Ultrasonography of multifidus muscle morphology and function in ice hockey players with and without low back pain

2019 ◽  
Vol 37 ◽  
pp. 77-85 ◽  
Author(s):  
Maryse Fortin ◽  
Amanda Rizk ◽  
Stephane Frenette ◽  
Mathieu Boily ◽  
Hassan Rivaz
2021 ◽  
Author(s):  
Maryse Fortin ◽  
Daniel Wolfe ◽  
Geoffrey Dover ◽  
Mathieu Boily

Abstract BackgroundNeuromuscular electrical stimulation (NMES) is used to improve muscle strength clinically when rehabilitating various musculoskeletal disorders. However, the effects of NMES on muscle morphology and function in individuals with non-specific chronic low back pain (CLBP) have scarcely been investigated. Although research links deficits in the paraspinal musculature with subjective reports of pain and disability, it is unknown if treatment with NMES can help reverse these deficits. Therefore, the primary aim of this study is to compare the effects of two muscle therapy protocols with a medium-frequency electrotherapy device (the StimaWELL 120MTRS system) on multifidus muscle morphology in CLBP patients. The secondary aims are to determine the effects of these protocols on multifidus muscle function, as well as subjective reports of pain intensity, pain interference, disability, and catastrophizing. MethodsA total of 30 participants with non-specific CLBP, aged 18-60, will be recruited from local orthopedic clinics and databases. Participants will be randomized (1:1) to either the phasic or combined (phasic + tonic) muscle therapy protocols on the StimaWELL 120MTRS system. Participants will undergo 20 supervised electrotherapy treatments over a 10-week period. The primary outcomes will be multifidus cross-sectional area (CSA) and fat infiltration. Secondary outcomes will include multifidus contraction (measured via %thickness change from a rested to contracted state), multifidus stiffness (at rest, and during contraction), as well as pain intensity, interference, disability, and catastrophizing. Both primary and secondary outcomes will be obtained at baseline and at 11-weeks; secondary outcomes measured via questionnaires will also be obtained at 6-weeks, while low back pain intensity will be measured before and after each treatment. Paired t-tests will be used to assess within-group changes for all primary outcome measures. A two-way repeated-measures analysis of variance will be use to assess changes in secondary outcomes over time. DiscussionThe results of this trial will help clarify the role of medium-frequency NMES on lumbar multifidus morphology and function. Trial RegistrationNCT04891692 Trial SponsorConcordia University, Montreal, Quebec, Canada


Spine ◽  
2014 ◽  
Vol 39 (17) ◽  
pp. 1417-1425 ◽  
Author(s):  
Jeffrey J. Hebert ◽  
Per Kjaer ◽  
Julie M. Fritz ◽  
Bruce F. Walker

2015 ◽  
Vol 27 (3) ◽  
pp. 943-945 ◽  
Author(s):  
Paolo Pillastrini ◽  
Silvano Ferrari ◽  
Silvia Rattin ◽  
Andrea Cupello ◽  
Jorge Hugo Villafañe ◽  
...  

2016 ◽  
Author(s):  
Vikram B Patel

Lumbar or lower back pain is a very debilitating condition that affects  almost one fifth of the adult population during a given year. Almost everyone walking on two feet is bound to suffer from some back pain during their lifetime. The health care burden for treating low back pain is enormous, especially if the lost work hours are combined with the amount used in diagnosing and treating low back pain. Lumbar facet (zygapophysial) joints are one of the major components involved in causing lower back pain. Diagnosing the pain generator is more of an art than a science. Combining various parameters in the patient’s history, physical examination, and diagnostic studies is not much different from solving a murder mystery. Although facet joint pain may be accompanied by other pain generators, that is, lumbar intervertebral disks, nerve roots, and vertebral bodies, once treated, the relief in pain is more helpful in performing proper rehabilitation and improving further deterioration in low back pain. Muscles are almost always painful due to myofascial pain syndrome that accompanies the facet joint–related pain. Treating one without addressing the other leads to failure in management and optimization of patient’s pain and function. Several treatments are available for treatment of facet joint–mediated pain, including steroid injections using a miniscule amount and radiofrequency ablation of the nerves supplying the facet joints (medial branches of the dorsal primary ramus of the lumbar nerve root). With proper diagnosis and treatment, a patient’s pain and function can be optimized to a level where it may not impact the day-to-day activities or even resumption of the patient’s routine job function. The following review describes the anatomy, pathophysiology, diagnosis, and treatment of lumbar facet joint–mediated pain.   Key words: facet joint pain, facet joint syndrome, low back pain, medial branch radiofrequency, spondylolisthesis


Author(s):  
Bianca Martins de Souza ◽  
Daiane Oliveira da Silva ◽  
Lais Paraguai Justo ◽  
Leandro Lazzareschi ◽  
Daniela Aparecida Biasotto-Gonzalez ◽  
...  

Background: Low back pain is one of the most common musculoskeletal problems among workers. Studies estimate that 90% of the adults will suffer at least one episode of low back pain in life that will lead to the temporary interruption of work. A type of exercise that has gained increasing popularity among individuals with low back pain in the last decade is the Pilates method. Objective: Determine the influence of the Pilates method on improvements in pain, kinesiophobia, central sensitization and function in patients with chronic nonspecific low back pain. Methods: Thirty-four male and female volunteers between 18 and 35 years of age with a complaint of nonspecific low back pain for at least three months will be divided into two groups: Pilates method and control group. An evaluation chart created by the authors will be used to collect data on personal information, history of diseases, alcohol use, smoking, pain intensity (visual analog scale) and medications used. The Tampa Scale for Kinesiophobia, Central Sensitization Questionnaire and Oswestry Disability Index will also be administered. Pilates exercises will be performed three time per week for four weeks and administered by a researcher with adequate training in the method. Reevaluations will be performed after the sixth treatment session in the Pilates group, two weeks after the initial evaluation in the control group, after the 12th session in the Pilates group and after four weeks in the control group. Another reevaluation will be performed three months after treatment. Results: The data will be submitted to statistical analysis and the level of significance will be set to 5%. Conclusion: Based on the results analyzed it will be possible to determine the influence of Pilates Method on improvements in pain, kinesiophobia, central sensitization and function in patients with chronic nonspecific low back pain.


2017 ◽  
Vol 29 (2) ◽  
pp. 85-90 ◽  
Author(s):  
Kyoung Kim ◽  
Kwan-sub Lee ◽  
Seok-Joo Choi ◽  
Chun-Bae Jeon ◽  
Gook-Joo Kim

2021 ◽  
Author(s):  
Sarafadeen Raheem ◽  
Sokunbi O. Ganiyu ◽  
Aminu A. Ibrahim ◽  
Anas Ismail ◽  
Mukadas O. Akindele ◽  
...  

Abstract Background: Impairments in the lumbar multifidus muscle such as reduced muscle thickness and fat infiltrations are evident in individuals with low back pain. Lumbar stabilization exercises (LSE) with real-time ultrasound imaging (RUSI) biofeedback has been reported to improve preferential activation of as well as retention in the ability to activate of the lumbar multifidus muscle, thus enhancing recovery. However, the effects of using this treatment approach in individuals with nonspecific chronic low back pain (NCLBP) seemed not to have widely reported. The purpose of this study is, therefore, to investigate the effects of LSE with RUSI biofeedback on lumbar multifidus muscle cross-sectional area in individuals with NCLBP patients. Method: This study is a prospective, single-center, assessor-blind three-arm, randomized controlled to be conducted at National Orthopedic Hospital, Kano State, Nigeria. Ninety-one individuals with NCLBP will be randomly assigned into one of the three treatment groups of equal sample size (n = 30); LSE group, LSE with RUSI biofeedback group, or control (minimal intervention). The participants in the LSE and LSE with RUSI biofeedback group will also receive the same intervention as the control group. All participants will receive treatment twice weekly for 8 weeks. The primary outcome will be lumbar multifidus muscles cross-sectional area while the secondary outcomes will be pain, functional disability and quality of life. All outcomes will be assessed at baseline, and at 8 weeks and 3 months post-intervention.Discussion: The outcome of the study may support the evidence for the effectiveness of LSE with RUSI biofeedback in the rehabilitation of individuals with NCLBP. It may also provide a rationale for the physiotherapists to make use of diagnostic ultrasound as a feedback mechanism in enhancing the performance and retention of LSE program as well as monitoring the patient’s recovery.Trial registration: Pan African Clinical Trials Registry, (PACTR201801002980602), Registered on 16 January 2018.


2020 ◽  
pp. annrheumdis-2020-217259
Author(s):  
Paula Dakin ◽  
Alan J Kivitz ◽  
Joseph S Gimbel ◽  
Nebojsa Skrepnik ◽  
Stephen J DiMartino ◽  
...  

ObjectivesTo study the efficacy and safety of fasinumab in moderate-to-severe, chronic low back pain (CLBP).MethodsIn this phase II/III, double-blind, placebo-controlled study, patients with CLBP aged ≥35 years with inadequate pain relief/intolerance to acetaminophen, non-steroidal anti-inflammatory drugs and opioids were randomised to fasinumab 6 or 9 mg subcutaneous every 4 weeks (Q4W), 9 mg intravenous every 8 weeks (Q8W) or placebo. Primary endpoint was change from baseline to week 16 in average daily low back pain intensity (LBPI) numeric rating score. Key secondary efficacy variables included Roland-Morris Disability Questionnaire (RMDQ) and Patient Global Assessment (PGA). The results are based on a modified intent-to-treat analysis of 563/800 planned patients when enrolment was stopped early given emerging signals of joint risk in other osteoarthritis (OA) studies at doses being tested here.ResultsSignificant placebo-adjusted LBPI reductions at week 16 were observed for fasinumab 9 mg Q4W and Q8W (least squares mean (standard error) −0.7 (0.3); both nominal p<0.05), but not 6 mg (–0.3 (0.3); p=0.39). RMDQ and PGA improvements to week 16 were greatest for fasinumab 9 mg intravenous. Numerically greater efficacy occurred in patients with, versus those without, peripheral OA (pOA) over 16 weeks. Treatment-emergent adverse events (AEs) occurred in 274/418 (65.6%) patients in the combined fasinumab groups and 94/140 (67.1%) placebo patients. Joint AEs, mostly rapid progressive OA type 1, were more frequent in the combined fasinumab groups (19 events in 16 patients (3.8%) vs 1 event in 1 patient (0.7%) for placebo); all except one occurred in pOA patients.ConclusionsFasinumab highest doses, but not lower dose, improved both CLBP pain and function. Most joint AEs occurred in pOA patients, consistent with earlier findings in symptomatic OA. Further study is needed of patients with CLBP with and without pOA to determine optimal benefit–risk.


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