Evaluation of Specific Stabilizing Exercise in the Treatment of Chronic Low Back Pain With Radiologic Diagnosis of Spondylolysis or Spondylolisthesis

O’Sullivan, Peter; Phyty, Grad Dip Manip; Twomey, Lance; Allison, Garry

doi:10.1097/00007632-199712150-00020

Cited by 964 publications

(594 citation statements)

References 51 publications

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“…The presence of paraspinal muscle changes in people with spondylolisthesis, as it was shown in the present study, provides further understanding of the possible mechanisms for efficacy of exercise in interventions in LBP. For instance, O'Sullivan et al [42] reported good clinical efficacy (decreased pain intensity and functional disability) of specific training of muscles surrounding the spine in individuals with spondylolysis and spondylolisthesis. Our data that also show a relationship of FJOA (multifidus and erector spinae) and disc space narrowing (erector spinae) with muscle changes provides justification for trials of training in other populations.…”

Section: Discussionmentioning

confidence: 99%

Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study

et al. 2009

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The objectives of the study were to evaluate the association between lumbar paraspinal muscle density, evaluated on computed tomography (CT) and age, sex and BMI; and to evaluate the association of those changes with low back pain (LBP) and spinal degeneration features in a community-based sample. This study was an ancillary project to the Framingham Study. A sample of 3,529 participants aged 40-80 years had a CT scan performed to assess aortic calcification. 187 individuals were randomly enrolled in this study. LBP in the last 12 months was evaluated using self-report questionnaire. Density (in Hounsfield units) of multifidus and erector spinae was evaluated on CT. The prevalence of intervertebral disc narrowing, facet joint osteoarthritis (FJOA), spondylolysis, spondylolisthesis and spinal stenosis were also evaluated. We used linear regression models to examine the association of paraspinal muscles density with age, sex, BMI, LBP, and spinal degeneration features. The results show that in our study, men have higher density of paraspinal muscles than women, younger individuals have higher density than older ones and individuals with lower weight have higher muscle density than overweight. No differences between individuals with and without LBP were found. Significant association was found between L4 multifidus/erector spinae density and FJOA at L4-L5; between multifidus at L4 and spondylolisthesis at L4-5; and between erector spinae at L4 and L5 with disc narrowing at L4-5 and L5-S1, respectively. We conclude that the paraspinal muscle density decreases with age, and increases BMI. It is associated with at some levels FJOA, spondylolisthesis and disc narrowing at the same level, but not associated with occurrence of LBP.

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Section: Discussionmentioning

confidence: 99%

Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study

et al. 2009

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“…O'Sullivan et al [42] found that individuals with chronic LBP and a radiological diagnosis of spondylolysis or spondylolisthesis who underwent a 10-week specific exercise treatment program involving the specific training of the deep abdominal muscles, with co-activation of the lumbar multifidus proximal to the pars defects showed a statistically significant reduction in pain intensity and functional disability levels, which was maintained at 30-month follow-up. The control group that received treatment as directed by their treating practitioner showed no significant change in these parameters after intervention or at follow-up.…”

Section: Stabilization Exercisesmentioning

confidence: 99%

Diagnosis and conservative management of degenerative lumbar spondylolisthesis

2007

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Degenerative spondylolisthesis (DS) is a disorder that causes the slip of one vertebral body over the one below due to degenerative changes in the spine. Lumbar DS is a major cause of spinal canal stenosis and is often related to low back and leg pain. We reviewed the symptoms, prognosis and conservative treatments for symptoms associated with DS. PubMed and MEDLINE databases (1950-2007) were searched for

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“…Although the link between posture and back pain is largely unknown, it has been speculated that end-of-range sitting and standing postures, that were shown to be associated with altered muscle activation patterns [1][2][3][4][5], may result in excessive loading of the passive spinal structures, eventual trauma and injury and could potentially pose a risk to the development of back pain [4,6]. Postural re-education is performed on the premise of optimizing spinal alignment to minimize stresses on the spinal structures and to improve trunk muscle efficiency in protecting the spine [7][8][9][10]. Objective evaluation of postures has traditionally been an important element of clinical assessment and evaluation of the effectiveness of postural re-training.…”

Section: Introductionmentioning

confidence: 99%

“…Objective evaluation of postures has traditionally been an important element of clinical assessment and evaluation of the effectiveness of postural re-training. In addition, objective evaluation of postural patterns is used clinically to sub-classify patients into specific motor control impairment sub-groups to guide intervention [10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Preliminary study: reliability of the spinal wheel. A novel device to measure spinal postures applied to sitting and standing

et al. 2009

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Postural re-education is an integral part of physiotherapy management in patients with back pain. Although the link between posture and back pain is largely unknown, postural re-education is performed on the premise of optimizing spinal alignment to minimize stresses on the passive structures of the spine, to facilitate optimal muscular support and thus to prevent possible damage and further pain. A reliable and clinically meaningful measurement of spinal postures to monitor such interventions remains challenging. This study evaluated within-day (intra-tester, inter-tester) and between-day (test-retest) reliability of a novel spinal wheel device measuring thoracic and lumbar postures during sitting and standing. 17 healthy volunteers (age 39.5 ± 5.4, BMI 25 ± 9.2; 9 males) were measured three times, by three testers, on two separate occasions (1 week apart). The angular change between C7 and T12 and between T12 and S1 provided thoracic and lumbar curvatures, respectively. Intra-class correlation coefficient (ICC) with 95% confidence intervals and typical error were calculated. Excellent reliability was demonstrated with intra-tester ICCs between 0.947 and 0.980 and typical error between 1.7°and 3.7°and intertester ICCs between 0.949 and 0.986 and typical error between 2.0°and 4.7°. Test-retest reliability was high with ICCs 0.719-0.908 and typical error between 4.0°and 7.4°. In conclusion, the spinal wheel demonstrated excellent within-day and high between-day reliability. The device may be used in conjunction with 2D camcorder to provide clinically useful visual evaluation of postures for assessment, intervention monitoring, and feedback during postural re-education.

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Evaluation of Specific Stabilizing Exercise in the Treatment of Chronic Low Back Pain With Radiologic Diagnosis of Spondylolysis or Spondylolisthesis

Abstract: A "specific exercise" treatment approach appears more effective than other commonly prescribed conservative treatment programs in patients with chronically symptomatic spondylolysis or spondylolisthesis.

Cited by 964 publications

References 51 publications

Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study

Changes in paraspinal muscles and their association with low back pain and spinal degeneration: CT study

Diagnosis and conservative management of degenerative lumbar spondylolisthesis

Preliminary study: reliability of the spinal wheel. A novel device to measure spinal postures applied to sitting and standing

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