Trunk Muscle Characteristics of the Multifidi, Erector Spinae, Psoas, and Quadratus Lumborum in Older Adults With and Without Chronic Low Back Pain.
J Megan Sions, James M Elliott, Ryan T Pohlig and 1 others
PMID 28158957WHAT IT FOUND
Older adults with chronic low back pain showed more fat within the multifidus and smaller erector spinae muscles than peers without pain, with differences also varying by sex.
This is an MRI comparison, not proof that exercises change these muscles.
Key findings
01Older adults with chronic low back pain had a higher multifidus muscle-to-fat index, an MRI measure of fat within the muscle (mean, 0.51), than older adults without chronic low back pain (mean, 0.49).
02Older adults with chronic low back pain had smaller erector spinae area after removing the MRI fat signal (mean, 8.56 cm2) than older adults without chronic low back pain (mean, 9.26 cm2).
03Compared with men, older women had greater multifidus MFI at L3 through L5, smaller multifidus rmCSA at L2 through L5, greater erector spinae MFI at L4, and smaller erector spinae rmCSA at all levels.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was a secondary analysis of existing MRI data from 53 participants with chronic low back pain and 49 without, so smaller differences may have been missed. The study was cross-sectional, so it cannot show whether trunk muscle changes caused chronic low back pain or resulted from it. Inclusion and exclusion criteria were not designed specifically to study trunk muscle characteristics. Measurements relied on T1-weighted axial images, and slice angle or partial volume effects may have affected level-specific fat estimates. Participants were aged 60 to 85 years and had not received low back services in the past 6 months, so the results may not apply to people currently receiving care.
The easy way to misread this
Do not conclude that trunk muscle fat causes chronic low back pain or that trunk exercises will reduce it. The study compared muscle characteristics at one time and did not test an intervention.