TY - JOUR
T1 - Functional and morphological lumbar multifidus characteristics in subgroups with low back pain in primary care
AU - Hofste, Anke
AU - Soer, Remko
AU - Groen, Gerbrand J.
AU - van der Palen, Job
AU - Geerdink, Frank J.B.
AU - Oosterveld, Frits G.J.
AU - Kiers, Henri
AU - Wolff, André P.
AU - Hermens, Hermie
N1 - Funding Information:
We are grateful for all the motivated physiotherapists in the Back Network Twente for assisting in recruitment of patients. We acknowledge all physiotherapists that performed the tests in the diagnostic centers: Therapiecentrum Twente Almelo and Oldenzaal, FITclinic Enschede and Fysik Haaksbergen in the Netherlands. This work was supported by Raak Publiek, Netherlands organisation for scientific research , project number: 2015-02-58P ; and Saxion University of Applied Sciences, Enschede, the Netherlands .
Funding Information:
We are grateful for all the motivated physiotherapists in the Back Network Twente for assisting in recruitment of patients. We acknowledge all physiotherapists that performed the tests in the diagnostic centers: Therapiecentrum Twente Almelo and Oldenzaal, FITclinic Enschede and Fysik Haaksbergen in the Netherlands. This work was supported by Raak Publiek, Netherlands organisation for scientific research, project number: 2015-02-58P; and Saxion University of Applied Sciences, Enschede, the Netherlands.
Publisher Copyright:
© 2021 The Author(s)
PY - 2021/10
Y1 - 2021/10
N2 - Background: Since the contribution of the lumbar multifidus(LM) is not well understood in relation to non-specific low back pain(LBP), this may limit physiotherapists in choosing the most appropriate treatment strategy. Objectives: This study aims to compare clinical characteristics, in terms of LM function and morphology, between subacute and chronic LBP patients from a large clinical practice cohort compared to healthy controls. Design: Multicenter case control study. Method: Subacute and chronic LBP patients and healthy controls between 18 and 65 years of age were included. Several clinical tests were performed: primary outcomes were the LM thickness from ultrasound measurements, trunk range of motion(ROM) from 3D kinematic tests, and median frequency and root mean square values of LM by electromyography measurements. The secondary outcomes Numeric Rating Scale for Pain(NRS) and the Oswestry Disability Index(ODI) were administered. Comparisons between groups were made with ANOVA, p-values<0.05, with Tukey's HSD post-hoc test were considered significant. Results: A total of 161 participants were included, 50 healthy controls, 59 chronic LBP patients, and 52 subacute LBP patients. Trunk ROM and LM thickness were significantly larger in healthy controls compared to all LBP patients(p < 0.01). A lower LM thickness was found between subacute and chronic LBP patients although not significant(p = 0.11–0.97). All between-group comparisons showed no statistically significant differences in electromyography outcomes (p = 0.10–0.32). NRS showed no significant differences between LBP subgroups(p = 0.21). Chronic LBP patients showed a significant higher ODI score compared to subacute LBP patients(p = 0.03). Conclusions: Trunk ROM and LM thickness show differences between LBP patients and healthy controls.
AB - Background: Since the contribution of the lumbar multifidus(LM) is not well understood in relation to non-specific low back pain(LBP), this may limit physiotherapists in choosing the most appropriate treatment strategy. Objectives: This study aims to compare clinical characteristics, in terms of LM function and morphology, between subacute and chronic LBP patients from a large clinical practice cohort compared to healthy controls. Design: Multicenter case control study. Method: Subacute and chronic LBP patients and healthy controls between 18 and 65 years of age were included. Several clinical tests were performed: primary outcomes were the LM thickness from ultrasound measurements, trunk range of motion(ROM) from 3D kinematic tests, and median frequency and root mean square values of LM by electromyography measurements. The secondary outcomes Numeric Rating Scale for Pain(NRS) and the Oswestry Disability Index(ODI) were administered. Comparisons between groups were made with ANOVA, p-values<0.05, with Tukey's HSD post-hoc test were considered significant. Results: A total of 161 participants were included, 50 healthy controls, 59 chronic LBP patients, and 52 subacute LBP patients. Trunk ROM and LM thickness were significantly larger in healthy controls compared to all LBP patients(p < 0.01). A lower LM thickness was found between subacute and chronic LBP patients although not significant(p = 0.11–0.97). All between-group comparisons showed no statistically significant differences in electromyography outcomes (p = 0.10–0.32). NRS showed no significant differences between LBP subgroups(p = 0.21). Chronic LBP patients showed a significant higher ODI score compared to subacute LBP patients(p = 0.03). Conclusions: Trunk ROM and LM thickness show differences between LBP patients and healthy controls.
KW - Electromyography
KW - Low back pain
KW - Lumbar multifidus
KW - Lumbar spine
KW - Spinal motion
KW - Spine morphology
UR - http://www.scopus.com/inward/record.url?scp=85110021761&partnerID=8YFLogxK
U2 - 10.1016/j.msksp.2021.102429
DO - 10.1016/j.msksp.2021.102429
M3 - Article
AN - SCOPUS:85110021761
VL - 55
JO - Musculoskeletal Science and Practice
JF - Musculoskeletal Science and Practice
SN - 2468-8630
M1 - 102429
ER -