Imperial College London

Dr Shin-Yi Chiou (Chloe)

Faculty of MedicineDepartment of Surgery & Cancer

Honorary Research Associate



+44 (0)20 3313 8833s.chiou12




7L16Lab BlockCharing Cross Campus






BibTex format

author = {Chiou, SY and Shih, YF and Chou, LW and McGregor, AH and Strutton, PH},
doi = {10.1002/j.1532-2149.2013.00428.x},
journal = {European Journal of Pain},
pages = {794--802},
title = {Impaired neural drive in patients with low back pain},
url = {},
volume = {18},
year = {2014}

RIS format (EndNote, RefMan)

AB - BackgroundControl of trunk movement relies on the integration between central neuronal circuits and peripheral skeletomuscular activities and it can be altered by pain. There is increasing evidence that there are deficits within the central nervous system controlling the trunk muscles in people with low back pain (LBP). However, it is unclear how LBP impacts upon neural drive to back muscles at different levels of voluntary contraction. Therefore, the purpose of this study was to investigate if neural drive is impaired in these patients.MethodsSeventeen patients with LBP and 11 healthy controls were recruited. Bilateral electromyographic (EMG) recordings were obtained from the erector spinae (ES) muscles at two vertebral levels (T12 and L4). Participants performed a series of brief isometric back extensions (50–100% maximum voluntary contraction – MVC), during which transcranial magnetic stimulation was delivered. The size of the evoked (superimposed) twitch was measured using dynamometry.ResultsThe size of the superimposed twitch decreased linearly with increasing contraction strength in the controls; however, this linear relationship was not observed in the patients. Additionally, patients had larger superimposed twitches and longer timetopeak amplitudes during MVCs than those observed in controls. Furthermore, patients had lower MVC and rootmeansquare EMG activity of ES muscles during MVCs.ConclusionsA decline of central neural drive to the back muscles at high level of voluntary contraction was observed in patients with LBP. These results suggest that it might be pertinent to include neuromuscular facilitation programmes and therapeutic exercise utilizing high voluntary contractions for patients with LBP.
AU - Chiou,SY
AU - Shih,YF
AU - Chou,LW
AU - McGregor,AH
AU - Strutton,PH
DO - 10.1002/j.1532-2149.2013.00428.x
EP - 802
PY - 2014///
SN - 1090-3801
SP - 794
TI - Impaired neural drive in patients with low back pain
T2 - European Journal of Pain
UR -
UR -
UR -
UR -
VL - 18
ER -