Document Detail

Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain: the relationship to pain and disability.
MedLine Citation:
PMID:  15543053     Owner:  NLM     Status:  MEDLINE    
STUDY DESIGN: Prospective, cross-sectional observational study. OBJECTIVES: The aim of this study was to determine if there was an association between wasting of psoas and multifidus as observed on MRI scans and the presenting symptoms, reported pathology, pain, or disability of a cohort of patients presenting with unilateral low back pain. SUMMARY OF BACKGROUND DATA: Current physiotherapy practice is often based on localized spine stabilizing muscle exercises; most attention has been focused on transversus abdominus and multifidus with relatively little on psoas. METHOD: Fifty consecutive patients presenting to a back pain triage clinic with unilateral low back pain lasting more than 12 weeks were recruited. The cross-sectional surface area (CSA) of the muscles was measured. Duration of symptoms, rating of pain, self-reported function, and the presence of neural compression were recorded. RESULTS: Data analysis compared the CSA between the symptomatic and asymptomatic sides. There was a statistically significant difference in CSA between the sides (P < 0.001). There was a positive correlation between the percentage decrease in CSA of psoas on the affected side and with the rating of pain (rho = 0.608, P < 0.01), reported nerve root compression (rho = 0.812, P < 0.01), and the duration of symptoms (rho = 0.886, P < 0.01). There was an association between decrease in the CSA of multifidus and duration of symptoms. CONCLUSIONS: Atrophy of multifidus has been used as one of the rationales for spine stabilization exercises. The evidence of coexisting atrophy of psoas and multifidus suggests that a future area for study should be selective exercise training of psoas, which is less commonly used in clinical practice.
Karen L Barker; Delva R Shamley; David Jackson
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Spine     Volume:  29     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-11-15     Completed Date:  2006-01-17     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  E515-9     Citation Subset:  IM    
Physiotherapy Research Unit, Nuffield Orthopaedic Centre NHS Trust, Oxford, UK.
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MeSH Terms
Confidence Intervals
Cross-Sectional Studies
Disabled Persons / rehabilitation*
Low Back Pain / pathology*,  rehabilitation*
Lumbar Vertebrae
Magnetic Resonance Imaging / statistics & numerical data
Middle Aged
Muscle, Skeletal / pathology
Muscular Atrophy / pathology
Prospective Studies
Psoas Muscles / pathology*
Statistics, Nonparametric

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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