Objectives The purpose of this study was to determine the efficacy (pain relief and functional outcome) and the effect on the cross-sectional area (CSA) of the lumbar multifidus in chronic low back pain patients (CLBP).
Methods To achieve this goal, fifty-nine patients were randomised into a 10-week stabilisation training (group 1, N = 19), a 10-week stabilisation training combined with dynamic resistance training (group 2, N = 20) and a 10-week stabilisation training combined with dynamic-static resistance training (group 3, N = 20). Prior to and after 10 weeks of training, the multifidus CSA’s, were derived from standard CT images at three different levels (upper endplate of L3 and upper and lower endplate of L4). Pain relief and functional outcome were evaluated.
Results Comparing pre-post training, the CSA of the multifidus statistically increased in group 3 at all levels. In contrast, no statistical differences over time were found in group 1 and 2. Comparing the increases in CSA during the study, a statistical significant greater increase was observed in group 3 compared to group 1 and 2. After intervention, all groups showed a statistically significant reduction in pain and functional disability levels, without statistically significant difference among the three intervention groups.
Conclusion The results of this study suggest that stabilisation exercises and dynamic intensive lumbar resistance training have no significant effect on the CSA of the lumbar multifidus in CLBP patients. The static holding component, between the concentric and eccentric phase was found to be critical in inducing muscle hypertrophy during the first 10 weeks. On the basis of the pain and disability improvements all of the treatments were equally beneficial.
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