Effects of core stability exercises on multifidus muscles in healthy women and women with chronic low-back pain

Klizienė, Irina; Sipavičienė, Saulė; Klizas, Šarūnas; Imbrasienė, Daiva

doi:10.3233/bmr-150596

Cited by 51 publications

(34 citation statements)

References 32 publications

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“…It further suggests an exercise countermeasure is needed to focus on the lumbar paraspinal muscles. Low load, lumbar core stabilization exercises are efficacious for back pain patients 54 , deconditioned 1,55 and healthy 56 adults on Earth, specifically improving paraspinal muscle CSA atrophy and strength 4,[57][58][59] , as well as acute 60,61 and chronic 57,62,63 low back pain. Such core-strengthening exercises specifically involve isometric exercises or lumbar extensor training.…”

Section: Discussionmentioning

confidence: 99%

Lumbar Spine Paraspinal Muscle and Intervertebral Disc Height Changes in Astronauts After Long-Duration Spaceflight on the International Space Station

Chang

Healey

Snyder

et al. 2016

Spine

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Study Design-Prospective case seriesObjective-Evaluate lumbar paraspinal muscle (PSM) cross-sectional area and intervertebral disc (IVD) height changes induced by a 6-month space mission on the International Space Station (ISS). The long-term objective of this project is to promote spine health and prevent spinal injury during space missions as well as here on Earth.Summary of Background-NASA crewmembers have a 4.3 times higher risk of herniated IVDs, compared to the general and military aviator populations. The highest risk occurs during the first year after a mission. Microgravity exposure during long-duration spaceflights results in ~5cm lengthening of body height, spinal pain, and skeletal deconditioning. How the PSMs and IVDs respond during spaceflight is not well described.Methods-Six NASA crewmembers were imaged supine with a 3T MRI. Imaging was conducted pre-flight, immediately post-flight and then 33 to 67 days after landing. Functional cross-sectional area (FCSA) measurements of the PSMs were performed at the L3-4 level. FCSA was measured by grayscale thresholding within the posterior lumbar extensors to isolate lean muscle on T2-weighted scans. IVD heights were measured at the anterior, middle and posterior sections of all lumbar levels. Repeated measures ANOVA was used to determine significance at p<0.05, followed by post-hoc testing.Results-Paraspinal lean muscle mass, as indicated by the FCSA, decreased from 86% of the total PSM cross-sectional area down to 72%, immediately after the mission. Recovery of 68% of HHS Public AccessAuthor manuscript Spine (Phila Pa 1976 Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript the post-flight loss occurred over the next 6 weeks, still leaving a significantly lower lean muscle fractional content compared to pre-flight values. In contrast, lumbar IVD heights were not appreciably different at any time point.Conclusions-The data reveal lumbar spine PSM atrophy after long-duration spaceflight. Some FCSA recovery was seen with 46 days post-flight in a terrestrial environment, but it remained incomplete compared to pre-flight levels.

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Section: Discussionmentioning

confidence: 99%

Lumbar Spine Paraspinal Muscle and Intervertebral Disc Height Changes in Astronauts After Long-Duration Spaceflight on the International Space Station

Chang

Healey

Snyder

et al. 2016

Spine

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“…The benefit of targeted MF muscle strengthening programs utilizing this functional peculiarity has been demonstrated in acute and chronic LBP. 16,17,21 A study of subjects with acute back pain has demonstrated normalization of the MF areas within a month following a specific motor re-education exercise. 17 The results of our morphometric study indirectly prove the benefit of strong MF muscles in IS as well.…”

Section: Role Of the Mf Muscle And Study Implicationsmentioning

confidence: 99%

Lumbar paraspinal muscle morphometry and its correlations with demographic and radiological factors in adult isthmic spondylolisthesis: a retrospective review of 120 surgically managed cases

Thakar¹,

Sivaraju²,

Aryan³

et al. 2016

SPI

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OBJECTIVE The objective of this study was to assess the cross-sectional areas (CSAs) of lumbar paraspinal muscles in adults with isthmic spondylolisthesis (IS), to compare them with those in the normative population, and to evaluate their correlations with demographic factors and MRI changes in various spinal elements. METHODS The authors conducted a retrospective study of patients who had undergone posterior lumbar interbody fusion for IS, and 2 of the authors acting as independent observers calculated the CSAs of various lumbar paraspinal muscles (psoas, erector spinae [ES], multifidus [MF]) on preoperative axial T2-weighted MR images from the L-3 to L-5 vertebral levels and computed the CSAs as ratios with respect to the corresponding vertebral body areas. These values were then compared with those in an age- and sex-matched normative population and were analyzed with respect to age, sex, duration of symptoms, grade of listhesis, and various MRI changes at the level of the listhesis (pedicle signal change, disc degeneration, and facetal arthropathy). RESULTS Compared with values in normative controls, the mean CSA value for the ES muscle was significantly higher in the study cohort of 120 patients (p = 0.002), whereas that for the MF muscle was significantly lower (p = 0.009), and more so in the patients with PSC (p = 0.002). Magnetic resonance imaging signal change in the pedicle was seen in half of the patients, all of whom demonstrated a Type 2 change. Of the variables tested in a multivariate analysis, age independently predicted lower area values for all 3 muscles (p ≤ 0.001), whereas female sex predicted a lower mean psoas area value (p < 0.001). None of the other variables significantly predicted any of the muscle area values. A decrease in the mean MF muscle area value alone was associated with a significantly increased likelihood of a PSC (p = 0.039). CONCLUSIONS Compared with normative controls, patients with IS suffer selective atrophy of their MF muscle, whereas their ES muscle undergoes a compensatory hypertrophy. Advancing age has a detrimental effect on the areas of the lumbar PSMs, whereas female sex predisposes to a decreased psoas muscle area. Multifidus muscle atrophy correlates with PSC, indicating the role of this deep stabilizer in the biomechanical stability of spondylolisthetic spines. This may be of clinical significance in targeted physiotherapy programs during the conservative management of IS.

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“…stabilization exercises, stabilization exercises plus dynamic-static resistance exercises) have been shown to increase multifidi CSA. 8 Few studies, however, have linked multifidi size to physical function in adults with LBP. 9 …”

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confidence: 99%

Multifidi Muscle Characteristics and Physical Function Among Older Adults With and Without Chronic Low Back Pain

Sions

Coyle

Velasco

et al. 2017

Archives of Physical Medicine and Rehabilitation

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Objective The purpose of this study was to determine if multifidi size and/or intramuscular fat were associated with self-reported and performance-based physical function in older adults with and without chronic LBP. Design Case-control study Setting Individuals participated in a standardized evaluation in a clinical laboratory and underwent magnetic resonance imaging (MRI) of the lumbar spine at a nearby facility. Patient Sample A volunteer sample of 106 community-dwelling older adults, aged 60-85 years, with (n=57) and without (n=49) chronic LBP were included in this secondary data analysis. Intervention Average right-left, L5 multifidi relative, i.e. total, cross-sectional area (rCSA); muscle-fat infiltration index (MFI), i.e. a measure of intramuscular fat; and relative muscle cross-sectional area (rmCSA), i.e. total CSA minus intramuscular fat CSA, were determined from MRIs. Linear regression modeling was performed with physical function measures as the dependent variables. Age, sex, and body mass index were entered as covariates. The main effects of L5 multifidi MFI and rmCSA, as well as their interaction with group assignment, were compared as independent variables. Main Outcome Measures Short Form-36 Health Survey Physical Functioning subscale (SF-36 PFS), Timed Up and Go (TUG), gait speed, and fast stair descent performance. Results Interaction terms between L5 multifidi MFI and group assignment were found to be significant contributors to the variance explained in all physical function measures (p≤.012). Neither the main effect, nor the interaction with group assignment for L5 multifidi rmCSA, significantly contributed to the variance explained in any of the physical function measures (p>.012). Conclusions Among older adults with chronic LBP of at least moderate intensity, L5 multifidi muscle composition, but not size, may help to explain physical function.

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Effects of core stability exercises on multifidus muscles in healthy women and women with chronic low-back pain

Abstract: A core stabilization exercise program significantly increased multifidus muscle CSAs in both healthy women and women with chronic LBP.

Cited by 51 publications

References 32 publications

Lumbar Spine Paraspinal Muscle and Intervertebral Disc Height Changes in Astronauts After Long-Duration Spaceflight on the International Space Station

Lumbar Spine Paraspinal Muscle and Intervertebral Disc Height Changes in Astronauts After Long-Duration Spaceflight on the International Space Station

Lumbar paraspinal muscle morphometry and its correlations with demographic and radiological factors in adult isthmic spondylolisthesis: a retrospective review of 120 surgically managed cases

Multifidi Muscle Characteristics and Physical Function Among Older Adults With and Without Chronic Low Back Pain

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