Background: Spine stability or core stability exercises are among the most recommended interventions in low back pain management. It is important to clarify whether physical activity and body adiposity affect lumbar muscle multifidus (LMM) among apparently healthy adults. Objectives: The current study aimed at investigating the effect of physical activity level (PAL) and body adiposity on fatty infiltration of LMM in apparently healthy individuals from an urban African setting. Methods: Fatty infiltration of LMM was visually graded as normal, slight, and severe using diagnostic ultrasound. Validated Hausa and English versions of IPAQ were employed to analyze PAL, and the bioelectrical impedance analysis machine was used to measure some of the body adiposity parameters and weight. Results: A slight fatty infiltration of LMM was observed in 40.3% of 196 participants. Slight fatty infiltration of LMM had a higher prevalence in female subjects (39.2%) than males (34.2%). Only two variables of age (P = 0.032; r = 0.153) and visceral fat (P = 0.0001; r = 0.308) had a relationship with fatty infiltration of LMM. Conclusions: Fatty infiltration of LMM was positively associated with visceral fat and weakly with age among the participants. However, fatty infiltration of LMM had no relationship with the PAL.

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.

The stability of the spinal column is largely dependent on the integrity of the spinal muscles, especially the multifidus muscle. However, this important role of the multifidus muscle might be compromised due to both mechanical and non-mechanical causes leading to change in its contents, fat deposition and reduction in the cross-sectional area. This study was carried out to determine the influence of physical activity level and body adiposity indices on lumbar multifidus muscle (LMM) fatty infiltration among individuals with low back pain (LBP). This was a cross-sectional study in which 94 participants, male and female samples with non-specific LBP were recruited conveniently and assessed for LMM fat infiltration, pain intensity, functional disability, physical activity and socio-demographic variables. There were positive and moderate correlations between LMM fatty infiltration body mass index (BMI) (r=0.575, p=0.001), waist circumference (WC) (r=0.514, p=0.001) and gender (r=0.409, p=0.001) for normally distributed data using Pearson moment correlation coefficient. For not normally distributed variables, LMM fatty infiltration was moderately and positively correlated with gender (r=0.422, p=0.001), %body fat (r=0.621, p=0.001), visceral fat (r=0.470, p=0.0001), Oswestry Disability Index (ODI) (r=0.238, p=0.021) and visual analogue scale (VAS) (r=0.232, p=0.024) respectively. However, there was a weak negative correlation between LMM fatty infiltration and occupation (r=p=0.046). There were significant differences between male and female multifidus fat infiltration and body adiposity indices. There was a positive relationship between multifidus fatty infiltration and BMI, gender, %body fat, visceral mass, ODI and VAS, while we observed a negative relationship between lumbar multifidus fatty infiltration and occupation. Furthermore, the best correlate of lumbar multifidus % body fat.