By: Joel Luedke
Low back pain can be debilitating and very frustrating. Research has shown in many studies that activity and rehab can have a significant impact on improving outcomes. That being said, what are the exact mechanisms that these exercise programs work through. This study takes a look specifically at a couple of levels of multifidi to see how a stabilization program affects them.
What They Did:
Researchers used an 8 week LSEP to look at how that program would directly effect the size and function of the multifidi muscles that play an important role in helping with general spinal stabilization. There was 34 patients with non-acute low back pain and 28 healthy controls to compare muscle size and function to. The researchers used RUSI to measure thickness of the multifidi muscles both at rest and during some movement to track and changes.
What They Found:
The patient group did not produce systematic changes in RUSI measures when compared to the controls even though RUSI impairments were observed at baseline and that patients had significant improvements in pain and disability. It was also found that the LSEP did not normalized the impairment of muscle activation compared to the controls.
What It All Means:
As with a lot of research the findings can be confusing and also make you think that nothing worked and that makes doing the exercises not worth it but don't let it deter you too much. While this particular study did not find the exact results they were looking for there were some silver linings. There were increases in ability to move and decreases in pain even without the corresponding changes in muscle thickness but improvements in these areas are always welcome.
I think the other thing this study shows is that while a 'standardized' back rehab program can be useful and effective there is nothing that is one size fits all. I think it also shows that these programs can be more effective when administered by a trained professional that can help customize them to your specific needs and also help correct in real time. This is paramount to find someone you trust that has the knowledge to dig into the root cause and address it.
Don't write off all the programs but make sure to be very aware of how things are coming along and find a rehab specialist to help increase your performance.
Abbreviations:
-Lumbar stabilization exercise program (LSEP)
-Rehabilitative ultrasound imaging (RUSI)
Source: Lariviere, C. The effects of an 8-week stabilization exercise program on lumbar multifidus muscle thickness and activation as measured with ultrasound imaging in patients with low back pain: An exploratory study.
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