Journal of Paramedical Sciences & Rehabilitation

Journal of Paramedical Sciences & Rehabilitation

Evaluation of the Immediate Effect of Lumbar Myofascial Tissue Release on Electromyographic Activity of Trunk Muscles During Axial Loading in Patients with Chronic Nonspecific Low Back Pain

Document Type : Original Article

Authors
Mobina Mirarab razi
Rasool Bagheri
Department of Physiotherapy, School of Rehabilitation, Semnan University of Medical Sciences, Semnan, Iran
10.22038/jpsr.2026.65485.2390
Abstract
Purpose:
Chronic nonspecific low back pain is one of the main challenges of global health systems. Although myofascial release (MFR) has been proposed as a promising therapeutic method, previous studies have failed to examine its effects on neuromuscular control during functional activities. This study aims to answer the question of whether MFR can instantaneously alter the activation pattern of low back stabilizing muscles in lifting tasks by designing a standard protocol and using surface electromyography. The findings of this research could provide a foundation for designing combined rehabilitation protocols
Methods:
This single-blind clinical trial study was performed on ۵۴ patients with chronic nonspecific low back pain who met the inclusion and exclusion criteria. Subjects were randomly divided into two groups (intervention and placebo). Electromyographic activity of the erector spinae longissimus and iliocostalis, multifidus, transversus abdominis, internal oblique, external oblique, and rectus abdominis muscles was recorded before and after myofascial release and immediately during loading in the intervention and placebo groups.
Results:
Myofascial release significantly decreased RMS and increased activation delay of the right transversus abdominis during loading and significantly increased activation delay of the left multifidus. The placebo intervention also affected the electromyographic activity of all trunk muscles except the left transversus abdominis, right multifidus, right rectus abdominis, and right and left iliocostalis during loading.
Conclusion:
According to the findings of this study, the immediate effect of myofascial release on trunk muscles during lifting was significant only for the right transversus abdominis and multifidus, highlighting the potential clinical relevance of myofascial release for these muscles. Myofascial release may modulate the activity of these specific stabilizing muscles during functional activities. However, the instability of electromyographic responses necessitates caution in interpreting electrophysiological findings as a single indicator of effectiveness. It is recommended to use MFR as an adjunctive method alongside other therapies (such as stabilization exercises) to improve neuromuscular control.
Keywords
Chronic nonspecific low back pain
Myofascial release
Loading
Electromyography
Subjects
  1. Kull P, Keilani M, Remer F, Crevenna R. Efficacy of pulsed electromagnetic field therapy on pain and physical function in patients with non-specific low back pain: a systematic review. Wien Med Wochenschr. 2025; 175(1): 11-19.
  2. Hartvigsen, J., Hancock, MJ., Kongsted, A., Louw, Q., et al. What low back pain is and why we need to pay attention. Lancet 2018; 391(10137): 2356-2367.
  3. Salas E., Hulla R., Vanzzini N., Trowbridge, C., et al. The relative efficacy of two exercise methods for older adults with chronic low back pain: A preliminary randomized control study. J Appl Biobehav Res. 2019; 24(1): e12132.
  4. Ehsani F, Arab A.M, Fatemi E. The relationship between abdominal muscle activity and pain, disability and fear of movement during standing postural tasks in females with chronic nonspecific low back pain. Koomesh (Rehabilitation) 2016; 18(2): 250-257. [Persian
  5. ]Chen, W. J., Chiou, W. K., Lee, Y. H., Lee, M. Y., Chen, M. L. Myo-electric behavior of the trunk muscles during static load holding in healthy subjects and low back pain patients. Clin Biomech. 1998; 13(1): S9-S15.
  6. Cathcart E., McSweene, T., Johnston R., Young H., Edwards D.J. Immediate biomechanical, systemic, and interoceptive effects of myofascial release on the thoracic spine: a randomised controlled trial.  J Bodyw Mov Ther 2019; 23(1):74-81.
  7. Gatchel, R. J., Polatin, P. B., Mayer, T. G. The dominant role of psychosocial risk factors in the development of chronic low back pain disability. Spine 1995; 20(24): 2702-2709.
  8. Ajimsha M.S., Daniel B., Chithra S. Effectiveness of Myofascial release in the management of chronic low back pain in nursing professionals. J Bodyw Mov Ther 2014; 18(2): 273-281.
  9. Schleip, R. Fascial plasticity–a new neurobiological explanation: Part 1. J Bodyw Mov Ther 2003; 7(1): 11-19.
  10. Suehiro T., Ishida H., Kobara K., Osaka H., Watanabe S. Altered trunk muscle recruitment patterns during lifting in individuals in remission from recurrent low back pain. J Electromyogr Kinesiol. 2018; 39: 128-133.
  11. Cholewicki, J., Lee, A. S., Reeves, N. P., Calle, E. A. Trunk muscle response to various protocols of lumbar traction. Man Ther. 2009; 14(5): 562-566.
  12. Stamm, T. A., Boesendorfer, A., Omara, M., Ritschl, V., et al. Outcomes research in non-specific low back pain. Wien Klin Wochenschr. 2019; 131(21): 550-557.
  13. Maher, C., Underwood, M., Buchbinder, R. Non-specific low back pain. Lancet 2017; 389(10070):736-747.
  14. Akbari, M., Sarrafzadeh, J., Maroufi, N., Haghani, H. Changes in postural and trunk muscles responses in patients with chronic nonspecific low back pain during sudden upper limb loading. Med J Islam Repub Iran. 2015; 29: 265.
  15. Ellythy, M. A. Effectiveness of myofascial release technique in management of patients with chronic low back pain. Bull Fac Phys Ther 2011;16(2).
  16. Ansari B., Bhati P., Singla D., Nazish N., Hussain, M. E. Lumbar Muscle Activation Pattern During Forward and Backward Walking in Participants with and Without Chronic Low Back Pain: An Electromyographic Study. J Chiropr Med 2018; 17(4): 217-225.
  17. Yaghoubi Z, Kahrizi S, Mohamad Parnian pour M, Faghihzadeh S. Short effects of two common stabilization exercise on back and abdominal muscle recruitment and lumbar curvature in non-specific chronic low back pain patients: a crossover clinical trial study. Koomesh 2014; 15(4): 511-521. [Persian]
  18. Scano A., Zanoletti M., Pirovano I., Spinelli, L., et al. NIRS-EMG for clinical applications: A systematic review. Appl Sci 2019 ;9(15): 2952.
  19. Stanborough, M. Direct release myofascial technique: Elsevier 2004.
  20. Çetinyol O, Saka S, Çetinkaya A. Acute effects of myofascial release technique on flexibility and pain: Outcome for chronic low back pain. J Bodyw Mov Ther. 2025; 41:194-198.
  21. Ożóg P., Weber-Rajek M., Radzimińska A., Goch, A. Analysis of Muscle Activity Following the Application of Myofascial Release Techniques for Low-Back Pain—A Randomized-Controlled Trial. J Clin Med 2021; 10(18): 4039.
  22. DeVocht, J. W., Pickar, J. G., Wilder, D. G. Spinal manipulation alters electromyographic activity of paraspinal muscles: a descriptive study. J Manipulative Physiol Ther. 2005; 28(7): 465-471.
  23. Bertolucci, L. F. Muscle Repositioning: A new verifiable approach to neuro-myofascial release? J Bodyw Mov Ther 2008; 12(3): 213-224.
  24. Watson P. J., Booker C. K., Main C. J. Evidence for the role of psychological factors in abnormal paraspinal activity in patients with chronic low back pain. J Musculoskelet Pain 1997; 5(4): 41-56.
  25. Kingma I., van Dieën J. H. Lifting over an obstacle: effects of one-handed lifting and hand support on trunk kinematics and low back loading. J Biomech 2004; 37(2): 249-255.
  26. Wesselink EO, Pool-Goudzwaard A, De Leener B, Law CSW, et al. Investigating the associations between lumbar paraspinal muscle health and age, BMI, sex, physical activity, and back pain using an automated computer-vision model: a UK Biobank study. Spine J. 2024; 24(7):1253-1266.
Journal of Paramedical Sciences & Rehabilitation
Volume 15, Issue 2
Summer 2026
Pages 165-156