O processamento é uma das principais características da radiografia digital. Diante da frequência da discopatia em cães, a importância do exame radiográfico na investigação inicial desta doença e na orientação de outros exames de imagem (tomografia computadorizada, mielotomografia e imagem por ressonância magnética), buscou-se avaliar a efetiva contribuição das ferramentas de processamento da imagem no diagnóstico das hérnias de disco. Para tanto, foram avaliados 80 forames intervertebrais através da radiologia computadorizada pelos filtros padrão, invertido e realce de borda e a combinação entre esses (padrão e invertido, padrão e realce de borda e realce de borda e invertido) para pesquisa da opacificação do forame intervertebral associada às hérnias de disco em cães. A análise radiográfica foi realizada por dois avaliadores às cegas com tempo de experiência superior a 10 anos em radiodiagnóstico. Foram calculadas as medidas de sensibilidade, especificidade, valores preditivos positivos e negativos, acurácia e razão de verossimilhanças para os respectivos filtros e a combinação destes pelos dois avaliadores. A tomografia computadorizada foi tomada como padrão ouro da detecção de opacificação do forame intervertebral. O coeficiente de kappa e seu respectivo intervalo de 95% de confiança foram utilizados para analisar a concordância dos resultados. Os valores de sensibilidade obtidos pelos avaliadores foram de 58,7% na detecção das opacificações pelo filtro padrão, 52,2% pelo filtro invertido e 50% de sensibilidade no estudo realizado pelo filtro realce de borda. Na combinação entre os filtros padrão e invertido e realce de borda e invertido os valores foram os mesmos com 43,5%, sendo que a sensibilidade do filtro padrão associado com o filtro realce de borda foi de 50%. A acurácia alcançada na detecção das opacificações do forame intervertebral pelos filtros individualmente foi de 78,8% para o filtro padrão, 75% para o filtro invertido e 75,6% para o filtro realce de borda, não apresentando diferenças significativas quando a combinação entre os filtros foi realizada, obtendo-se 76,9% nas associações entre os filtros padrão e invertido e padrão e realce de borda e 75,6% através dos filtros realce de borda e invertido. O processamento da imagem digital pode aumentar a acurácia na detecção das opacificações do forame, no entanto os filtros podem somente realçar uma alteração existente e não aumentar a capacidade de detecção da lesão pelo exame radiográfico simples sendo necessária para tal, a associação de exames de imagem mais sensíveis (mielografia/tomografia computadorizada/ imagem por ressonância magnética). A preferência pessoal na utilização dos filtros também foi comprovada. / Processing is a major feature of digital radiography. Given the frequency of disc disease in dogs, the importance of radiographic examination in the initial investigation of this disease and the guidance of other imaging studies (computed tomography, myelography and magnetic resonance imaging), it was evaluate the effective contribution of the processing tools image in the diagnosis of herniated discs. For this, eigthy intervertebral foramina through were evaluated computed radiography by standart filters, reverse and edge enhancement and the combination of these (standard and inverted pattern, standard and edge enhancement and edge enhancement and inverted) in the investigation of opacification of the intervertebral foramen associated with hernia disc in dogs. Radiographic analysis was performed by two raters blind to time of more than 10 years experience in diagnostic radiology. It was calculated measures of sensitivity, specificity, positive and negative predictive values, accuracy and likelihood ratio for the respective filters and the combination of the two evaluators. Therefore, the CT scan was taken as the gold standard of detection opacification of the intervertebral foramen. The kappa coefficient and its corresponding interval of 95% confidence intervals were used to analyze the correlation of the results. The sensitivity values obtained by the evaluators were 58.7% in detecting the opacities of the standard filter, the filter inverted 52.2% and 50% sensitivity in the study by edge enhancement filter. In combination between standard and inverted filters and edge enhancement and inverted values were the same with 43.5%, and the sensitivity of the filter pattern associated with the filter edge enhancement was 50%. The accuracy achieved in the detection of opacities of the intervertebral foramen by the filters individually was 78.8% for the standard filter, 75% to inverted filter and 75.6% for edge enhancement filter, showing no significant differences when the combination between the filters was performed. yielding 76.9% associations between the filters standard and inverted pattern, and pattern and edge enhancement and 75.6% through the filter edge enhancement and inverted. The digital image processing can increase the accuracy in the detection of opacities foramen, however filters can only highlight a change and not increase the existing capacity of lesion detection by simple radiographic examination is necessary association of more sensitive imaging ( myelography / CT / MRI). Personal preference through the use of filters was also confirmed.

Introdução: A dor lombar crônica pode ser definida como dor ou desconforto persistente por mais de 12 semanas nos níveis lombar e sacral da coluna vertebral. Cerca de 5% dos pacientes apresentam comprometimento de raiz nervosa, e uma razão comum é a herniação discal. Os músculos multífido lombar (ML) e transverso do abdome (TrA) são preferencialmente acometidos frente a episódios de dor lombar. Contudo, há escassa literatura que tenha avaliado a fadiga do ML e a capacidade de ativação do TrA em indivíduos com e sem hérnia de disco lombar. Objetivo: Avaliar a fadiga do músculo multífido lombar e a capacidade de ativação do transverso do abdome em indivíduos com hérnia de disco e dor lombar crônica, e controle. Métodos: Participaram do estudo 60 indivíduos com idade entre 20 a 50 anos, divididos em dois grupos: Hérnia Lombar (GHL) com dor há mais de três meses (n=30) e Grupo Controle (GC) sem dor (n=30). A fadiga do multífido lombar foi avaliada com a eletromiografia de superfície durante a realização do teste de esforço de Sorensen e a capacidade de ativação do TrA pela Unidade de Biofeedback Pressórico (UBP). A dor foi avaliada com a escala visual analógica - EVA e questionário McGill de Dor, a incapacidade funcional pelo Índice de incapacidade de Oswestry e o relato de esforço percebido pela escala de Borg. O nível de significância adotado foi de 5%. Na análise dos dados de frequência mediana quanto menor o valor maior a fadiga. Resultados: Houve aumento da fadiga nos dois grupos, porém mais intensa no GHL (p=0,0001) proporcionando a instalação da fadiga em menor tempo (163 s). Na capacidade de ativação do TrA, o GHL apresentou ativação insuficiente (-0,9 mmHg) e GC próximo a valores ideais ( -3,9 mmHg). Na escala de Borg, houve diferença entre os grupos para o esforço inicial (p=0,0002), contudo não foi observado diferença para o esforço final (p=0,0611). O GHL apresentou dor moderada (6,4 cm) quando avaliada pela EVA e pelo Questionário McGill de dor nas categorias sensorial (19,2) afetiva (8,6) e total (36,3) e incapacidade funcional mínima. Conclusão: Os indivíduos com hérnia de disco e dor lombar crônica apresentam maior fadiga do músculo multífido lombar e ativação do transverso do abdome insuficiente quando comparados aos controles. / Introduction: Chronic low back pain can be defined as pain or discomfort lasting more than 12 weeks in the lumbar and sacral levels of the spine. About 5% of patients have nerve root impairment, and the more common etiology is the disc herniation. The lumbar multifidus (LM) and transversus abdominis (TrA) muscles are often affected in low back pain. However, the literature on the fatigue assessment of ML and the ability of TRA activation in individuals with and without lumbar disc herniation is scarce. Objective: To evaluate the lumbar multifidus muscle fatigue and transversus abdominis activation in individuals with disc herniation and chronic low back pain, and control. Methods: The study included 60 subjects aged 20 to 50 years, divided into two groups: lumbar herniated group (GLH) with pain for more than three months (n = 30) and control group (CG) without pain (n = 30). The fatigue of the lumbar multifidus was measured with surface electromyography during the Sorensen test and ability of activation of TRA with Unit Biofeedback pressure (PBU). Pain was assessed by visual analog scale - VAS and McGill pain questionnaire, functional disability by Oswestry Disability Index, and the reporting of perceived exertion with Borg scale. The significance level was established in 5%. Results: We found increased fatigue in both groups however more intense in GLH (p=0.0001) providing the onset of fatigue in less time (163 s). The ability to activate the TrA, the GLH showed insufficient activation (-0.9 mmHg) and CG near the ideal values (-3.9 mmHg). In Borg scale, difference was observed between groups for the initial effort (p = 0.0002), however no difference was observed for the final effort (p = 0.061). The GLH had moderate pain (6.4 cm) when assessed by the VAS and the McGill Pain Questionnaire in sensory (19.2), affective (8.6) and total (36.3) categories and minimal functional disability. Conclusion: Individuals with disc herniation and chronic low back pain have higher fatigue of lumbar multifidus and insufficient transversus abdominis muscle activation when compared to controls.

ABSTRACT Background: Most cases of lumbar disc herniation are asymptomatic. When symptomatic, LDH may cause a significant physical and mental distress. Initially, most patients are treated conservative but sometimes operations may be required. Aim: The aim of this study was to provide a review of the scientific basis of physiotherapy, including behavioural therapy, as a treatment to lumbar disc herniation regarding pain, function and the size of disc herniation in people suffering from lumbar disc herniation. Method: Four databases were used in the searches of literature. Assessment of the validity of the studies was done with the PEDro-scale and valuation of evidence rate was made according to guidelines made by the Swedish Council on Health Technology Assessment (SBU). Result: Nine RCT-studies were included with a total of 713 participants. The scientific basis is moderate to support a pain reduction and limited regarding improvement of physical function when it comes to physical exercises, including MDT. There is also a limited scientific basis supporting a reduction of pain from manipulation. Laser, on the other hand, showed a limited scientific basis to have no effect on pain. Traction and acupuncture had an insufficient scientific basis. Overall there were an insufficient scientific basis on the size of disc herniation.There was no study found examining the efficacy on behavioural therapy. Conclusion: The scientific basis is moderate to support a pain reduction when it comes to physical exercises, including MDT. There were few studies of high evidential rate and the scientific basis is difficult to determine due to heterogeneous studies. Additional science is required to determine which physiotherapy methods are the most effective for patients with lumbar disc herniation. / SAMMANFATTNING Bakgrund: Många gånger ger ett diskbråck inga besvär men symtomgivande diskbråck kan vara väldigt fysiskt och psykiskt påfrestande för patienten. Initialt behandlas de flesta konservativt. Syfte: Syftet med denna litteraturöversikt är att granska det vetenskapliga underlaget för olika sjukgymnastiska behandlingars effektivitet, inkluderande beteendemedicinska åtgärder, på smärta, funktion och diskbråcksstorlek vid ländryggsdiskbråck. Metod: Fyra databaser användes för litteratursökningar. Bedömning av studiernas validitet gjordes med PEDro-skalan och bevisvärdet bedömdes enligt riktlinjer från SBU. Resultat: Nio RCT-studier inkluderades med totalt 713 deltagare. Det vetenskapliga underlaget (VU) för att träning/ MDT, är effektivt gällande smärtreduktion visade sig vara måttligt, och begränsat gällande funktionsförbättring. Även manipulation hade begränsat VU, då det gäller smärtreduktion. Laser visade sig ha ett begränsat VU för att inte ha någon effekt på smärta. Traktion och akupunktur visade sig ha ett otillräckligt VU. Övergående fanns det ett otillräckligt VU gällande effekten på diskbråcksstorlek. Ingen studie identifierades med beteendemedicinska åtgärder vid ländryggsdiskbråck. Slutsats: Det VU visade sig måttligt för att träning/MDT är effektivt gällande smärtreduktion. Antalet studier av hög kvalitet är begränsat och VU är svårvärderat då studierna är heterogena. Ytterligare forskning behövs för att kunna avgöra vilka behandlingsmetoder som är effektiva vid ländryggsdiskbråck.

Intervertebral disc herniations have been indicated as a possible injury development pathway due to occupational vibration exposures in seated postures through epidemiological investigations. Little experimental evidence exists to corroborate the strong epidemiological link between intervertebral disc herniations and vibration exposures using basic scientific approaches. The purpose of the current investigation was to provide some basic experimental evidence of the epidemiological link between intervertebral herniation and exposure to vibration. Partial intervertebral disc herniations were created in in-vitro porcine functional spinal units using a herniation protocol of repetitive flexion/extension motions under modest compressive forces. After herniation initiation, functional spinal units were exposed to 8 different vibration and postural constraint loading protocols consisting of two postural conditions (full flexion and neutral) and 4 vibration loading conditions (whole-body vibration, shock loading, static compressive loads, and whole-body vibration in addition to shock loading) to assess the effects of vibration and posture on functional spinal unit damage progression. There were three main outcome variables used to quantify damage progression; average stiffness changes, herniation distance progression (distance of tracking changes), and specimen height changes, while cumulative loading factors were considered. Additionally the concordance between two types of contrast enhanced medical imaging (Computed Tomography and discograms) was qualified to a dissection ‘gold standard’, and an attempt was made to classify disc damage progression via three categorical variables. Concordance to a dissection ‘gold standard’ was higher for the Computed Tomography medical imaging type that for the Discograms. The categorical criteria used to qualify disc damage progression were insufficiently sensitive to detect damage progressions illustrated through dissection and medical imaging techniques. The partial herniation loading protocol was quantified to be more damaging overall to the functional spinal units compared to the vibration and postural constraint loading protocols. However, the vibration and postural constraint loading protocols provided sufficient mechanical insult to the functional spinal units to progress damage to the intervertebral discs. Vibration loading exposures were found to alter specimen height changes and distance of tracking changes, however posture had no significant effects on these variables. Neither posture nor vibration loading had any meaningful significant effects on average stiffness changes.

Intervertebral disc herniations have been indicated as a possible injury development pathway due to occupational vibration exposures in seated postures through epidemiological investigations. Little experimental evidence exists to corroborate the strong epidemiological link between intervertebral disc herniations and vibration exposures using basic scientific approaches. The purpose of the current investigation was to provide some basic experimental evidence of the epidemiological link between intervertebral herniation and exposure to vibration. Partial intervertebral disc herniations were created in in-vitro porcine functional spinal units using a herniation protocol of repetitive flexion/extension motions under modest compressive forces. After herniation initiation, functional spinal units were exposed to 8 different vibration and postural constraint loading protocols consisting of two postural conditions (full flexion and neutral) and 4 vibration loading conditions (whole-body vibration, shock loading, static compressive loads, and whole-body vibration in addition to shock loading) to assess the effects of vibration and posture on functional spinal unit damage progression. There were three main outcome variables used to quantify damage progression; average stiffness changes, herniation distance progression (distance of tracking changes), and specimen height changes, while cumulative loading factors were considered. Additionally the concordance between two types of contrast enhanced medical imaging (Computed Tomography and discograms) was qualified to a dissection ‘gold standard’, and an attempt was made to classify disc damage progression via three categorical variables. Concordance to a dissection ‘gold standard’ was higher for the Computed Tomography medical imaging type that for the Discograms. The categorical criteria used to qualify disc damage progression were insufficiently sensitive to detect damage progressions illustrated through dissection and medical imaging techniques. The partial herniation loading protocol was quantified to be more damaging overall to the functional spinal units compared to the vibration and postural constraint loading protocols. However, the vibration and postural constraint loading protocols provided sufficient mechanical insult to the functional spinal units to progress damage to the intervertebral discs. Vibration loading exposures were found to alter specimen height changes and distance of tracking changes, however posture had no significant effects on these variables. Neither posture nor vibration loading had any meaningful significant effects on average stiffness changes.

This thesis is an investigation of the access provided to the vertebral canal in dogs by the hemilaminectomy and mini-hemilaminectomy surgical techniques using computed tomography (CT), and the completeness of evacuating extruded material in dogs with intervertebral disc (IVD) extrusion using magnetic resonance imaging (MRI). Hemilaminectomy and mini-hemilaminectomy were performed on opposite sides of the spine at T11-T12, T13-L1, and L2-L3 in 10 cadavers. Measurements of the vertebral canal height, defect height, and any dorsal and ventral remnants of the vertebral arch were obtained by CT. A covariate analysis was used to compare measurements with the surgical technique, surgical site, and side of the vertebral column. Defect height was greater with hemilaminectomy due to a smaller dorsal lamina remnant. There was no statistical difference in the height of the ventral remnant, or with surgical site. Nineteen prospectively recruited dogs with suspected IVD extrusion were randomly assigned to hemilaminectomy (10 dogs) or mini-hemilaminectomy (9 dogs) groups. Intervertebral disc extrusion was identified pre-operatively with MRI and later confirmed surgically, and immediate post-operative MRI was performed at the surgical site. The volume of extruded IVD material pre- and post-operative was calculated from transverse T2 images. Although residual IVD material was present in post-operative images from all dogs in the hemilaminectomy group and only 4 in the mini-hemilaminectomy group, there was no statistically significant difference between the proportionate volumes of material removed by either technique. The median residual volume with hemilaminectomy was 13.6% (confidence interval: 7.8 – 23.6%), and with mini-hemilaminectomy was 7.7% (4.3 – 13.8%). The results of this study confirm that the difference in the defect height between techniques is related to the removal of the articular processes creating a larger defect along the dorsal vertebral canal, while no difference in access to the ventral canal was observed. No effect of vertebral site was detected suggesting neither procedure provides an advantage over the other due to location of the lesion along the thoracolumbar spine. Residual extruded IVD material occurs with both techniques; while no statistical difference was noted, a larger population should be examined. / Ontario Veterinary College Pet Trust

Temos aktualumas: 95% žmonių, kurių amžius 25–55 metai turi juosmeninės stuburo dalies tarpslankstelinę disko išvaržą L4–L5 arba L5–S1 segmentuose (Jordon et al., 2009). McKenzie tiesimo judesiai padeda daugumai pacientų, kurie skundžiasi juosmeninės stuburo dalies skausmais (Richmond, 2012). Tai saugus, nebrangus ir patikimas metodas, kuris naudojamas, kai norima išspręsti juosmeninės stuburo dalies skausmus su skausmo plitimu į koją (McKenzie, 2011). Darbo objektas: kineziterapijos ir McKenzie pratimų poveikis skausmui ir stuburo paslankumui esant juosmeninės stuburo dalies išvaržai. Tikslas: nustatyti McKenzie pratimų poveikį skausmui bei stuburo paslankumui esant juosmeninės stuburo dalies išvaržai. Uždaviniai: 1.Įvertinti ir palyginti juosmeninės stuburo dalies skausmo pokyčius taikant kineziterapiją ir McKenzie pratimus. 2.Įvertinti ir palyginti stuburo dalies paslankumą taikant kineziterapiją ir McKenzie pratimus. 3.Įvertinti ir palyginti funkcinę negalią klausimynais taikant kineziterapiją ir McKenzie pratimus. Hipotezė: manome, kad taikant McKenzie pratimus kartu su tradicine kineziterapija labiau sumažės skausmas, pagerės stuburo paslankumas juosmeninėje stuburo dalyje bei pagerės funkcinė būklė. Išvados: 1.McKenzie pratimai labiau sumažino juosmeninės stuburo dalies skausmą nei tradicinė kineziterapija. 2.McKnezie pratimai ir tradicinė kineziterapija pagerino juosmeninės stuburo dalies paslankumą. 3.McKenzie pratimai ir tradicinė kineziterapija sumažino... [toliau žr. visą tekstą] / Importance of the study: relevance of the topic: 95% of people, whos age is 25–55 years, have lumbar spine disc herniation in L4–L5 or L5–S1 segments (Jordon et al., 2009). McKenzie laying movements help for the most of the patients, who are complaining about lumbar spine part pains (Richmond, 2012). It is a safe, cheap and reliable method, which is used to solve lumbar spine part pains with pain spreading to the leg (McKenzie, 2011). Object of the research: effect of physical therapy and McKenzie exercises on pain and spine mobility in the lumbar spine hernia. The aim of the research: to determine the effect of McKenzie exercises regarding pain and mobility of spine in lumbar herniated disc. The task of the research: 1.To evaluate and compare the changes in pain of lumbar spine through physical therapy and McKenzie exercises. 2.To evaluate and compare changes in the mobility of lumbar spine through physical therapy and McKenzie exercises. 3.To evaluate and compare the functional disability after using physical therapy and McKenzie exercises. Hypothesis: the expected outcome is that physical therapy along with McKenzie exercises will reduce the pain, improve spinal mobility in the lumbar spine part and improves functional status Conclusions: 1.McKenzie exercises greater reduced the pain in lower back than conventional physical therapy. 2.McKnezie exercises and conventional physiotherapy improved the mobility of the lumbar spine. 3.McKenzie exercises and... [to full text]

Psychosocial factors have been advanced as an explanation for the development of chronic disability in 20 to 30% of patients treated by lumbar disc surgery. Aims: The overall aim of this thesis was to study the role of psychosocial factors in patients undergoing first-time lumbar disc surgery in relation to the outcome of both surgery and subsequent physiotherapy. Methods: Sixty-nine patients with lumbar disc herniation undergoing first-time disc surgery participated in the studies; in addition, Study I included 162 knee patients for comparison. Psychosocial factors were assessed preoperatively, as was the activation of the physiological stress response system. Pain, disabil-ity and quality of life were assessed before, and 3 and 12 months after surgery. Coping and kinesiophobia were analysed before and one year after surgery. The results of two different postoperative training programmes were compared. Results: There were no differences between disc and knee patients regarding the presence of psychosocial stress factors preoperatively (Study I). Disc patients with low diurnal cortisol variability had lower physical function, perceived fewer possibilities to influence their pain and were more prone to catastrophise than patients with high diurnal cortisol variability (Study II). The results of clinic-based physiotherapy and home training did not differ regarding postoperative disability and pain 3 months after surgery. The home-based group had less pain and higher quality of life in comparison to the clinic-based group 12 months after surgery (Study III). Patients’ expectations of returning to work could best predict pain, disability, quality of life and sick leave one year after surgery (Study IV). Psychosocial factors were only weakly asso-ciated to pain, disability, quality of life and sick leave preoperatively. However, these associations were stronger in patients with residual pain one year after surgery. Conclusion: Psychosocial factors and, in particular, patients’ expectations regarding outcome are associated with the results of lumbar disc surgery. Assessing psychosocial factors preoperatively and developing an active home training programme after surgery could create options leading to better results for these patients.

Introdução: A dor lombar crônica pode ser definida como dor ou desconforto persistente por mais de 12 semanas nos níveis lombar e sacral da coluna vertebral. Cerca de 5% dos pacientes apresentam comprometimento de raiz nervosa, e uma razão comum é a herniação discal. Os músculos multífido lombar (ML) e transverso do abdome (TrA) são preferencialmente acometidos frente a episódios de dor lombar. Contudo, há escassa literatura que tenha avaliado a fadiga do ML e a capacidade de ativação do TrA em indivíduos com e sem hérnia de disco lombar. Objetivo: Avaliar a fadiga do músculo multífido lombar e a capacidade de ativação do transverso do abdome em indivíduos com hérnia de disco e dor lombar crônica, e controle. Métodos: Participaram do estudo 60 indivíduos com idade entre 20 a 50 anos, divididos em dois grupos: Hérnia Lombar (GHL) com dor há mais de três meses (n=30) e Grupo Controle (GC) sem dor (n=30). A fadiga do multífido lombar foi avaliada com a eletromiografia de superfície durante a realização do teste de esforço de Sorensen e a capacidade de ativação do TrA pela Unidade de Biofeedback Pressórico (UBP). A dor foi avaliada com a escala visual analógica - EVA e questionário McGill de Dor, a incapacidade funcional pelo Índice de incapacidade de Oswestry e o relato de esforço percebido pela escala de Borg. O nível de significância adotado foi de 5%. Na análise dos dados de frequência mediana quanto menor o valor maior a fadiga. Resultados: Houve aumento da fadiga nos dois grupos, porém mais intensa no GHL (p=0,0001) proporcionando a instalação da fadiga em menor tempo (163 s). Na capacidade de ativação do TrA, o GHL apresentou ativação insuficiente (-0,9 mmHg) e GC próximo a valores ideais ( -3,9 mmHg). Na escala de Borg, houve diferença entre os grupos para o esforço inicial (p=0,0002), contudo não foi observado diferença para o esforço final (p=0,0611). O GHL apresentou dor moderada (6,4 cm) quando avaliada pela EVA e pelo Questionário McGill de dor nas categorias sensorial (19,2) afetiva (8,6) e total (36,3) e incapacidade funcional mínima. Conclusão: Os indivíduos com hérnia de disco e dor lombar crônica apresentam maior fadiga do músculo multífido lombar e ativação do transverso do abdome insuficiente quando comparados aos controles. / Introduction: Chronic low back pain can be defined as pain or discomfort lasting more than 12 weeks in the lumbar and sacral levels of the spine. About 5% of patients have nerve root impairment, and the more common etiology is the disc herniation. The lumbar multifidus (LM) and transversus abdominis (TrA) muscles are often affected in low back pain. However, the literature on the fatigue assessment of ML and the ability of TRA activation in individuals with and without lumbar disc herniation is scarce. Objective: To evaluate the lumbar multifidus muscle fatigue and transversus abdominis activation in individuals with disc herniation and chronic low back pain, and control. Methods: The study included 60 subjects aged 20 to 50 years, divided into two groups: lumbar herniated group (GLH) with pain for more than three months (n = 30) and control group (CG) without pain (n = 30). The fatigue of the lumbar multifidus was measured with surface electromyography during the Sorensen test and ability of activation of TRA with Unit Biofeedback pressure (PBU). Pain was assessed by visual analog scale - VAS and McGill pain questionnaire, functional disability by Oswestry Disability Index, and the reporting of perceived exertion with Borg scale. The significance level was established in 5%. Results: We found increased fatigue in both groups however more intense in GLH (p=0.0001) providing the onset of fatigue in less time (163 s). The ability to activate the TrA, the GLH showed insufficient activation (-0.9 mmHg) and CG near the ideal values (-3.9 mmHg). In Borg scale, difference was observed between groups for the initial effort (p = 0.0002), however no difference was observed for the final effort (p = 0.061). The GLH had moderate pain (6.4 cm) when assessed by the VAS and the McGill Pain Questionnaire in sensory (19.2), affective (8.6) and total (36.3) categories and minimal functional disability. Conclusion: Individuals with disc herniation and chronic low back pain have higher fatigue of lumbar multifidus and insufficient transversus abdominis muscle activation when compared to controls.

O processamento é uma das principais características da radiografia digital. Diante da frequência da discopatia em cães, a importância do exame radiográfico na investigação inicial desta doença e na orientação de outros exames de imagem (tomografia computadorizada, mielotomografia e imagem por ressonância magnética), buscou-se avaliar a efetiva contribuição das ferramentas de processamento da imagem no diagnóstico das hérnias de disco. Para tanto, foram avaliados 80 forames intervertebrais através da radiologia computadorizada pelos filtros padrão, invertido e realce de borda e a combinação entre esses (padrão e invertido, padrão e realce de borda e realce de borda e invertido) para pesquisa da opacificação do forame intervertebral associada às hérnias de disco em cães. A análise radiográfica foi realizada por dois avaliadores às cegas com tempo de experiência superior a 10 anos em radiodiagnóstico. Foram calculadas as medidas de sensibilidade, especificidade, valores preditivos positivos e negativos, acurácia e razão de verossimilhanças para os respectivos filtros e a combinação destes pelos dois avaliadores. A tomografia computadorizada foi tomada como padrão ouro da detecção de opacificação do forame intervertebral. O coeficiente de kappa e seu respectivo intervalo de 95% de confiança foram utilizados para analisar a concordância dos resultados. Os valores de sensibilidade obtidos pelos avaliadores foram de 58,7% na detecção das opacificações pelo filtro padrão, 52,2% pelo filtro invertido e 50% de sensibilidade no estudo realizado pelo filtro realce de borda. Na combinação entre os filtros padrão e invertido e realce de borda e invertido os valores foram os mesmos com 43,5%, sendo que a sensibilidade do filtro padrão associado com o filtro realce de borda foi de 50%. A acurácia alcançada na detecção das opacificações do forame intervertebral pelos filtros individualmente foi de 78,8% para o filtro padrão, 75% para o filtro invertido e 75,6% para o filtro realce de borda, não apresentando diferenças significativas quando a combinação entre os filtros foi realizada, obtendo-se 76,9% nas associações entre os filtros padrão e invertido e padrão e realce de borda e 75,6% através dos filtros realce de borda e invertido. O processamento da imagem digital pode aumentar a acurácia na detecção das opacificações do forame, no entanto os filtros podem somente realçar uma alteração existente e não aumentar a capacidade de detecção da lesão pelo exame radiográfico simples sendo necessária para tal, a associação de exames de imagem mais sensíveis (mielografia/tomografia computadorizada/ imagem por ressonância magnética). A preferência pessoal na utilização dos filtros também foi comprovada. / Processing is a major feature of digital radiography. Given the frequency of disc disease in dogs, the importance of radiographic examination in the initial investigation of this disease and the guidance of other imaging studies (computed tomography, myelography and magnetic resonance imaging), it was evaluate the effective contribution of the processing tools image in the diagnosis of herniated discs. For this, eigthy intervertebral foramina through were evaluated computed radiography by standart filters, reverse and edge enhancement and the combination of these (standard and inverted pattern, standard and edge enhancement and edge enhancement and inverted) in the investigation of opacification of the intervertebral foramen associated with hernia disc in dogs. Radiographic analysis was performed by two raters blind to time of more than 10 years experience in diagnostic radiology. It was calculated measures of sensitivity, specificity, positive and negative predictive values, accuracy and likelihood ratio for the respective filters and the combination of the two evaluators. Therefore, the CT scan was taken as the gold standard of detection opacification of the intervertebral foramen. The kappa coefficient and its corresponding interval of 95% confidence intervals were used to analyze the correlation of the results. The sensitivity values obtained by the evaluators were 58.7% in detecting the opacities of the standard filter, the filter inverted 52.2% and 50% sensitivity in the study by edge enhancement filter. In combination between standard and inverted filters and edge enhancement and inverted values were the same with 43.5%, and the sensitivity of the filter pattern associated with the filter edge enhancement was 50%. The accuracy achieved in the detection of opacities of the intervertebral foramen by the filters individually was 78.8% for the standard filter, 75% to inverted filter and 75.6% for edge enhancement filter, showing no significant differences when the combination between the filters was performed. yielding 76.9% associations between the filters standard and inverted pattern, and pattern and edge enhancement and 75.6% through the filter edge enhancement and inverted. The digital image processing can increase the accuracy in the detection of opacities foramen, however filters can only highlight a change and not increase the existing capacity of lesion detection by simple radiographic examination is necessary association of more sensitive imaging ( myelography / CT / MRI). Personal preference through the use of filters was also confirmed.