Neuromuscular fatigue during a modified biering-sørensen test in subjects with and without low back pain

Studies employing modified Biering-Sørenson tests have reported that low back endurance is related to the potential for developing low back pain. Understanding the manner in which spinal musculature fatigues in people with and without LBP is necessary to gain insight into the sensitivity of the modified Biering-Sørenson test to differentiate back health. Twenty male volunteers were divided into a LBP group of subjects with current subacute or a history of LBP that limited their activity (n = 10) and a control group (n = 10). The median frequency of the fast Fourier transform was calculated from bilateral surface electromyography (EMG) of the upper lumbar erector spinae (ULES), lower lumbar erector spinae (LLES) and biceps femoris while maintaining a prescribed modified Biering-Sørensen test position and exerting isometric forces equivalent to 100, 120, 140 and 160% of the estimated mass of the head-arms-trunk (HAT) segment. Time to failure was also investigated across the percentages of HAT. Fatigue time decreased with increasing load and differences between groups increased as load increased, however these differences were not significant. Significant differences in the EMG median frequency between groups occurred in the right biceps femoris (p ≤ 0.05) with significant pairwise differences occurring at 140% for the left biceps femoris and at 160% for the right biceps femoris. There were significant pairwise differences at 120% for average EMG of the right biceps femoris and at 140% for the right ULES, and right and left biceps femoris (p ≤ 0.05). The modified Biering-Sørensen test as usually performed at 100% HAT is not sufficient to demonstrate significant differences between controls and subjects with varying degrees of mild back disability based on the Oswestry classification. Key pointsThe results do not wholly support the modified Biering-Sørensen test utilizing resistance of 100% HAT to discern differences in fatigue in subjects with mild low back pain.A greater activation of the biceps femoris by low back pain individuals probably contributed to the lack of significant differences in back fatigue times.The possibility exists that subjects with more sophisticated strategies could yield higher fatigue times despite inferior neuromuscular fatigue and the existence of low back pain.