The Effects of Dynamic Isolated Lumbar Extensor Training on Lumbar Multifidus Functional Cross-Sectional Area and Functional Status of Patients With Chronic Nonspecific Low Back Pain

Willemink, Martin J.; Es, Hendrik W. van; Helmhout, Pieter H.; Diederik, Arjen L.; Kelder, Johannes C.; Heesewijk, Johannes P. M. van

doi:10.1097/brs.0b013e318274fb2f

Cited by 47 publications

(47 citation statements)

References 24 publications

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“…All participants underwent a MRI safety screen prior to being positioned supine with a pillow under their knees in the scanner. 32 MRI was performed using a 1.5 Tesla scanner (Siemens MAGNETOM Espree, Malvern, PA, USA) with a spine coil that produced 25, 2D, T1-weighted, spin-echo, sequenced images in the axial plane at levels L1 through S1 [repetition time/echo time=879/13ms; field of view=230 × 230mm; encoding matrix=480 × 640; phase encoding direction=anterior-to-posterior; bandwidth=180; flip angle=150 degrees]. Images were 5mm thick with a 1.5mm interval between slices.…”

Section: Methodsmentioning

confidence: 99%

Criterion Validity of Ultrasound Imaging: Assessment of Multifidi Cross-Sectional Area in Older Adults With and Without Chronic Low Back Pain

Sions

Teyhen²,

Hicks³

2017

Journal of Geriatric Physical Therapy

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Background and Purpose Ultrasound imaging (US) may be a cost-conscious alternative to magnetic resonance imaging (MRI), which is the criterion standard for muscle cross-sectional area (CSA) assessment. Within the trunk, when compared to MRI, US has been shown to be valid for assessing lumbar multifidi CSA in younger, asymptomatic individuals. To date, there are no studies validating US for multifidi CSA assessment in older adults or individuals with low back pain. Given age- and pain-related muscle changes, validation of US is needed in these populations. If valid for multifidi CSA assessment, US may be used to evaluate short-term changes in muscle size in response to exercise-based interventions among older adults. The primary objective of this study was to evaluate the validity of US for multifidi CSA assessment as compared to MRI in older adults with and without chronic low back pain (CLBP). The secondary objective was to determine whether a single ultrasound image was valid for assessment of multifidi CSA or if the average of 3 ultrasound images should be recommended. Methods Twenty community-dwelling older adults, i.e. 10 with and 10 without chronic low back pain, ages 60 to 85 years, were recruited. Ultrasound images and MRI slices of multifidi muscle were obtained and L4 multifidi CSAs were measured. Intraclass correlation coefficients (ICCs) were calculated to assess agreement between MRI measures and a single US image and MRI measures and the average of 3 ultrasound images. Results and Discussion ICC point estimates were excellent for older adults with CLBP for a single US image (ICCs=.90–.97), but ICC point estimates for participants without CLBP ranged from fair-to-excellent (ICCs=.48–.86). ICC point estimates for the average of 3 US images for both groups were better than for a single image (ICCs=.95–.99). Conclusions For assessment of L4 multifidi CSA, US is a valid alternative to MRI for older adults with and without CLBP. However, limitations of US, such as the inability to quantify intramuscular fat, which may be increased with aging and CLBP, should be considered. CSA measurement of 3 US images, rather than a single image, is recommended.

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Section: Methodsmentioning

confidence: 99%

Criterion Validity of Ultrasound Imaging: Assessment of Multifidi Cross-Sectional Area in Older Adults With and Without Chronic Low Back Pain

Sions

Teyhen²,

Hicks³

2017

Journal of Geriatric Physical Therapy

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“…The frequency for the LEXT was selected based on previous works which have showed inconsistent improvements in functional changes, lumbar muscle cross sectional area and self-reported functional improvement with training frequencies less than three times a week. (11, 21, 33, 46) The frequency of contact times was also chosen to match the TOTRX group between the study team and the participants. This was monitored by monthly assessment of 1RM values to ensure that an increase was occurring at the anticipated rate for this group.…”

Section: Methodsmentioning

confidence: 99%

Resistance Exercise, Disability, and Pain Catastrophizing in Obese Adults with Back Pain

Vincent

George

Seay

et al. 2014

Medicine &Amp; Science in Sports &Amp; Exercise

113

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Purpose The purpose of this study was to compare the effects of two different resistance exercise protocols on self-reported disability, fear avoidance beliefs, pain catastrophizing and back pain symptoms in obese, older adults with low back pain. Methods Obese adults (N=49; 60–85 years) with chronic low back pain (LBP) were randomized into a total body resistance exercise intervention (TOTRX), lumbar extensor exercise intervention (LEXT) or a control group (CON). Main outcomes included perceived disability (Oswestry Disability Index [ODI], Roland Morris Disability Questionnaire [RMDQ]). Psychosocial measures included the Fear Avoidance Beliefs (FAB) survey, Tampa Scale of Kinesiophobia (TSK), Pain Catastrophizing Scale (PCS). LBP severity was measured during three functional tasks: walking, stair climb and chair rise using an 11 point numerical pain rating scale (NRSpain). Results The TOTRX group had greater reductions in self-reported disability scores due to back pain (ODI, RMDQ) compared to LEXT (p<0.05). The PCS scores decreased in the TOTRX compared to CON by month four (64.3% vs 4.8%, p<0.05). Pain severity during chair rise activity, and walking pain severity was decreased in both LEXT and TOTRX relative to the CON group. Conclusions Greater reductions in perceived disability due to LBP can be achieved with TOTRX compared to LEXT. Pain catastrophizing and pain severity decreased most with TOTRX. The positive change in psychological outlook may assist obese, older adults with chronic back pain re-consider the harmfulness of the pain and facilitate regular participation in other exercise programs.

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“…Some manufacturers produce devices that provide the restraint set-up that research suggests is optimal in producing the conditions to test or train ILEX (eg, Lumbar Extension Machine, MedX, Ocala, Florida; BackUp Dynamometer, Priority One Equipment, Grand Junction, Colorado; Lower Back Revival System, OriGENE Concepts BV, Delft, the Netherlands etc 47 48 50 51…”

Section: Methodsmentioning

confidence: 99%

A review of the specificity of exercises designed for conditioning the lumbar extensors

2013

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Numerous exercise approaches have been designed with the intention of conditioning the lumbar extensors. Those examined appear to activate the lumbar extensors; however, the specificity of many of these exercises for producing chronic adaptations may be questionable, potentially due to the compound nature of them allowing involvement of other musculature such as the hip extensors. Many of the reviewed exercises offer potential to condition the lumbar extensors, however, isolation of lumbar extension through appropriate pelvic restraint appears important for optimising specific adaptations in the lumbar extensors.

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The Effects of Dynamic Isolated Lumbar Extensor Training on Lumbar Multifidus Functional Cross-Sectional Area and Functional Status of Patients With Chronic Nonspecific Low Back Pain

Cited by 47 publications

References 24 publications

Criterion Validity of Ultrasound Imaging: Assessment of Multifidi Cross-Sectional Area in Older Adults With and Without Chronic Low Back Pain

Criterion Validity of Ultrasound Imaging: Assessment of Multifidi Cross-Sectional Area in Older Adults With and Without Chronic Low Back Pain

Resistance Exercise, Disability, and Pain Catastrophizing in Obese Adults with Back Pain

A review of the specificity of exercises designed for conditioning the lumbar extensors

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