Effect of Intensive Training on the Isokinetic Strength and Structure of Lumbar Muscles in Patients With Chronic Low Back Pain

Rissanen, Aaro; Kalimo, Hannu; Alaranta, Hannu

doi:10.1097/00007632-199502000-00014

Cited by 101 publications

(44 citation statements)

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“…Paraspinal muscle atrophy is reported to be counteracted by postoperative exercise of the back muscles. However, without special muscle training, recovery seems impossible [21,22]. Thus, because the adverse effects caused by iatrogenic muscle damage may potentially persist for several years after the surgery, the use of techniques that cause less damage to the paraspinal muscles should be considered when performing lumbar surgery.…”

Section: Discussionmentioning

confidence: 99%

Spinous process-splitting open pedicle screw fusion provides favorable results in patients with low back discomfort and pain compared to conventional open pedicle screw fixation over 1 year after surgery

et al. 2012

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Introduction The conventional open pedicle screw fusion (PSF) requires an extensive detachment of the paraspinal muscle from the posterior aspect of the lumbar spine, which can cause muscle injury and subsequently lead to ''approachrelated morbidity''. The spinous process-splitting (SPS) approach for decompression, unilateral laminotomy for bilateral decompression, and the Wiltse approach for pedicle screw insertion are considered to be less invasive to the paraspinal musculature. We investigated whether SPS open PSF combined with the abovementioned techniques attenuates the paraspinal muscle damage and yields favorable clinical results, including alleviation in the low back discomfort, in comparison to the conventional open PSF. Methods We studied 53 patients who underwent singlelevel PSF for the treatment of degenerative spondylolisthesis (27 patients underwent SPS open PSF and the other 26 underwent the conventional open PSF). The clinical outcomes were assessed using the Japanese Orthopedic Association (JOA) score, the Roland-Morris disability questionnaire (RDQ), and the visual analog scale (VAS) for low back pain and low back discomfort (heavy feeling or stiffness). Postoperative multifidus (MF) atrophy was evaluated using MRI. Follow-up examinations were performed at 1 and 3 years after the surgery.Results Although there was no significant difference in the JOA and RDQ score between the two groups, the VAS score for low back pain and discomfort after the surgery were significantly lower in the SPS open PSF group than in the conventional open PSF group. The extent of MF atrophy after SPS open PSF was reduced more significantly than after the conventional open PSF during the follow-up. The MF atrophy ratio was found to correlate with low back discomfort at the 1-year follow-up examination. ConclusionIn conclusion, SPS open PSF was less damaging to the paraspinal muscle than the conventional open PSF and had a significant clinical effect, reducing low back discomfort over 1 year after the surgery.

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Section: Discussionmentioning

confidence: 99%

Spinous process-splitting open pedicle screw fusion provides favorable results in patients with low back discomfort and pain compared to conventional open pedicle screw fixation over 1 year after surgery

et al. 2012

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“…The fact that a strictly male population was used prevents this study from possible gender-related bias, e.g., different morphologic adaptations of strength training in men and women [6,21].…”

Section: Generalizability Of the Study Populationmentioning

confidence: 99%

Comparison of a high-intensity and a low-intensity lumbar extensor training program as minimal intervention treatment in low back pain: a randomized trial

et al. 2004

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“…In a study of effects of 3 months of maximal or submaximal physical rehabilitation in patients with chronic low back pain, trunk extension strength increased about 20% and type 2 multifidus fiber size increased about 10% in men (both p < 0.05). Women had an increase in extension strength of about 10% (p = 0.16), but not an impressive increase in type 2 multifidus fiber size (103) . Limited muscle-biopsy studies have been performed in relation to comparative exercise types such as resistance and eccentric ergometer training.…”

Section: Clinical Demographic and Physical Activity Relations To Rementioning

confidence: 90%

“…By contrast, increased use can stimulate greater muscle strength and type 2 fiber size (103) . In a study of effects of 3 months of maximal or submaximal physical rehabilitation in patients with chronic low back pain, trunk extension strength increased about 20% and type 2 multifidus fiber size increased about 10% in men (both p < 0.05).…”

Section: Clinical Demographic and Physical Activity Relations To Rementioning

confidence: 97%

Clinical, Biomechanical, and Physiological Translational Interpretations of Human Resting Myofascial Tone or Tension

Masi

Nair²,

Evans³

et al. 2010

IJTMB

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Methods: Biomechanical, clinical, and physiological studies were reviewed to interpret the passive stiffness properties of HRMT that help to stabilize various relaxed functions such as quiet balanced standing. Biomechanical analyses and experimental studies of the lumbar multifidus were reviewed to interpret its passive stiffness properties. The lumbar multifidus was illustrated as the major core stabilizing muscle of the spine, serving an important passive biomechanical role in the body.Results: Research into muscle physiology suggests that passive resting tension (CNS-independent) is generated in sarcomeres by the molecular elasticity of low-level cycling cross-bridges between the actomyosin filaments. In turn, tension is complexly transmitted to intimately enveloping fascial matrix fibrils and other molecular elements in connective tissue, which, collectively, constitute the myofascial unit. Postural myofascial tonus varies with age and sex. Also, individuals in the population are proposed to vary in a polymorphism of postural HRMT. A few people are expected to have outlier degrees of innate postural hypotonicity or hypertonicity. Such biomechanical variations likely predispose to greater risk of related musculoskeletal disorders, a situation that deserves greater attention in clinical practice and research. Axial myofascial hypertonicity was hypothesized to predispose to ankylosing spondylitis. This often-progressive deforming condition of vertebrae and sacroiliac joints is characterized by stiffness features and particular localization of bony lesions at entheseal sites. Such unique features imply concentrations and transmissions of excessive force, leading to tissue micro-injury and maladaptive repair reactions.Conclusions: The HRMT model is now expanded and translated for clinical relevance to therapists. Its passive role in helping to maintain balanced postures is supported by biomechanical principles of myofascial elasticity, tension, stress, stiffness, and tensegrity. Further research is needed to determine the molecular basis of HRMT in sarcomeres, the transmission of tension by the enveloping fascial elements, and the means by which the myofascia helps to maintain efficient passive postural balance in the body. Significant deficiencies or excesses of postural HRMT may predispose to symptomatic or pathologic musculoskeletal disorders whose mechanisms are currently unexplained.

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Effect of Intensive Training on the Isokinetic Strength and Structure of Lumbar Muscles in Patients With Chronic Low Back Pain

Cited by 101 publications

References 0 publications

Spinous process-splitting open pedicle screw fusion provides favorable results in patients with low back discomfort and pain compared to conventional open pedicle screw fixation over 1 year after surgery

Spinous process-splitting open pedicle screw fusion provides favorable results in patients with low back discomfort and pain compared to conventional open pedicle screw fixation over 1 year after surgery

Comparison of a high-intensity and a low-intensity lumbar extensor training program as minimal intervention treatment in low back pain: a randomized trial

Clinical, Biomechanical, and Physiological Translational Interpretations of Human Resting Myofascial Tone or Tension

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