We found conflicting data regarding the validity of methods used to examine back muscle fatigue .
The Biering-Sorensen test  , performed in conjunction with surface electromyography spectral analysis , turned out to be the most widely used and comparatively , the most optimal modality currently available to assess objective back muscle fatigue in daily clinical practise , even though critical limitations are discussed .
Implication s for Rehabilitation Despite its limitations , the Biering-Sorensen test is currently the most used , convenient and easily available fatiguing test for lumbar muscles .
Pooled mean frequency and half-width of the spectrum are currently the most valid electromyographic parameters to assess fatigue in chronic non-specific low back pain .
PURPOSE This systematic literature review aim ed at examining the validity and applicability in everyday clinical rehabilitation practise of methods for the assessment of back muscle fatiguability in patients with chronic non-specific low back pain ( CNSLBP ) .
Lumbar muscle fatigue and recovery in patients with long-term low-back trouble--electromyography and health-related factors.
OBJECTIVE The aim was to explore the validity and reliability of EMG for assessing lumbar muscle fatigue . DESIGN Patients with long-term low-back trouble ( n=57 ) were compared to a healthy reference group ( n=55 ) . Back muscle fatigue and recovery were studied in relation to health-related factors . BACKGROUND EMG spectral variables are important tools in the assessment of patients with low-back trouble . The influence of disability on these variables needs further investigation . METHODS  EMG from the lower back muscles was recorded during a 45 s trunk extension at 80 % of maximal voluntary contraction torque and during recovery . Disability was studied using question naires . RESULTS The reliability was high for maximal voluntary contraction torque and EMG initial median frequency , lower for the median frequency slope , and insufficient for median frequency recovery half-time . The patients had lower maximal voluntary contraction torque , higher initial median frequency at L5 level , flatter slope , and longer recovery half-time than the healthy subjects did . However , for subjects with significantly negative slope , indicating fatigue , there was no significant difference in slope between patients and healthy subjects , while , for subjects without such fatigue , patients showed significantly flatter slopes at L5 . The sensitivity/specificity of the test was 86%/78 % . The most significant variables selected with logistic regression were maximal voluntary contraction torque and initial median frequency at L5 . Patients without significantly negative slopes during contraction and /or not exponential-like EMG recovery scored worse on several items concerning disability and self-efficacy . CONCLUSIONS EMG spectral variables in combination with torque might be used for classification . For patients with long-term low-back trouble , the ability to fatigue the lumbar muscles sufficiently to obtain a significantly negative slope during an 80 % maximal voluntary contraction may be a sign of better functioning . RELEVANCE The ability to fatigue the back muscles during a test requiring a high force output might be achieved with back muscle training focused on increasing strength and self-efficacy
We found conflicting data regarding the validity of methods used to examine back muscle fatigue .
The Biering-Sorensen test  , performed in conjunction with surface electromyography spectral analysis , turned out to be the most widely used and comparatively , the most optimal modality currently available to assess objective back muscle fatigue in daily clinical practise , even though critical limitations are discussed .
Implication s for Rehabilitation Despite its limitations , the Biering-Sorensen test is currently the most used , convenient and easily available fatiguing test for lumbar muscles .
Pooled mean frequency and half-width of the spectrum are currently the most valid electromyographic parameters to assess fatigue in chronic non-specific low back pain .
PURPOSE This systematic literature review aim ed at examining the validity and applicability in everyday clinical rehabilitation practise of methods for the assessment of back muscle fatiguability in patients with chronic non-specific low back pain ( CNSLBP ) .