Do changes in transversus abdominis and lumbar multifidus during conservative treatment explain changes in clinical outcomes related to non-specific low back pain? A systematic review.
Previous research describes an inconsistent relation between changes in transversus abdominis (TrA) or lumbar multifidus (LM) and changes in clinical outcomes. This systematic review was designed to summarize evidence regarding the association between temporal changes in muscle morphometry and activity in response to treatment and temporal changes in clinical outcomes. 15 articles were included after scrutinization by two reviewers using the predetermined selection criteria. The methodological quality of these articles was appraised using a standard tool.
These methods revealed strong evidence that alterations in TrA thickness change during contraction) or feedforward activation of TrA were unrelated to temporal changes in LBP/LBP-related disability. There was limited evidence that changes in TrA lateral sliding or LM endurance were unrelated to changes in LBP intensity. Conflicting evidence was found for the relation between changes in LM morphometry and changes in LBP/LBP-related disability.
This systematic review highlighted that changes in morphometry or activation of transversus abdominis following conservative treatments tend not to be associated with the corresponding changes in clinical outcomes. The relation between post-treatment changes in characteristics of lumbar multifidus and clinical improvements remains uncertain. A central mechanism may be hypothesised. > From: Wong et al., J Pain (2013) (Epub ahead of print). All rights reserved to Journal of Pain.
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