DOI: https://doi.org/10.22141/1608-1706.4.19.2018.142103

EMG activity of stabilizing muscles in sacroiliac joint in patients with sacroiliac dysfunction

V.А. Staude, Ye.B. Radzishevska, D.R. Dupliy

Abstract


Background. The purpose was to investigate EMG activity of muscles, which stabilized sacroiliac joint and support trunk vertical stability while two legs standing and one leg standing in patients with sacroiliac joint (SIJ) dysfunction with the pelvic tilt, sacral base tilt in frontal plane, sacrum rotation, asymmetry SIJ space width in comparison with healthy volunteers. Materials and methods. Thirty­six healthy volunteers were examined. Average volunteers height was 173 cm (from 168 cm to 183 cm), average body mass index was 2.99 (from 3.34 to 2.62). Fifty­six patients with SIJ dysfunction were investigated. Inclusion criteria were: pain in the area posterior spinae iliac superior, irradiated to groin, buttocks, thigh; more than 3 months history of pain; failed previous conservative treatment; positive 4 from 6 provocative tests. Exclusive criterion was positive only 1 or 2 from 6 provocative tests. As a result 50 patients were included in the investigation. The patients’ age was from 20 to 71years old. Average age was 39 years. All patients and volunteers were examined with X­ray, standing in anatomical position. On X­rays we measured sacral base tilt in frontal plane; pelvic tilt in frontal plane; angle of sacral rotation around axial line; sacroiliac joint space width in three parts: ventral, medial and dorsal. We investigated EMG activity of muscles, which stabilize SIJ during two legs standing, one leg standing (Stork test). During this test EMG activity of m. erector spinae, m. gluteus medius, m. abdominis obliquus externum, m. biceps femoris, m. rectus femoris was recorded. Results. After cluster analysis all patients were divided into four clusters. The first cluster was characterized by large asymmetry in sacroiliac joint width in ventral part, small asymmetry in medial and dorsal parts. The second cluster was characterized by symmetry of width  of SIJ space in all parts. The third cluster was characterized by large asymmetry sacroiliac joint space width in medial part, small asymmetry in dorsal part. The fourth cluster was characterized by large asymmetry in width of sacroiliac joint space in dorsal part and small asymmetry in medial part. EMG activity of stabilizing muscles in 4th cluster patients has the most difference with EMG activity in healthy volunteers. EMG activity of the muscles in the 3rd cluster patients has less difference with healthy volunteers and EMG activity in the 1st cluster patients has less difference with volunteers. EMG activity of the muscles in the 2nd cluster patients has no difference with EMG activity in healthy volunteers. Conclusions. Every cluster has typical parameters. Patients (first, third, fourth clusters) have unfavorable mathematical prognosis. These patients have large integrative asymmetry indices of SIJ space in at least two parts. EMG activity of stabilizing muscles in the 1st, 3rd, 4th clusters patients has large difference with EMG activity of the muscles of volunteers. Only EMG activity of the muscles in the 2nd cluster patients has no difference with EMG activity in healthy volunteers. Mathematical prognosis for the 2nd cluster patients is most favorable.


Keywords


EMG activity; SIJ dysfunction; one leg standing position; asymmetrical SIJ stiffness

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