Muscle functional magnetic resonance imaging and acute low back pain: a pilot study to characterize lumbar muscle activity asymmetries and examine the effects of osteopathic manipulative treatment

Abstract

Background: Muscle functional magnetic resonance imaging (mfMRI) measures transverse relaxation time (T2), and allows for determination of the spatial pattern of muscle activation. The purposes of this pilot study were to examine whether MRI-derived T2 or side-to-side differences in T2 (asymmetries) differ in low back muscles between subjects with acute low back pain (LBP) compared to asymptomatic controls, and to determine if a single osteopathic manipulative treatment (OMT) session alters these T2 properties immediately and 48-hours after treatment.

Non-thrust manual therapy reduces erector spinae short-latency stretch reflex asymmetries in patients with chronic low back pain

“…Several studies have noted reduced paraspinal muscle activity following thrust based MT (i.e., HVLA spinal manipulation) of individuals with LBP (DeVocht et al, 2005;Ellestad et al, 1988;Krekoukias et al, 2009;Lehman et al, 2001), and we recently reported that a combination of MT's (incorporating both thrust and non-thrust MT) normalizes side-to-side differences in the muscle activation patterns of trunk muscles of individuals with sub-acute LBP (Clark et al, 2009). Additionally, we also recently reported that thrust based MT did not systematically alter the erector spinae stretch reflex amplitude in patients with chronic LBP or asymptomatic controls, but that in study participants exhibiting an audible response to manipulation the stretch reflex was reduced $20% .…”

“…We further hypothesized that this observation was mechanistically driven by the MT's acting to attenuate the gain of the muscle spindle afferents and reduce reflexive contractile activity. Indeed, many scientists and clinicians have long-postulated that MT's exert their biologic effects on the nervous system (Clark et al, 2009;Cote et al, 1994;Dishman et al, 2008;Johansson and Sojka, 1991;Knutson, 2000;Korr, 1975;Pickar, 2002;Sung et al, 2005;Terrett and Vernon, 1984;Vernon et al, 1990). For example, more than three decades ago it was hypothesized that MT's mechanistically act by reducing the gain, or sensitivity, of the monosynaptic stretch reflex (a.k.a., myotatic reflex, deep tendon reflex) (Korr, 1975).…”

The hypertrophy of the lateral abdominal wall andquadratus lumborumis sport-specific: an MRI segmental study in professional tennis and soccer players

“…The muscles of the lateral abdominal wall (OT: external oblique, internal oblique, and transversus abdominis) and quadratus lumborum (QL) play an important role during kicking and tennis strokes (Raty et al, 1999;Chow et al, 2009). The asymmetric hypertrophy of these muscles may increase the risk of low back pain (Hides et al, 2008;Clark et al, 2009). It remains to be determined whether tennis and soccer practice elicits the hypertrophy of QL and the muscles of the lateral abdominal wall.…”

Mutifidus in Spinal Stability: Analysis of Inhibition with Muscle Activation Techniques

“…Given this link, it is unsurprising that multifidus alterations can be predictive of different spinal injuries [9]. Habitual techniques used to measure multifidus activation [16][17][18][19] are electromyography, ultrasound, MRI, manual techniques. Among the latter, we have identified the technique that will form the focus of the current study, namely that of muscular activation (MAT ® …”