Departments of Bioengineering, University of California San Diego, La Jolla, California, USA.
Departments of Nanoengineering, University of California San Diego, La Jolla, California, USA.
BMC Musculoskelet Disord. 2019 Jun 18;20(1):290. doi: 10.1186/s12891-019-2658-1.
Muscle atrophy and fatty infiltration of the lumbar extensors is associated with LBP. Exercise-based rehabilitation targets strengthening these muscles, but few studies show consistent changes in muscle quality with standard-of-care rehabilitation. The goal of this study was to assess the effect of high-intensity resistance exercise on lumbar extensor muscle size (cross sectional area) and quality (fat fraction) in individuals with low back pain (LBP).
Fourteen patients with LBP were recruited from a local rehabilitation clinic. Patients underwent MRI scanning before and after a standardized 10-week high-intensity machine-based, resistance exercise program. Patient pain, disability, anxiety/depression, satisfaction, strength, and range of motion was compared pre- and post-rehabilitation using analysis of covariance (covariates: age, gender). Exercise-induced changes in MRI, and patient functional outcome measures were correlated using Pearson's correlation test.
No significant differences were found in muscle size or fatty infiltration of the lumbar extensors over the course of rehabilitation (p > 0.31). However, patients reported reduced pain (p = 0.002) and were stronger (p = 0.03) at the conclusion of the program. Improvements in muscle size and quality for both multifidus and erector spinae correlated with improvements in disability, anxiety/depression, and strength.
While average muscle size and fatty infiltration levels did not change with high-intensity exercise, the results suggest that a subgroup of patients who demonstrate improvements in muscle health demonstrate the largest functional improvements. Future research is needed to identify which patients are most likely to respond to this type of treatment.
腰椎伸肌的萎缩和脂肪浸润与下腰痛（LBP）有关。基于运动的康复针对这些肌肉进行强化，但很少有研究显示标准康复治疗后肌肉质量有一致的变化。本研究的目的是评估高强度阻力运动对腰痛患者腰椎伸肌大小（横截面积）和质量（脂肪分数）的影响。
从当地康复诊所招募了 14 名患有 LBP 的患者。患者在接受标准化的 10 周高强度机器基础阻力运动方案前后接受 MRI 扫描。使用协方差分析（协变量：年龄、性别）比较康复前后患者的疼痛、残疾、焦虑/抑郁、满意度、力量和活动范围。使用 Pearson 相关检验分析 MRI 中运动引起的变化与患者功能结果测量值之间的相关性。
在康复过程中，腰椎伸肌的肌肉大小或脂肪浸润没有显著变化（p > 0.31）。然而，患者报告在项目结束时疼痛减轻（p = 0.002）且更强壮（p = 0.03）。多裂肌和竖脊肌的肌肉大小和质量的改善与残疾、焦虑/抑郁和力量的改善相关。
虽然高强度运动并没有改变肌肉的平均大小和脂肪浸润水平，但结果表明，肌肉健康有改善的亚组患者表现出最大的功能改善。需要进一步研究以确定哪些患者最有可能对这种治疗方法产生反应。
