Effects of Low-Load Motor Control Exercises and a High-Load Lifting Exercise on Lumbar Multifidus Thickness

Abstract

Study DesignRandomized controlled trial ObjectiveThe aim of this study was to compare the effects of low-load motor control exercises and a high-load lifting exercise, on lumbar multifidus (LM) thickness on either side of the spine and whether the effects are affected by pain intensity or change in pain intensity, among patients with nociceptive mechanical LBP. Summary of Background DataThere is evidence that patients with low back pain may have a decreased size of the (LM) muscles with an asymmetry between sides in the lower back. It has also been shown that low-load motor control training can affect this asymmetry. It is, however, not known whether a high-load exercise has the same effect. MethodsSixty-five participants diagnosed with nociceptive mechanical low back painwere included and randomized into low-load motor control exercises or a high-load lifting exercise, the deadlift. The LM thickness was measured using rehabilitative ultrasound imaging, at baseline and after a 2-month training period. ResultsThere were no differences between interventions regarding effect on LM muscle thickness. However, the analysis showed a significant effect for asymmetry. The thickness of the LMmuscle on the small side increased significantly compared to the large side in both intervention groups, without influence of pain at baseline, or change in pain intensity. ConclusionsThere was a difference in thickness of the LM muscles between sides. It seems that exercises focusing on spinal alignment may increase the thickness of the LM muscles on the small side, irrespective of exercise load.The increase in LM thickness does not appear to be mediated by either current pain intensity or the magnitude of change in pain intensity. study 20 .Still, neither the thickness of the LM muscles, nor the effects of LMC and HLL on LM thicknessin patients with nociceptive mechanical LBP have been investigated previously.Theprimary aim of this study was therefore to investigate the LM thickness and compare the effects of LMC exercises and a HLL exercise, on LM thickness among patients with nociceptive mechanical LBP.Also, a secondary aim wasto investigate whether changesin LM thickness wasaffected by baseline or change in pain intensity. MATERIALS AND METHODS Study DesignThis study is part of a larger data collection evaluating the effects of LMC exercises and an HLL exercise (NCT01061632) 20 . Here, we investigated the effects on percentage change [(follow-upbaseline/baseline)*100] in thickness of the LM muscle at the fifth lumbar vertebra at the small and large sides. The study protocol was approved by The Regional Ethical Review Board in . ParticipantsConsecutive individuals seeking care for LBP with a duration of more than three months at two occupational health care centers, and classified as having nociceptive mechanical LBP 21 were screened for eligibility (n=85) 20 . The eligibility screening controlled for inclusion and exclusion criteria such as red-(i.e., pathological processes) and yellow flags (i.e., pain and pain behavior secondary...

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