Multifidi Muscle Characteristics and Physical Function Among Older Adults With and Without Chronic Low Back Pain.
J Megan Sions, Peter C Coyle, Teonette O Velasco and 2 others
PMID 27590444WHAT IT FOUND
Older adults with chronic low back pain who had more fat within a deep back muscle scored worse on walking, balance, stairs and self-reported function.
Muscle size did not explain function. This relationship was seen only in older adults with pain.
Key findings
01Participants with chronic low back pain had worse self-reported physical function, slower gait speed, and worse Timed Up and Go and stair descent performance than participants without pain, even after accounting for BMI.
02Among older adults with chronic low back pain, higher multifidi fat was associated with lower self-reported function and gait speed, and longer Timed Up and Go and stair times.
03Multifidi size did not significantly explain physical function beyond covariates and low back pain status.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The supplied text does not state the number of participants analysed. The study was a secondary data analysis, and the sample size was not calculated before the study began. The authors state that future longitudinal research is needed, so the study does not establish cause. The analysis used T1-weighted MRI, which the authors note may be less accurate and rapid than newer methods for muscle composition. Only one lumbar level was measured, so adjacent levels might differ. The gait speed test used a 2.44 meter course, which the authors note may be less valid than a 10 meter course. The study included only older adults with chronic, moderate-intensity low back pain, so findings may not apply to acute or less intense pain. Activity level was not measured, although the authors note it can affect muscle quality and physical function. The authors mention small sample size as a possible reason for lack of side-to-side differences in some analyses.
Declared interests
The paper is listed as supported by NIH extramural funding. Dr. Elliott reported 35% ownership or investment interest in Pain ID, LLC, outside this work.
The easy way to misread this
Do not conclude that reducing back muscle fat will improve physical function. This study measured muscle fat and size without testing any treatment.