatment, the subjects repeated the above mentioned maximum …

Emg Analysis Of Latissimus Dorsi, Middle Trapezius, And Erector Spinae Muscle Activity During Spinal Rotation: A Pilot Study, Alyssa Wagner, Brandon Forister, Zachary Huot

Physical Therapy Scholarly Projects

Purpose/Hypothesis: Rotation of the spine is a common movement used to complete daily activities and participate in sports. As a contributing factor to back injuries, the performance of spinal rotation is an important consideration for the rehabilitation of current and prevention of future back injuries. Muscles involved in spinal rotation have been researched, though limited findings exist for one of the largest back muscles, the Latissimus Dorsi (LD). The LD muscle contributes to many movements of the trunk and limbs given its multiple attachment sites including the pelvis, ribs, scapula, and humerus. Influence of the LD on spinal rotation has …

Walking With A Robotic Exoskeleton Does Not Mimic Natural Gait: A Within-Subjects Study, Chad Swank, Sharon Wang-Price, Fan Gao, Sattam Almutairi

Kinesiology and Health Promotion Faculty Publications

Background: Robotic exoskeleton devices enable individuals with lower extremity weakness to stand up and walk over ground with full weight-bearing and reciprocal gait. Limited information is available on how a robotic exoskeleton affects gait characteristics.

Objective: The purpose of this study was to examine whether wearing a robotic exoskeleton affects temporospatial parameters, kinematics, and muscle activity during gait.

Methods: The study was completed by 15 healthy adults (mean age 26.2 [SD 8.3] years; 6 males, 9 females). Each participant performed walking under 2 conditions: with and without wearing a robotic exoskeleton (EKSO). A 10-camera motion analysis system synchronized with 6 …

Electromyographic (Emg) Activity Of The Gluteus Medius During Various Hip Exercises, Kalie Maiden, Mitchell Karbo, Taylor Doeden, Analise Richtsmeier

Physical Therapy Scholarly Projects

Background and Purpose. The purpose of the study was to record and analyze muscle recruitment patterns of the gluteus medius and gluteus maximus muscles when performing a side lying abduction exercise requiring consistent force to roll a ball up and down the wall using the dominant lower extremity. Comparisons were made between the use of either a small, medium or large ball. The subjects performed a standing abduction exercises with theraband around both ankles as well.

Case Description. Fifteen subjects were recruited from the University of North Dakota Department of Physical Therapy to perform the four different types of exercises. …

Insertion And Presence Of Fine-Wire Intramuscular Electrodes To The Lumbar Paraspinal Muscles Do Not Affect Muscle Performance And Activation During Highexertion Spinal Extension Activities, Szu-Ping Lee, Jo Armour Smith, Matthew Kimber, Kelsey Houk

Physical Therapy Faculty Articles and Research

Background

Low back pain (LBP) is commonly associated with paraspinal muscle dysfunctions. A method to study deep lumbar paraspinal (i.e. multifidus) muscle function and neuromuscular activation pattern is intramuscular electromyography (EMG). Previous studies have shown that the procedure does not significantly impact muscle function during activities involving low-level muscle contractions. However, it is currently unknown how muscular function and activation are affected during high-exertion contractions.

Objective

To examine the effects of insertion and presence of fine-wire EMG electrodes in the lumbar multifidus on muscle strength, endurance, and activation profiles during high-exertion spinal extension muscle contractions.

Design

Single-blinded, repeated measures intervention …

Individuals With Recurrent Low Back Pain Exhibit Significant Changes Of Paraspinal Muscle Performance After Lumbar Multifidus Intramuscular Fine Wire Electrode Insertion, Anthony Duong, Vincent Dinglasan, Russell Totten

UNLV Theses, Dissertations, Professional Papers, and Capstones

STUDY DESIGN: Case control study. BACKGROUND: Recurrent low back pain (RLBP) is associated with paraspinal muscle dysfunction. Intramuscular electromyography (EMG) is a common tool for studying activation of the deep lumbar paraspinal muscles such as multifidi muscles, but it is currently currently unclear how muscle performance and activation are affected by the pain and micro-injury associated with intramuscular fine-wire electrode (IFWE) insertion and how it interacts with the presence of RLBP. OBJECTIVES: The purpose of this study was to examine how IFWE insertion into the lumbar multifidus affects paraspinal muscle strength and endurance in subjects with and without RLBP. METHODS: …