The Intervention Effects of Different Treatment for Chronic Low Back Pain as
Assessed by the Cross-sectional Area of the Multifidus Muscle

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Abstract

[Purpose] The purpose of this this study was to examine the immediate effects of intervention of proprioceptive neuromuscular facilitation (PNF), neuromuscular joint facilitation (NJF) and NJF+pelvic floor muscle (PFM) exercise. [Subjects] Thirteen young people (5 males, 8 females) who had chronic low back pain on one side for more than 6 months. [Methods] Subjects were asked to lie on their sides with the painful side uppremost. The subjects received PNF, and NJF, NJF+PFM exercise treatments. The changes in the cross-sectional area of the multifidusmuscle were measured using ultrasonography. [Results] The cross-sectional area of the multifidus muscle of NJF+PFM group showed the largest increases on both the sides with and without pain. [Conclusion] Our results show that chronic low back pain can be improved by a combination of PFM exercise and the NJF pattern.

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Most cited references 2

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Multifidus muscle recovery is not automatic after resolution of acute, first-episode low back pain.

G Jull, George B. Richardson, J Hides (1996)

A clinical study was conducted on 39 patients with acute, first-episode, unilateral low back pain and unilateral, segmental inhibition of the multifidus muscle. Patients were allocated randomly to a control or treatment group. To document the natural course of lumber multifidus recovery and to evaluate the effectiveness of specific, localized, exercise therapy on muscle recovery. Acute low back pain usually resolves spontaneously, but the recurrence rate is high. Inhibition of multifidus occurs with acute, first-episode, low back pain, and pathologic changes in this muscle have been linked with poor outcome and recurrence of symptoms. Patients in group 1 received medical treatment only. Patients in group 2 received medical treatment and specific, localized, exercise therapy. Outcome measures for both groups included 4 weekly assessments of pain, disability, range of motion, and size of the multifidus cross-sectional area. Independent examiners were blinded to group allocation. Patients were reassessed at a 10-week follow-up examination. Multifidus muscle recovery was not spontaneous on remission of painful symptoms in patients in group 1. Muscle recovery was more rapid and more complete in patients in group 2 who received exercise therapy (P = 0.0001). Other outcome measurements were similar for the two groups at the 4-week examination. Although they resumed normal levels of activity, patients in group 1 still had decreased multifidus muscle size at the 10-week follow-up examination. Multifidus muscle recovery is not spontaneous on remission of painful symptoms. Lack of localized, muscle support may be one reason for the high recurrence rate of low back pain following the initial episode.

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Comparison of CT scan muscle measurements and isokinetic trunk strength in postoperative patients.

Derek Smith, Christian Mayer, Robert Gatchel … (1988)

The present study compared the computed tomography (CT) scan muscle area/muscle density and isokinetic trunk strength of a group of spinal surgery patients (35 males and 11 females) 3 months postoperatively. Analyses showed trunk strength means to be below 50% of gender-specific "normal" values obtained by evaluating a normative sample. Extensor strength was more significantly affected than flexors. Single-cut CT scans performed at the time of isokinetic trunk strength assessment demonstrated psoas and erector spinae atrophy through a significant decrease in muscle density, with only a trend towards decreased cross-sectional area. Findings also indicated that there was a significant correlation between increased mechanical trunk strength performance and greater muscle density on CT scan. Strength was significantly lower for the male patients undergoing spinal fusion compared with those undergoing disc excision. However, no significant difference was found in strength measures between: males with high versus low pain level and working versus nonworking males at the time of evaluation.

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Author and article information

Journal

Journal ID (nlm-ta): J Phys Ther Sci

Journal ID (iso-abbrev): J Phys Ther Sci

Journal ID (publisher-id): JPTS

Title: Journal of Physical Therapy Science

Publisher: The Society of Physical Therapy Science

ISSN (Print): 0915-5287

ISSN (Electronic): 2187-5626

Publication date (Electronic): 20 August 2013

Publication date (Print): July 2013

Volume: 25

Issue: 7

Pages: 811-813

Affiliations

[1) ] Department of Physical Therapy, Faculty of Health Science, Graduate School of International University of Health and Welfare

[2) ] Department of Radiological Sciences, Faculty of Health Science, International University of Health and Welfare

Author notes

Mailing address: Huang Qiuchen, Department of Physical Therapy, Faculty of Health Science, Graduate School of International University of Health and Welfare: 2600-1 Kitakanemaru, Ohtawara City, Tochigi 324-8501, Japan. TEL +81 80-6799-9938 E-mail: qiuchen_1984@ 123456126.com

Article

Publisher ID: jpts-2013-037

DOI: 10.1589/jpts.25.811

PMC ID: 3820390

PubMed ID: 24259859

SO-VID: fcb2be4c-93bd-4223-aa6d-feed8a37c59c

License:

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Derivatives (by-nc-nd) License.

History

Date received : 30 January 2013

Date accepted : 01 March 2013

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The Intervention Effects of Different Treatment for Chronic Low Back Pain as Assessed by the Cross-sectional Area of the Multifidus Muscle

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