scholarly journals Exercise and tropism of the multifidus muscle in low back pain: a short review

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


2019 ◽  
Vol 12 ◽  
pp. 117954411984957 ◽  
Author(s):  
Jaclyn Megan Sions ◽  
DeJ’a Chyanna Crippen ◽  
Gregory Evan Hicks ◽  
Abdulmohsen Meshari Alroumi ◽  
Tara Jo Manal ◽  
...  

Study design: Cross-sectional study. Background: Neuromuscular electrical stimulation (NMES) is an effective tool for stimulating multifidus muscle contractions. Ultrasound imaging (USI) is valid and reliable for quantifying multifidus activity represented by percent thickness change from a resting to contracted state. Thus, USI may be used to help determine optimal NMES intensity. Objectives: To explore NMES intensity effects on multifidus thickening in adults with chronic low back pain (CLBP). Methods: Sixty patients with CLBP participated. L4/5 multifidus ultrasound images were obtained and percent thickness change from a resting to a contracted state was determined at baseline with a limb lift and during NMES application. During NMES, the examiner recorded the intensity, in milliampere, when the multifidus first started to thicken as observed with USI. The examiner also recorded the NMES intensity that resulted in no further multifidus thickening (ie, high-tolerance group) or, in cases where maximal thickening was not observed, the NMES intensity of the submaximal contraction (ie, low-tolerance group). Differences between participants with high versus low NMES tolerance were evaluated. Results: During NMES, the multifidus began thickening at a higher intensity for the high-tolerance group (n = 39), that is, 34 mA, compared with the low-tolerance group (n = 21), that is, 32 mA ( P = .001). A greater mean intensity in the high-tolerance group, that is, 62 mA, as compared to 45 mA in the low-tolerance group, resulted in a larger percent thickness change, that is, 30.89% compared to 20.60%, respectively ( P < .001). Conclusions: Results provide clinicians with NMES intensity targets to facilitate multifidus muscle thickening, which provides insight into muscle activity.


2019 ◽  
Vol 5 (1) ◽  
pp. e000556
Author(s):  
Ulrike H Mitchell ◽  
A Wayne Johnson ◽  
Patrick J Owen ◽  
Timo Rantalainen ◽  
Daniel Belavy

ObjectiveThe transversus abdominis muscle (TrA) is active during running as a secondary respiratory muscle and acts, together with the multifidus, as trunk stabiliser. The purpose of this study was to determine size and symmetry of TrA and multifidus muscles at rest and with contraction in endurance runners without low back pain.DesignCross-sectional study.SettingA medical imaging centre in Melbourne, Australia.ParticipantsThirty middle-aged (43years±7) endurance-trained male (n=18) and female (n=12) runners without current or history of low back pain.Outcome measuresMRI at rest and with the core engaged. The TrA and multifidus muscles were measured for thickness and length (TrA) and anteroposterior and mediolateral thickness (multifidus). Muscle activation was extrapolated from rest to contraction and compared with the same and contralateral side. Paired t-tests were performed to compare sides and contraction status.ResultsLeft and right TrA and multifidus demonstrated similar parameters at rest (p>0.05). However, with contraction, the right TrA and multifidus (in mediolateral direction) were 9.2% (p=0.038) and 42% (p<0.001) thicker, respectively, than their counterparts on the left. There was no TrA thickness side difference with contraction in left-handed participants (p=0.985). When stratified by sex, the contracted TrA on the right side remained 8.4% thicker, but it was no longer statistically significant (p=0.134). The side difference with contraction of the TrA became less with increasing training age.ConclusionsRight-handed long-term runners without low back pain exhibit a greater right side core muscle activation when performing an isometric contraction. This activation preference diminishes with increasing training age.


2019 ◽  
Vol 2019 ◽  
pp. 1-11 ◽  
Author(s):  
Katarzyna Patrycja Dzik ◽  
Wojciech Skrobot ◽  
Katarzyna Barbara Kaczor ◽  
Damian Jozef Flis ◽  
Mateusz Jakub Karnia ◽  
...  

Recent studies show that vitamin D deficiency may be responsible for muscle atrophy. The purpose of this study was to investigate markers of muscle atrophy, signalling proteins, and mitochondrial capacity in patients with chronic low back pain with a focus on gender and serum vitamin D level. The study involved patients with chronic low back pain (LBP) qualified for posterior lumbar interbody fusion (PLIF). Patients were divided into three groups: supplemented (SUPL) with vitamin D (3200 IU/day for 5 weeks), placebo with normal levels of vitamin D (SUF), and the placebo group with vitamin D deficiency (DEF). The marker of muscle atrophy including atrogin-1 and protein content for IGF-1, Akt, FOXO3a, PGC-1α, and citrate synthase (CS) activity were determined in collected multifidus muscle. In the paraspinal muscle, IGF-1 levels were higher in the SUF group as compared to both the SUPL and DEF groups (p<0.05). In the SUPL group, we found significantly increased protein content for pAkt (p<0.05) and decreased level of FOXO3a (p<0.05). Atrogin-1 content was significantly different between men and women (p<0.05). The protein content of PGC-1α was significantly higher in the SUF group as compared to the DEF group (p<0.05). CS activity in the paraspinal muscle was higher in the SUPL group than in the DEF group (p<0.05). Our results suggest that vitamin D deficiency is associated with elevated oxidative stress, muscle atrophy, and reduced mitochondrial function in the multifidus muscle. Therefore, vitamin D-deficient LBP patients might have reduced possibilities on early and effective rehabilitation after PLIF surgery.


Author(s):  
Hirohito Kanamoto ◽  
Sumihisa Orita ◽  
Kazuhide Inage ◽  
Yasuhiro Shiga ◽  
Koki Abe ◽  
...  

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

2013 ◽  
Vol 19 (6) ◽  
pp. 651-657 ◽  
Author(s):  
Yoshihiro Mukai ◽  
Shota Takenaka ◽  
Noboru Hosono ◽  
Toshitada Miwa ◽  
Takeshi Fuji

Object This randomized study was designed to elucidate the time course of the perioperative development of intramuscular multifidus muscle pressure after posterior lumbar interbody fusion (PLIF) and to investigate whether the route of pedicle screw insertion affects this pressure and resultant low-back pain. Although several studies have focused on intramuscular pressure associated with posterior lumbar surgery, those studies examined intramuscular pressure generated by the muscle retractors during surgery. No study has investigated the intramuscular pressure after PLIF. Methods Forty patients with L4–5 degenerative spondylolisthesis were randomly assigned to undergo either the mini-open PLIF procedure with pedicle screw insertion between the multifidus and longissimus muscles (n = 20) or the conventional PLIF procedure via a midline approach only (n = 20). Intramuscular pressure was measured 5 times (at 30 minutes and at 6, 12, 24, and 48 hours after surgery) with an intraoperatively installed sensor. Concurrently, the FACES Pain Rating Scale score for low-back pain and the total dose of postoperative analgesics were recorded. Results With the patients in the supine position, for both groups the mean pressure values were consistently 40–50 mm Hg, which exceeded the critical capillary pressure of the muscle. With the patients in the lateral decubitus position, the pressure decreased over time (from 14 to 9 mm Hg in the mini-open group and from 20 to 10 mm Hg in the conventional group). Among patients in the mini-open group, the pressure was lower, but the difference was not statistically significant. Postoperative pain and postoperative analgesic dosages were also lower . Conclusions To the authors' knowledge, this is the first study to evaluate postoperative intramuscular pressure after PLIF. Although the results did not demonstrate a significant difference in the intramuscular pressure between the 2 types of PLIF, mini-open PLIF was associated with less pain after surgery. Clinical trial registration no.: UMIN000010069 (www.umin.ac.jp/ctr/index.htm).


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