Paraspinal Muscles and Intervertebral Dysfunction: Part One

Fryer, Gary; Morris, Tony; Gibbons, Peter

doi:10.1016/j.jmpt.2004.02.006

Cited by 68 publications

(45 citation statements)

References 40 publications

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“…J Orthop Sports Phys Ther 2015;45 (9) 21 Changed coordination between paraspinal muscles appears to be consistent with clinical observations of reduced ability to move the lumbar spine independently of the thorax (ie, poor "dissociation" of lumbar and thoracolumbar motion) in some individuals. 3,25 Although poorly dissociated spinal movement may be relevant to LBP, clinical methods to assess this function require validation.…”

Section: T T Conclusionsupporting

confidence: 68%

“…Intertester reliability has are able to change their motor behavior, the increment in the total score of the LBP group was approximately half that achieved by the pain-free group. As the training involved specific cognitive attention to movement and muscle activity (ie, cognitive skill training), the difference could be a consequence of deficits in proprioception 14 or muscle function, 1,5,9,19 or may indicate a change in the ability of the group to learn a new task. 26 Individuals with LBP may require longer and/or more intense training.…”

Section: Relevance For Identification Of Lbp Subgroupsmentioning

confidence: 99%

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Validation of a Clinical Test of Thoracolumbar Dissociation in Chronic Low Back Pain

Cancino

Schabrun²,

Danneels³

et al. 2015

J Orthop Sports Phys Ther

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Motor control deficits are common in chronic/recurrent low back pain (LBP) 3,13,19,24,33,34,36 and include altered paraspinal muscle function. 4,5,19,29 Recovery from LBP does not ensure restoration of spine function or movement, and recurrent LBP involves persistent alterations of motor control, including modified coordination between short/deep (eg, multifidus) and long/ superficial (eg, thoracic erector spinae) paraspinal muscles, with a tendency to contract these muscles en masse rather than to activate T T BACKGROUND:Control deficits of back muscles and trunk movement are common in chronic/recurrent low back pain (LBP). A reliable clinical test to rate an individual's ability to dissociate lumbopelvic movement from the thoracolumbar region has been described. This test rates the performance quality of 5 key aspects against criterion standards. T T METHODS: Concurrent validity was examinedby comparison of clinical test scores (overall score and each individual criterion) against spine kinematics. Discriminant validity was evaluated by comparison of scores between pain-free controls and participants with LBP. A receiver operating characteristic curve was calculated to determine the optimal cutoff or score to differentiate between good and poor performers. T T RESULTS:Concurrent validity was supported by the significant correlation between the total score and motion of the T5 vertebra relative to the S1 vertebra (P<.05). Scores for some (4 correlations of 14 measures) but not all individual criteria were correlated with the kinematic features that each criterion was expected to reflect. Discriminant validity was supported by higher test scores for pain-free controls than for participants with LBP after 2 minutes of training (P = .045). Scores of less than 5.5 were more prevalent in the LBP group (pretraining LBP versus control, 72% versus 35%; P = .008; posttraining LBP versus control, 48% versus 16%; P = .018). T T CONCLUSION:This preliminary study of concurrent and discriminant validity of the test provides a foundation to further investigate its utility to characterize thoracolumbar movement patterns in individuals with LBP.

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Section: T T Conclusionsupporting

confidence: 68%

Section: Relevance For Identification Of Lbp Subgroupsmentioning

confidence: 99%

Validation of a Clinical Test of Thoracolumbar Dissociation in Chronic Low Back Pain

Cancino

Schabrun²,

Danneels³

et al. 2015

J Orthop Sports Phys Ther

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“…23,24 Such spasms are thought to act as a protective mechanism, splinting injured areas of the spine. Injuries may be superficial such as strain/sprain or more serious such as disk protrusion, spondylosis, or fracture.…”

Section: Discussionmentioning

confidence: 99%

Lumbar magnetic resonance imaging hypolordosis in symptomatic patients: association with paraspinal muscle spasms

Gilbert¹,

Wheeler²,

Storey³

et al. 2009

Journal of Chiropractic Medicine

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Objective: This study examined a set of patients who were symptomatic for low back pain and who had significant lumbar hypolordosis as assessed by visual evaluation of magnetic resonance images to investigate the frequency of comorbid paraspinal muscle spasms as determined via history or physical examination. Methods: A retrospective chart review was performed on 50 patients who had significant hypolordosis on magnetic resonance imaging (MRI) (Cobb angle b20°) to determine whether they were positive for paraspinal muscle spasms by either history or physical examination. Results: Of the 50 patients with significant hypolordosis on MRI, 66% (33) had a history of paraspinal muscle spasms, 76% (38) had a positive physical examination for palpation of paraspinal muscle spasms, and 48% (24) were positive for both history and physical examination. Conclusions: This retrospective study suggests that most symptomatic patients with significant hypolordosis on lumbar MRI have a positive history or physical examination for paraspinal muscle spasm. Thus, MRI finding of significant hypolordosis (Cobb angle b20°) could potentially be a valuable tool in addition to medical history and physical examination in aiding clinicians in diagnosing paraspinal muscle spasms in symptomatic patients and in helping them to formulate appropriate and effective treatments.

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“…A literature review has shown that the concept of reactive muscle contraction associated with intervertebral dysfunction seems plausible (Fryer et al, 2004a). The deep paraspinal muscle inhibition observed during dynamic and static activities was used as a theoretical framework for a possible relationship between dysfunctional muscle activity and tissue texture change findings with SD.…”

Section: Physiological Studiesmentioning

confidence: 99%

EBM in Clinical Practice: Implementation in Osteopathic Diagnosis and Manipulative Treatment for Non-Specific Low Back Pain Patients

Zegarra-Parodi¹,

Draper-Rodi²,

Fabre³

et al. 2012

Evidence Based Medicine - Closer to Patients or Scientists?

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Paraspinal Muscles and Intervertebral Dysfunction: Part One

Abstract: Although little direct evidence exists of the nature of clinically detected paraspinal tissue texture change, the concept of reactive muscle contraction appears plausible. Increased paraspinal EMG activity associated with LBP does not appear to be mediated by a simple protective reflex.

Cited by 68 publications

References 40 publications

Validation of a Clinical Test of Thoracolumbar Dissociation in Chronic Low Back Pain

Validation of a Clinical Test of Thoracolumbar Dissociation in Chronic Low Back Pain

Lumbar magnetic resonance imaging hypolordosis in symptomatic patients: association with paraspinal muscle spasms

EBM in Clinical Practice: Implementation in Osteopathic Diagnosis and Manipulative Treatment for Non-Specific Low Back Pain Patients

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