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      Association between abdominal muscle activity and lumbar muscle morphology, and their role in the functional assessment of patients with low back pain: A cross-sectional study

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          Abstract

          Objectives:

          The study aims to investigate the relationship between abdominal muscle activity and the cross-sectional area (CSA) of the lumbar muscles and assess their role in the functional assessment of patients with chronic non-specific low back pain (CNSLBP).

          Methods:

          142 patients with CNSLBP were included in this study. Disability levels were evaluated with the Roland-Morris Low Back Pain and Disability Questionnaire. The functional assessments of the participants were evaluated with a 6-minute walk test. Abdominal muscle activity was measured using a pressure biofeedback unit. The CSA of the bilateral multifidus, erector spinae, and psoas muscles were measured T2-weighted MRI images at the L2-L5 levels.

          Results:

          Significant correlations were found between the abdominal muscle activity during the posterior pelvic tilt movement and the CSA of the erector spinae muscle at the L4 and L5 levels, and the psoas muscle at the L2–L5 levels (correlation coefficient range from 0.32 to 0.48). Abdominal muscle activity yielded a significant additional contribution to the variance on the functional assessment (R 2 change=0.101).

          Conclusions:

          The relationship of abdominal muscle activity with lumbar muscles and the contribution of muscle activities to functional assessment should be considered in the management of patients with CNSLBP.

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          Most cited references45

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          Non-specific low back pain.

          Non-specific low back pain affects people of all ages and is a leading contributor to disease burden worldwide. Management guidelines endorse triage to identify the rare cases of low back pain that are caused by medically serious pathology, and so require diagnostic work-up or specialist referral, or both. Because non-specific low back pain does not have a known pathoanatomical cause, treatment focuses on reducing pain and its consequences. Management consists of education and reassurance, analgesic medicines, non-pharmacological therapies, and timely review. The clinical course of low back pain is often favourable, thus many patients require little if any formal medical care. Two treatment strategies are currently used, a stepped approach beginning with more simple care that is progressed if the patient does not respond, and the use of simple risk prediction methods to individualise the amount and type of care provided. The overuse of imaging, opioids, and surgery remains a widespread problem.
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            The role of core stability in athletic function.

            The importance of function of the central core of the body for stabilisation and force generation in all sports activities is being increasingly recognised. 'Core stability' is seen as being pivotal for efficient biomechanical function to maximise force generation and minimise joint loads in all types of activities ranging from running to throwing. However, there is less clarity about what exactly constitutes 'the core', either anatomically or physiologically, and physical evaluation of core function is also variable. 'Core stability' is defined as the ability to control the position and motion of the trunk over the pelvis to allow optimum production, transfer and control of force and motion to the terminal segment in integrated athletic activities. Core muscle activity is best understood as the pre-programmed integration of local, single-joint muscles and multi-joint muscles to provide stability and produce motion. This results in proximal stability for distal mobility, a proximal to distal patterning of generation of force, and the creation of interactive moments that move and protect distal joints. Evaluation of the core should be dynamic, and include evaluation of the specific functions (trunk control over the planted leg) and directions of motions (three-planar activity). Rehabilitation should include the restoring of the core itself, but also include the core as the base for extremity function.
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              A study of the natural history of back pain. Part I: development of a reliable and sensitive measure of disability in low-back pain.

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                Author and article information

                Journal
                J Musculoskelet Neuronal Interact
                J Musculoskelet Neuronal Interact
                Journal of Musculoskeletal & Neuronal Interactions
                International Society of Musculoskeletal and Neuronal Interactions (Greece )
                1108-7161
                2022
                : 22
                : 3
                : 375-384
                Affiliations
                [1 ]Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Gazi University, Turkey
                [2 ]Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Cumhuriyet University, Turkey
                [3 ]Department of Radiology, Faculty of Medicine, Gazi University, Turkey
                Author notes
                Corresponding author: Musa Polat, MD, Sivas Cumhuriyet University, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey, 58140 E-mail: musapolat@ 123456cumhuriyet.edu.tr
                Article
                JMNI-22-375
                9438515
                36046994
                7b4df59c-fe29-4bbc-879e-c65b90f1f257
                Copyright: © Journal of Musculoskeletal and Neuronal Interactions

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 4.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 03 August 2022
                Categories
                Original Article

                abdominal muscles,low back pain,magnetic resonance imaging,pain management,paraspinal muscles

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