Department of Physical Therapy, School of Rehabilitation Sciences, International Campus of Iran University of Medical Sciences, Tehran, Iran; College of Health Sciences, Western University of Health Sciences, Pomona, CA, USA.
Gradient Corporation, Boston, MA, USA.
J Bodyw Mov Ther. 2021 Apr;26:147-152. doi: 10.1016/j.jbmt.2020.12.035. Epub 2020 Dec 30.
Decrease in cross-sectional thickness of lumbar multifidus (MF) muscles during prolonged low back pain episodes commonly occurs. Restoration of the MF muscle size can be an effective way of treating chronic low back pain (CLBP) patients. Traditionally, clinicians apply muscle stabilization exercises for these patients. Recent studies support the need for active strengthening exercises for treatment of the CLBP patients.
The MF muscles provide lumbar stability, and therefore we hypothesized that strengthening of these muscles can be more effective than the MF muscle stabilization exercises in restoration of the muscle size.
Study design was a randomized allocation control trial with two groups of adult female CLBP patients (n = 12 each; age range of 20-45). Patients in the control group underwent stabilization exercises and the patients in the intervention group underwent the hip abductor strengthening exercises.
For all subjects of each group, the trials continued in 24 sessions distributed over 8 weeks and the MF muscles were measured in the beginning of the first session and one week after completion of the last session.
Statistical significance (p-value) of the change in the average MF muscle thickness, pain, and disability scores along with for each group were estimated.
Both regimens of exercises can significantly decrease the pain and disability: average pain and disability reductions of 46% (p-value of 0.001) and 33% (p-value of 0.02) via stabilization versus average pain and disability reductions of 65% (p-value of 0.001) and 59% (p-value of 0.001) via hip abductor strengthening. However, the hip abductor strengthening is the sole statistically significant exercise regimen (p-value of 0.014 vs 0.94) for increasing the MF muscle size.
Replacement of the traditional stabilization exercises with the hip abductor strengthening exercises for effective treatment of female adults with CLBP is recommended.
在长时间的腰痛发作期间，腰椎多裂肌（MF）的横截面积通常会减少。恢复 MF 肌肉大小可能是治疗慢性腰痛（CLBP）患者的有效方法。传统上，临床医生为这些患者应用肌肉稳定练习。最近的研究支持对 CLBP 患者进行主动强化锻炼的必要性。
MF 肌肉为腰椎提供稳定性，因此我们假设这些肌肉的强化比 MF 肌肉稳定练习更能有效恢复肌肉大小。
研究设计为一项随机分组对照试验，共有 12 名成年女性 CLBP 患者（年龄范围 20-45 岁）分为两组。对照组患者进行稳定练习，干预组患者进行髋关节外展肌强化练习。
对于每个组的所有受试者，试验在 8 周内持续进行 24 次，在第一次会议开始时和最后一次会议结束后一周测量 MF 肌肉。
估计每组平均 MF 肌肉厚度、疼痛和残疾评分变化的统计学意义（p 值）。
两种运动方案都能显著减轻疼痛和残疾：稳定练习平均疼痛和残疾减轻 46%（p 值<0.001）和 33%（p 值=0.02），髋关节外展肌强化练习平均疼痛和残疾减轻 65%（p 值<0.001）和 59%（p 值<0.001）。然而，髋关节外展肌强化是唯一具有统计学意义的运动方案（p 值=0.014 对 0.94），可增加 MF 肌肉大小。
建议用髋关节外展肌强化练习代替传统的稳定练习，有效治疗成年女性 CLBP。
