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Rezazadeh F, aali S, yousefi M. Frequency pattern of lower limb muscle activity in athletes with hamstring injury and chronic nonspecific low back pain during walking. aumj 2026; 15 (3) : 7
URL: http://aums.abzums.ac.ir/article-1-1978-en.html
1- Department of Sport Biomechanics, Faculty of Educational Science and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran , rezazadeh.farhad@uma.ac.ir
2- Department of Sport Science Education, Farhangian University, P.O., Tehran, Iran.
3- Department of Sports Biomechanics, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
Abstract:   (28 Views)
Introduction: Walking is a fundamental indicator of motor performance and functional neuromuscular control, and alterations in gait patterns among athletes have been associated with an increased risk of musculoskeletal injury and the persistence of low back pain. The coexistence of hamstring injury and chronic nonspecific low back pain may disrupt normal neuromuscular coordination and modify the activation patterns of lower-limb muscles during locomotion. Such alterations may reflect adaptive or compensatory strategies adopted to maintain gait stability and lumbopelvic control. Therefore, this study aimed to compare the frequency spectrum of electrical activity in selected lower-limb muscles during walking between athletes with concomitant hamstring injury and chronic nonspecific low back pain and healthy athletes.
Methods: This cross-sectional comparative study included 40 athletes aged 16–35 years who were assigned to a case group with concomitant hamstring injury and chronic nonspecific low back pain (n = 20) and a healthy control group (n = 20). Surface electromyography (sEMG) was used to record the electrical activity of eight selected lower-limb muscles, including the tibialis anterior, gastrocnemius, vastus medialis, vastus lateralis, rectus femoris, semitendinosus, biceps femoris, and gluteus medius, during walking. The median frequency of muscle electrical activity was calculated during three distinct phases of the gait cycle: heel strike, mid-stance, and push-off. Between-group differences were analyzed using independent-samples t-tests. The study was reviewed and approved by the Research Ethics Committee of the University of Mohaghegh Ardabili (IR.UMA.REC.1404.029).
Results: Statistically significant between-group differences were identified in the frequency spectrum of the vastus medialis (p = 0.028) and rectus femoris (p = 0.006) during the heel-strike phase. During mid-stance, significant differences were observed in the tibialis anterior (p = 0.012), vastus lateralis (p = 0.021), and vastus medialis (p = 0.018). During the push-off phase, significant between-group differences were detected in the rectus femoris (p = 0.049) and biceps femoris (p = 0.019). These findings indicate phase-specific alterations in the frequency characteristics of lower-limb muscle activation among athletes presenting with concomitant hamstring injury and chronic nonspecific low back pain compared with healthy athletes.
Conclusion: The observed alterations in the frequency spectrum of lower-limb muscle activity across different phases of gait may reflect compensatory neuromuscular adaptations aimed at maintaining dynamic stability and controlling the lumbopelvic region in athletes with concomitant hamstring injury and chronic nonspecific low back pain. The identification of phase-specific changes in muscle activation patterns may provide clinically relevant information for understanding altered gait mechanics in this population. These findings may also contribute to the development of individualized and targeted rehabilitation programs designed to restore optimal neuromuscular coordination, correct abnormal muscle activation patterns, improve lumbopelvic stability, and potentially reduce excessive mechanical loading on the lumbar spine.
Article number: 7
     
Type of Study: Research | Subject: General
Received: 2025/11/23 | Accepted: 2026/01/25 | Published: 2026/09/22

References
1. Chu SK, Rho ME. Hamstring Injuries in the Athlete: Diagnosis, Treatment, and Return to Play. Current sports medicine reports. 2016;15(3):184-90. [DOI:10.1249/JSR.0000000000000264]
2. Chebbi S, Chamari K, Van Dyk N, Gabbett T, Tabben M. Hamstring Injury Prevention for Elite Soccer Players: A Real-World Prevention Program Showing the Effect of Players' Compliance on the Outcome. Journal of strength and conditioning research. 2022;36(5):1383-8. [DOI:10.1519/JSC.0000000000003505]
3. Alonso-Fernandez D, Martinez-Fernandez J, Docampo-Blanco P, Fernandez-Rodriguez R. Impact of askling L-PROTOCOL on biceps femoris architecture, hamstring flexibility and sprint performance. International journal of sports medicine. 2022;43(04):373-80. [DOI:10.1055/a-1627-0957]
4. Brown JR, Macklin I, Waller M. Using the Nordic hamstring exercise to reduce hamstring injuries in Gaelic football. Strength & Conditioning Journal. 2020;42(2):1-5. [DOI:10.1519/SSC.0000000000000516]
5. Cejudo A, Centenera-Centenera JM, Santonja-Medina F. The Potential Role of Hamstring Extensibility on Sagittal Pelvic Tilt, Sagittal Spinal Curves and Recurrent Low Back Pain in Team Sports Players: A Gender Perspective Analysis. Int J Environ Res Public Health. 2021;18(16). [DOI:10.3390/ijerph18168654]
6. Presland JD, Timmins RG, Maniar N, Tofari PJ, Kidgell DJ, Shield AJ, et al. Muscle Activity and Activation in Previously Strain-Injured Lower Limbs: A Systematic Review. Sports medicine (Auckland, NZ). 2021;51(11):2311-27. [DOI:10.1007/s40279-021-01487-w]
7. Jankaew A, Jan YK, Yang TH, Wu HW, Lin CF. Influence of Hamstring Injuries and Vision on Posterior Chain Muscle Activation during Challenging Single-Limb Balance Control among Athletes with Hamstring Strain Injuries. Journal of musculoskeletal & neuronal interactions. 2024;24(4):343-52.
8. Shamsi M, Mirzaei M, Pourahmadi M. Comparison of the Effects of Static Stretching and Strengthening on Electromyographic‎ Activity of Paravertebral Muscles in Patients with Chronic Non-specific LBP with‎ Tightened Hamstring Muscles: A Randomized Controlled Clinical Trial‎. Journal of Paramedical Sciences & Rehabilitation. 2022;10(4):79-90. [Text in Persian]
9. Van Dillen LR, Sahrmann SA, Norton BJ, Caldwell CA, McDonnell MK, Bloom NJ. Movement system impairment-based categories for low back pain: stage 1 validation. The Journal of orthopaedic and sports physical therapy. 2003;33(3):126-42. [DOI:10.2519/jospt.2003.33.3.126]
10. Jandre Reis FJ, Macedo AR. Influence of Hamstring Tightness in Pelvic, Lumbar and Trunk Range of Motion in Low Back Pain and Asymptomatic Volunteers during Forward Bending. Asian spine journal. 2015;9(4):535-40. [DOI:10.4184/asj.2015.9.4.535]
11. Chou R, Qaseem A, Owens DK, Shekelle P, Physicians* CGCotACo. Diagnostic imaging for low back pain: advice for high-value health care from the American College of Physicians. Annals of internal medicine. 2011;154(3):181-9. [DOI:10.7326/0003-4819-154-3-201102010-00008]
12. Edwards J, Hayden J, Asbridge M, Gregoire B, Magee K. Prevalence of low back pain in emergency settings: a systematic review and meta-analysis. BMC Musculoskelet Disord. 2017;18(1):143. [DOI:10.1186/s12891-017-1511-7]
13. Lima M, Ferreira AS, Reis FJJ, Paes V, Meziat-Filho N. Chronic low back pain and back muscle activity during functional tasks. Gait & posture. 2018;61:250-6. [DOI:10.1016/j.gaitpost.2018.01.021]
14. MAYER TG, TENCER AF, Kristoferson S, Mooney V. Use of noninvasive techniques for quantification of spinal range-of-motion in normal subjects and chronic low-back dysfunction patients. Spine. 1984;9(6):588-95. [DOI:10.1097/00007632-198409000-00009]
15. Bashiri A, Letafatkar A, Yalfani A, Hadadnezhad M. The Effects of Hydrotherapy Prehabilitation Exercise on the Level of Pain and Core Muscles Electromyography in Chronic Low Back Pain Patients' Candidate of Laminectomy Surgery. The Scientific Journal of Rehabilitation Medicine. 2021;10(4):806-21. [Text in Persian] [DOI:10.32598/SJRM.10.4.22]
16. Dankaerts W, O'Sullivan P, Burnett A, Straker L. Altered patterns of superficial trunk muscle activation during sitting in nonspecific chronic low back pain patients: importance of subclassification. Spine (Phila Pa 1976). 2006;31(17):2017-23. [DOI:10.1097/01.brs.0000228728.11076.82]
17. Ghamkhar L, Kahlaee AH. Trunk muscles activation pattern during walking in subjects with and without chronic low back pain: a systematic review. PM & R : the journal of injury, function, and rehabilitation. 2015;7(5):519-26. [DOI:10.1016/j.pmrj.2015.01.013]
18. Sadler S, Spink M, Chuter V. Gluteus medius muscle activity during gait in people with and without chronic nonspecific low back pain: A case control study. Gait & posture. 2021;83:15-9. [DOI:10.1016/j.gaitpost.2020.10.003]
19. van der Hulst M, Vollenbroek-Hutten MM, Rietman JS, Schaake L, Groothuis-Oudshoorn KG, Hermens HJ. Back muscle activation patterns in chronic low back pain during walking: a "guarding" hypothesis. The Clinical journal of pain. 2010;26(1):30-7. [DOI:10.1097/AJP.0b013e3181b40eca]
20. Fakhri Mirzanag e, barghamadi M, Imani s. Comparison of the Electrical Activity of Lower Limb and Core Muscles During Walking in Men With Chronic Low Back Pain Compared to Healthy Controls. Journal of Guilan University of Medical Sciences. 2025;34(1):92-103. [Text in Persian] [DOI:10.32598/JGUMS.34.1.2271.1]
21. Aali S, Letafatkar A, Ebrahimi I, Barati AH, Hadadnejad M. Does iliopsoas tightness affects synergistic muscle activity in hip extension during stance phase of gait? International Journal of Medical Research & Health Sciences. 2017;6(6):118-22.
22. von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Journal of clinical epidemiology. 2008;61(4):344-9. [DOI:10.1016/j.jclinepi.2007.11.008]
23. Porwal S, Rizvi MR, Sharma A, Ahmad F, Alshahrani MS, Raizah A, et al. Enhancing Functional Ability in Chronic Nonspecific Lower Back Pain: The Impact of EMG-Guided Trunk Stabilization Exercises. Healthcare (Basel, Switzerland). 2023;11(15). [DOI:10.3390/healthcare11152153]
24. Mohamadzadeh F, Letafatkar A, Abbaszadeh GH. Comparison the effects of stability training alone and in combination with pain education on pain, function and proprioception in patients with non-specific chronic low back pain. 2021.
25. alvani e, ziya M, Sahebozamani M. The effect of dynamic neuromuscular stability (DNS) training on dynamic balance and functional disability in athletes with non-specific chronic low back pain. Journal for Research in Sport Rehabilitation. 2020;8(15):127-38. [Text in Persian]
26. Mousavi SJ, Parnianpour M, Mehdian H, Montazeri A, Mobini B. The Oswestry Disability Index, the Roland-Morris Disability Questionnaire, and the Quebec Back Pain Disability Scale: translation and validation studies of the Iranian versions. Spine (Phila Pa 1976). 2006;31(14):E454-9. [DOI:10.1097/01.brs.0000222141.61424.f7]
27. Sebyani M, Minoonejad H, Shirzad E, Alizadeh M. Effect of Changing the Muscles Activation Patterns in Prone Hip Extension on Kinematical Variables Affecting the Hamstring Injury. Research in Sport Medicine and Technology. 2023;21(25):114-29. [Text in Persian] [DOI:10.61186/jsmt.21.25.114]
28. Askling CM, Tengvar M, Thorstensson A. Acute hamstring injuries in Swedish elite football: a prospective randomised controlled clinical trial comparing two rehabilitation protocols. British journal of sports medicine. 2013;47(15):953-9. [DOI:10.1136/bjsports-2013-092165]
29. Khodaei M, Letafatkar A, Shojaedin SS. The effect of therapeutic exercises on pain, function and fear avoidance beliefs in patients with chronic nonspecific low back pain. 2024. [Text in Persian]
30. Ghorbani S, Letafatkar A, Kasbparast M. Comparison of the effects and durabilities of isolated and combined core stabilization exercise and reflexology massage on muscle endurance and pain in females with chronic non-specific low back pain. The Scientific Journal of Rehabilitation Medicine. 2018;7(2):90-102. [Text in Persian]
31. Picciano AM, Rowlands MS, Worrell T. Reliability of open and closed kinetic chain subtalar joint neutral positions and navicular drop test. The Journal of orthopaedic and sports physical therapy. 1993;18(4):553-8. [DOI:10.2519/jospt.1993.18.4.553]
32. Farahpour N, Jafarnezhadgero A, Allard P, Majlesi M. Muscle activity and kinetics of lower limbs during walking in pronated feet individuals with and without low back pain. Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology. 2018;39:35-41. [DOI:10.1016/j.jelekin.2018.01.006]
33. Hermens HJ, Freriks B, Disselhorst-Klug C, Rau G. Development of recommendations for SEMG sensors and sensor placement procedures. Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology. 2000;10(5):361-74. [DOI:10.1016/S1050-6411(00)00027-4]
34. Jafarnezhadgero AA, Anvari M, Granacher U. Long-term effects of shoe mileage on ground reaction forces and lower limb muscle activities during walking in individuals with genu varus. Clinical biomechanics (Bristol, Avon). 2020;73:55-62. [DOI:10.1016/j.clinbiomech.2020.01.006]
35. Hedges D, Janis R, Mickelson S, Keith C, Bennett D, Brown BL. P300 amplitude in Alzheimer's disease: a meta-analysis and meta-regression. Clinical EEG and neuroscience. 2016;47(1):48-55. [DOI:10.1177/1550059414550567]
36. Jafarnezhadgero A, Alavi Mehr SM. The Effect of Thera-Band Resistance Training on the Electromyography Frequency Spectrum of Trunk and Lower Limb Muscles in Low Back Pain Patients with Pronated Feet During Walking: A Clinical Trial. Journal of Rafsanjan University of Medical Sciences. 2019;18(5):427-40. [Text in Persian]
37. Jafarnezhadgero A, Ghane G, Valizadehorang A. Comparison of Lower Limb Muscular Activities during Three Different Running Patterns in Pronated Feet Individuals with and without Low Back Pain. Anesthesiology and Pain. 2020;11(4):1-18. [Text in Persian]
38. Guimarães CQ, Sakamoto AC, Laurentino GE, Teixeira-Salmela LF. Electromyographic activity during active prone hip extension did not discriminate individuals with and without low back pain. Revista brasileira de fisioterapia (Sao Carlos (Sao Paulo, Brazil)). 2010;14(4):351-7. [DOI:10.1590/S1413-35552010005000017]
39. Hart JM, Weltman A, Ingersoll CD. Quadriceps activation following aerobic exercise in persons with low back pain and healthy controls. Clinical biomechanics (Bristol, Avon). 2010;25(8):847-51. [DOI:10.1016/j.clinbiomech.2010.05.009]
40. Zazulak BT, Hewett TE, Reeves NP, Goldberg B, Cholewicki J. Deficits in neuromuscular control of the trunk predict knee injury risk: a prospective biomechanical-epidemiologic study. The American journal of sports medicine. 2007;35(7):1123-30. [DOI:10.1177/0363546507301585]
41. Schuermans J, Danneels L, Van Tiggelen D, Palmans T, Witvrouw E. Proximal Neuromuscular Control Protects Against Hamstring Injuries in Male Soccer Players: A Prospective Study With Electromyography Time-Series Analysis During Maximal Sprinting. The American journal of sports medicine. 2017;45(6):1315-25. [DOI:10.1177/0363546516687750]
42. Nurse CA, Lewis CL, Shefelbine SJ. Frontal plane pelvic kinematics during high velocity running: Association with hamstring injury history. Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine. 2023;64:133-9. [DOI:10.1016/j.ptsp.2023.10.002]
43. Burnet EN, Arena RA, Pidcoe PE. Relationship between gluteus medius muscle activity, pelvic motion, and metabolic energy in running (P190). The Engineering of Sport 7: Springer; 2008. p. 267-71. [DOI:10.1007/978-2-287-09413-2_33]

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