Different ways to balance the spine in sitting: Muscle activity in specific postures differs between individuals with and without a history of back pain in sitting

Background: Previous research explored muscle activity in four distinct sitting postures with fine-wire electromyography, and found that lumbar multifidus muscle activity increased incrementally between sitting with flat thoracolumbar and lumbar regions, long thoracolumbar lordosis, or short lordosis confined to the lumbar region. This study used similar methods to explore whether people with a history of low back pain provoked by prolonged sitting used different patterns of trunk muscle activity in specific postures. Methods: Fine-wire electromyography electrodes were inserted into the right lumbar multifidus (deep and superficial), iliocostalis (lateral and medial), longissimus thoracis and transversus abdominis muscles. Superficial abdominal muscle activity was recorded with surface or fine-wire electrodes. Electromyography amplitude was compared between postures for the back pain group and observations were contrasted with the changes previously reported for pain-free controls. For comparison between groups normalised and non-normalised electromyography amplitudes were compared. Findings: Individuals with a history of back pain demonstrated greater activity of the longissimus thoracis muscle in the long lordosis compared with the flat posture [mean difference (95% CI): 46.6 (17.5-75.7)%, normalised to sitting posture peak activity], but pain-free participants did not [mean difference: 7.7 (minus 12-27.6)%]. Pain-free participants modulated lumbar multifidus activity with changes in lumbar curve, but people with a history of pain in prolonged sitting did not change multifidus activity between the long and short lordotic postures. Interpretation: In clinical ergonomic interventions that modify spinal curves and sagittal balance in sitting, the muscle activity used in those postures may differ between people with and without a history of back pain.