Effects of different verbal instructions on change of lumbar multifidus muscle thickness in asymptomatic adults and in patients with low back pain

Abstract

Spinal stabilisation exercise has been shown to be effective in the rehabilitation of low back pain (LBP). Due to the isometric nature of spinal stabilisation exercise, manual therapists use various verbal instructions to elicit lumbar multifidus muscle contraction.The purpose of this study was to assess whether or not three verbal instructions would alter muscle thickness of the lumbar multifidus muscle differently in asymptomatic individuals and patients with LBP.Three verbal instructions were selected for this study: (1) swell the muscle underneath the transducer, (2) draw your belly button in towards your spinal column and (3) think about tilting your pelvis but without really doing it. Lumbar multifidus muscle thickness was determined using parasagittal ultrasound (US) imaging. Measurements of muscle thickness were collected at rest and during verbal instructions from 21 asymptomatic adults and 21 patients with LBP. Percent changes of muscle thickness during contraction and at rest were compared between groups and across verbal instructions.ANOVA results showed no significant interaction for both L4-5 and L5-S1, but a significant main effect of verbal instruction (P 5 0.049) at L4-5.Post hoc analysis showed a greater increase with verbal instruction #3 than verbal instruction #2 (P 5 0.009). There was no significant main effect of group at either segment.The results of the study suggest that both groups responded similarly to the three verbal instructions. Verbal instructions may increase lumbar multifidus muscle thickness by different amounts at L4-5, but by the same amount at L5-S1.

Effect of Core Stabilizing Training on Young Individuals Presenting Different Stages of Degenerative Disc Disease—Preliminary Report

“…Despite an abundance of previous research, the treatment of DDD still raises considerable uncertainties concerning the course of rehabilitation [ 25 ]. The literature comprises numerous publications on the influence and effectiveness of stabilizing exercises for the lumbar multifidus muscle and the transverse abdominal muscle in patients with low back pain [ 7 , 26 , 27 , 28 , 29 ]; however, there is little scientific evidence to support this form of exercise for treating people under 35 years of age. The present study examined another criterion for the division of patients, namely, the type of damage to the intervertebral disc (disc protrusion or extrusion in the subacute stage of the disease according to the ASNR classification).…”

Rehabilitative Ultrasound Imaging Evaluation in Physiotherapy: Piloting a Systematic Review

“…Activity continued in the subsequent years, and picked up significantly in 2017. Evidently, it is not just a passing trend [44] even today. Therefore, it is a line of research on a global level, which is of interest, and in the light of the evidence analyzed, can be potentially very useful for the evaluation and evidence of the techniques used in physiotherapy.…”

“…It would be interesting for future research that measurements could also be obtained at this level given the popularity of taking measurements at L4/L5. On the other hand, we found publications in which three instructions are assessed when asking the patient to contract the lumbar muscles after comparing healthy patients with symptomatic ones [44]. The aim of these studies was to determine if the contraction was better depending on the point of exploration and given instructions.…”

Abdominal Expansion versus Abdominal Drawing-In Strategy on Thickness and Electromyography of Lumbar Stabilizers in People with Nonspecific Low Back Pain: A Cross-Sectional Study

“…Res. Public Health 2021, 18, 4487 2 of 11 the thickness of the TrA and MF in healthy adults and patients with LBP [8][9][10]. After the AD strategy was implemented in different body positions and in combination with various dynamic exercises, patients with LBP showed positive outcomes regarding self-reported pain and physical disability [11,12].…”

“…Previous studies reported that the AD strategy improve control of deep lumbar stabilization muscles [ 7 ]. Ultrasound imaging (USI) studies verified that the AD strategy is effective in increasing the thickness of the TrA and MF in healthy adults and patients with LBP [ 8 , 9 , 10 ]. After the AD strategy was implemented in different body positions and in combination with various dynamic exercises, patients with LBP showed positive outcomes regarding self-reported pain and physical disability [ 11 , 12 ].…”