State-of-the-Art Exercise Concepts for Lumbopelvic and Spinal Muscles – Transferability to Microgravity

Abstract

Low back pain (LBP) is the leading cause of disability worldwide. Over the last three decades, changes to key recommendations in clinical practice guidelines for management of LBP have placed greater emphasis on self-management and utilization of exercise programs targeting improvements in function. Recommendations have also suggested that physical treatments for persistent LBP should be tailored to the individual. This mini review will draw parallels between changes, which occur to the neuromuscular system in microgravity and conditions such as LBP which occur on Earth. Prolonged exposure to microgravity is associated with both LBP and muscle atrophy of the intrinsic muscles of the spine, including the lumbar multifidus. The finding of atrophy of spinal muscles has also commonly been reported in terrestrial LBP sufferers. Studying astronauts provides a unique perspective and valuable model for testing the effectiveness of exercise interventions, which have been developed on Earth. One such approach is motor control training, which is a broad term that can include all the sensory and motor aspects of spinal motor function. There is evidence to support the use of this exercise approach, but unlike changes seen in muscles of LBP sufferers on Earth, the changes induced by exposure to microgravity are rapid, and are relatively consistent in nature. Drawing parallels between changes which occur to the neuromuscular system in the absence of gravity and which exercises best restore size and function could help health professionals tailor improved interventions for terrestrial populations.

Lumbar muscle atrophy and increased relative intramuscular lipid concentration are not mitigated by daily artificial gravity after 60-day head-down tilt bed rest

“…Among those deteriorations, flattening of spinal curvature and atrophy of lumbar musculature have been documented in astronauts (4). Understanding the effects of prolonged axial unloading on the spinal curvature and lumbar musculature can provide unique information that could be used to design interventions not only for space missions but also for people with low back pain on Earth (28), which is the leading cause of disability worldwide (26).…”

Relationship between the morphology and composition of the lumbar paraspinal and psoas muscles and lumbar intervertebral motion in chronic low‐back pain: An exploratory study

“…Given that changes commonly occur in the trunk muscles of people with LBP (for review see (Hides, Hodges, & Lambrecht, 2019)), and the known biomechanical role of muscles such as the MF and LES in controlling segmental (rotational and translational) motion of individual vertebrae, there is a gap in the literature regarding the potential relationship between changes in trunk muscles and in vivo intervertebral motion during flexion and extension of the spine. A recent systematic review examined interactions between passive structures, muscles, and the neural control system, and concluded that there is a lack of studies investigating multiple systems at an intersegmental level (Du Rose, 2018).…”

Vibrating Exercise Equipment in Middle-Age and Older Women with Chronic Low Back Pain and Effects on Bioelectrical Activity, Range of Motion and Pain Intensity: A Randomized, Single-Blinded Sham Intervention Study

“…Furthermore, PA also prevents the formation of fibrosis in muscle tissue and has a role to play in promoting the anti-inflammatory properties of macrophages, reducing tissue sensitivity and metabolism. Use of PA also has a positive impact on myofascial tissue and supports the concept of "physical activity as medicine" [10]. Mora and Valencia [11] believe that for PA to have optimum health benefits in older adults, it must consist of aerobic, strength, flexibility and proprioceptive exercises.…”