Lumbar Multifidus Muscle Thickness Does Not Predict Patients With Low Back Pain Who Improve With Trunk Stabilization Exercises

作者：Zielinski Kristen A; Henry Sharon M^*; Ouellette Morton Rebecca H; DeSarno Michael J

来源：Archives of Physical Medicine and Rehabilitation, 2013, 94(6): 1132-1138.

DOI：10.1016/j.apmr.2012.12.001

• Clinical prediction rule
• Exercise
• Low back pain
• Rehabilitation

Objective: To understand lumbar multifidus (LM) muscle activation as a clinical feature to predict patients with low back pain (LBP) who are likely to benefit from stabilization (STB) exercises. %26lt;br%26gt;Design: Prospective, cohort study. %26lt;br%26gt;Setting: Outpatient physical therapy clinics. %26lt;br%26gt;Participants: Persons with LBP were recruited for this study. Subjects (N=25) were classified as either eligible to receive STB exercises or ineligible on the basis of current clinical prediction rules. %26lt;br%26gt;Interventions: Six weeks of STB treatment. %26lt;br%26gt;Main Outcome Measures: Before and after treatment, subjects underwent rehabilitative ultrasound imaging to quantify LM-muscle activation and completed disability and pain questionnaires. Analyses were performed to examine the (1) relation between LM-muscle activation and current clinical features used to predict patients with LBP likely to benefit from STB exercises, (2) LM-muscle activation between the STB-eligible and STB-ineligible groups before and after STB treatment, and (3) relation between LM-muscle activation before STB treatment and (a) disability and (b) pain outcomes after treatment for both groups. %26lt;br%26gt;Results: No relation was found between LM-muscle activation and the number of clinical features. Before STB treatment, LM-muscle activation between the STB-eligible and STB-ineligible groups did not differ. After STB treatment, LM-muscle activation differed between the groups; however, this interaction was because the LM-muscle activation for the STB-eligible group decreased after treatment while that for the STB-ineligible group increased after treatment. Finally, only the STB-eligible group had a significant reduction in disability following treatment; however, no relation was found between LM-muscle activation before treatment and (a) disability or (b) pain outcomes after treatment in the STB-eligible group. %26lt;br%26gt;Conclusions: LM-muscle activation does not appear to be a clinical feature that predicts patients with LBP likely to benefit from STB exercises.

• 出版日期2013-6