Cargando…

Does Motor Control Exercise Restore Normal Morphology of Lumbar Multifidus Muscle in People with Low Back Pain? – A Systematic Review

Aberrant morphological changes in lumbar multifidus muscle (LMM) are prevalent among patients with low back pain (LBP). Motor control exercise (MCE) aims to improve the activation and coordination of deep trunk muscles (eg, LMM), which may restore normal LMM morphology and reduce LBP. However, its e...

Descripción completa

Detalles Bibliográficos
Autores principales: Pinto, Sabina M, Boghra, Sweta B, Macedo, Luciana G, Zheng, Yong-Ping, Pang, Marco Y C, Cheung, Jason P Y, Karppinen, Jaro, Samartzis, Dino, Wong, Arnold Y L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8384346/
https://www.ncbi.nlm.nih.gov/pubmed/34447268
http://dx.doi.org/10.2147/JPR.S314971
_version_ 1783741900863307776
author Pinto, Sabina M
Boghra, Sweta B
Macedo, Luciana G
Zheng, Yong-Ping
Pang, Marco Y C
Cheung, Jason P Y
Karppinen, Jaro
Samartzis, Dino
Wong, Arnold Y L
author_facet Pinto, Sabina M
Boghra, Sweta B
Macedo, Luciana G
Zheng, Yong-Ping
Pang, Marco Y C
Cheung, Jason P Y
Karppinen, Jaro
Samartzis, Dino
Wong, Arnold Y L
author_sort Pinto, Sabina M
collection PubMed
description Aberrant morphological changes in lumbar multifidus muscle (LMM) are prevalent among patients with low back pain (LBP). Motor control exercise (MCE) aims to improve the activation and coordination of deep trunk muscles (eg, LMM), which may restore normal LMM morphology and reduce LBP. However, its effects on LMM morphology have not been summarized. This review aimed to summarize evidence regarding the (1) effectiveness of MCE in altering LMM morphometry and decreasing LBP; and (2) relations between post-MCE changes in LMM morphometry and LBP/LBP-related disability. Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Cochrane Central Register of Controlled Trials, the Physiotherapy Evidence Database, EMBASE and SPORTDiscus were searched from inception to 30 September 2020 to identify relevant randomized controlled trials. Two reviewers independently screened articles, extracted data, and evaluated risk of bias and quality of evidence. Four hundred and fifty-one participants across 9 trials were included in the review. Very low-quality evidence supported that 36 sessions of MCE were better than general physiotherapy in causing minimal detectable increases in LMM cross-sectional areas of patients with chronic LBP. Very low- to low-quality evidence suggested that MCE was similar to other interventions in increasing resting LMM thickness in patients with chronic LBP. Low-quality evidence substantiated that MCE was significantly better than McKenzie exercise or analgesics in increasing contracted LMM thickness in patients with chronic LBP. Low-quality evidence corroborated that MCE was not significantly better than other exercises in treating people with acute/chronic LBP. Low-quality evidence suggested no relation between post-MCE changes in LMM morphometry and LBP/LBP-related disability. Collectively, while MCE may increase LMM dimensions in patients with chronic LBP, such changes may be unrelated to clinical outcomes. This raises the question regarding the role of LMM in LBP development/progression.
format Online
Article
Text
id pubmed-8384346
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Dove
record_format MEDLINE/PubMed
spelling pubmed-83843462021-08-25 Does Motor Control Exercise Restore Normal Morphology of Lumbar Multifidus Muscle in People with Low Back Pain? – A Systematic Review Pinto, Sabina M Boghra, Sweta B Macedo, Luciana G Zheng, Yong-Ping Pang, Marco Y C Cheung, Jason P Y Karppinen, Jaro Samartzis, Dino Wong, Arnold Y L J Pain Res Review Aberrant morphological changes in lumbar multifidus muscle (LMM) are prevalent among patients with low back pain (LBP). Motor control exercise (MCE) aims to improve the activation and coordination of deep trunk muscles (eg, LMM), which may restore normal LMM morphology and reduce LBP. However, its effects on LMM morphology have not been summarized. This review aimed to summarize evidence regarding the (1) effectiveness of MCE in altering LMM morphometry and decreasing LBP; and (2) relations between post-MCE changes in LMM morphometry and LBP/LBP-related disability. Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Cochrane Central Register of Controlled Trials, the Physiotherapy Evidence Database, EMBASE and SPORTDiscus were searched from inception to 30 September 2020 to identify relevant randomized controlled trials. Two reviewers independently screened articles, extracted data, and evaluated risk of bias and quality of evidence. Four hundred and fifty-one participants across 9 trials were included in the review. Very low-quality evidence supported that 36 sessions of MCE were better than general physiotherapy in causing minimal detectable increases in LMM cross-sectional areas of patients with chronic LBP. Very low- to low-quality evidence suggested that MCE was similar to other interventions in increasing resting LMM thickness in patients with chronic LBP. Low-quality evidence substantiated that MCE was significantly better than McKenzie exercise or analgesics in increasing contracted LMM thickness in patients with chronic LBP. Low-quality evidence corroborated that MCE was not significantly better than other exercises in treating people with acute/chronic LBP. Low-quality evidence suggested no relation between post-MCE changes in LMM morphometry and LBP/LBP-related disability. Collectively, while MCE may increase LMM dimensions in patients with chronic LBP, such changes may be unrelated to clinical outcomes. This raises the question regarding the role of LMM in LBP development/progression. Dove 2021-08-20 /pmc/articles/PMC8384346/ /pubmed/34447268 http://dx.doi.org/10.2147/JPR.S314971 Text en © 2021 Pinto et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Pinto, Sabina M
Boghra, Sweta B
Macedo, Luciana G
Zheng, Yong-Ping
Pang, Marco Y C
Cheung, Jason P Y
Karppinen, Jaro
Samartzis, Dino
Wong, Arnold Y L
Does Motor Control Exercise Restore Normal Morphology of Lumbar Multifidus Muscle in People with Low Back Pain? – A Systematic Review
title Does Motor Control Exercise Restore Normal Morphology of Lumbar Multifidus Muscle in People with Low Back Pain? – A Systematic Review
title_full Does Motor Control Exercise Restore Normal Morphology of Lumbar Multifidus Muscle in People with Low Back Pain? – A Systematic Review
title_fullStr Does Motor Control Exercise Restore Normal Morphology of Lumbar Multifidus Muscle in People with Low Back Pain? – A Systematic Review
title_full_unstemmed Does Motor Control Exercise Restore Normal Morphology of Lumbar Multifidus Muscle in People with Low Back Pain? – A Systematic Review
title_short Does Motor Control Exercise Restore Normal Morphology of Lumbar Multifidus Muscle in People with Low Back Pain? – A Systematic Review
title_sort does motor control exercise restore normal morphology of lumbar multifidus muscle in people with low back pain? – a systematic review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8384346/
https://www.ncbi.nlm.nih.gov/pubmed/34447268
http://dx.doi.org/10.2147/JPR.S314971
work_keys_str_mv AT pintosabinam doesmotorcontrolexerciserestorenormalmorphologyoflumbarmultifidusmuscleinpeoplewithlowbackpainasystematicreview
AT boghraswetab doesmotorcontrolexerciserestorenormalmorphologyoflumbarmultifidusmuscleinpeoplewithlowbackpainasystematicreview
AT macedolucianag doesmotorcontrolexerciserestorenormalmorphologyoflumbarmultifidusmuscleinpeoplewithlowbackpainasystematicreview
AT zhengyongping doesmotorcontrolexerciserestorenormalmorphologyoflumbarmultifidusmuscleinpeoplewithlowbackpainasystematicreview
AT pangmarcoyc doesmotorcontrolexerciserestorenormalmorphologyoflumbarmultifidusmuscleinpeoplewithlowbackpainasystematicreview
AT cheungjasonpy doesmotorcontrolexerciserestorenormalmorphologyoflumbarmultifidusmuscleinpeoplewithlowbackpainasystematicreview
AT karppinenjaro doesmotorcontrolexerciserestorenormalmorphologyoflumbarmultifidusmuscleinpeoplewithlowbackpainasystematicreview
AT samartzisdino doesmotorcontrolexerciserestorenormalmorphologyoflumbarmultifidusmuscleinpeoplewithlowbackpainasystematicreview
AT wongarnoldyl doesmotorcontrolexerciserestorenormalmorphologyoflumbarmultifidusmuscleinpeoplewithlowbackpainasystematicreview