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Effects of different verbal instructions on change of lumbar multifidus muscle thickness in asymptomatic adults and in patients with low back pain

TLDR
The results of the study suggest that both groups responded similarly to the three verbal instructions, and verbal instructions may increase lumbar multifidus muscle thickness by different amounts at L4-5, but by the same amount at L5-S1.
Abstract
Background: Spinal stabilisation exercise has been shown to be effective in the rehabilitation of low back pain (LBP). Due to the isometric nature of spinal stabilisation exercise, manual therapists use various verbal instructions to elicit lumbar multifidus muscle contraction.Objectives: The purpose of this study was to assess whether or not three verbal instructions would alter muscle thickness of the lumbar multifidus muscle differently in asymptomatic individuals and patients with LBP.Methods: Three verbal instructions were selected for this study: (1) swell the muscle underneath the transducer, (2) draw your belly button in towards your spinal column and (3) think about tilting your pelvis but without really doing it. Lumbar multifidus muscle thickness was determined using parasagittal ultrasound (US) imaging. Measurements of muscle thickness were collected at rest and during verbal instructions from 21 asymptomatic adults and 21 patients with LBP. Percent changes of muscle thickness during contracti...

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Reliability of rehabilitative ultrasound imaging of the transversus abdominis and lumbar multifidus musculature

TL;DR: In this article, the intraexaminer and interexaminer reliability of rehabilitation ultrasound imaging (RUSI) in obtaining thickness measurements of the transversus abdominis (TrA) and lumbar multifidus muscles at rest and during contractions was evaluated.
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Rehabilitative Ultrasound Imaging Evaluation in Physiotherapy: Piloting a Systematic Review.

TL;DR: This pilot study checked the proposed systematic review protocol methodology, evaluating the evidence from the last five years, and coordinating the work of the team of reviewers in performing a complete systematic review prior to a full systematic review.
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Short-term effects of two deep dry needling techniques on pressure pain thresholds and electromyographic amplitude of the lumbosacral multifidus in patients with low back pain - a randomized clinical trial.

TL;DR: Deep DN with needle manipulation appeared to reduce mechanical pressure sensitivity more than DN without manipulation for patients with LBP, and although a single session of DN could reduce pressure pain sensitivity, it may not be sufficient to improve LM muscle function.
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Effects of tactile feedback on lumbar multifidus muscle activity in asymptomatic healthy adults and patients with low back pain.

TL;DR: Adding tactile stimulation to verbal instruction appeared to provide an inhibitory effect on LM activity in both asymptomatic healthy adults and patients with LBP.
Journal ArticleDOI

Abdominal Expansion versus Abdominal Drawing-In Strategy on Thickness and Electromyography of Lumbar Stabilizers in People with Nonspecific Low Back Pain: A Cross-Sectional Study.

TL;DR: In this paper, the immediate effects of the abdominal expansion versus abdominal drawing-in (AD) strategy on lumbar stabilization muscles in people with nonspecific low back pain (LBP) were investigated.
References
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Journal ArticleDOI

Low Back Pain Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association

TL;DR: The Orthopaedic Section of the American Physical Therapy Association (APTA) has created evidence-based practice guidelines for OPT management of patients with musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability, and Health (ICF).
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Preliminary Development of a Clinical Prediction Rule for Determining Which Patients With Low Back Pain Will Respond to a Stabilization Exercise Program

TL;DR: The response to a stabilization exercise program in patients with LBP can be predicted from variables collected from the clinical examination, and the prediction rules could be used to determine whether patients with low back pain are likely to benefit from stabilization exercises.
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Correlation between the MRI changes in the lumbar multifidus muscles and leg pain.

TL;DR: Examination of the paraspinal muscles looking for atrophy of MF muscle should be considered when assessing MR images of lumbar spine, which may explain the referred leg pain in the absence of other MR abnormalities.
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Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain: the relationship to pain and disability.

TL;DR: The evidence of coexisting atrophy of psoas and multifidus suggests that a future area for study should be selective exercise training of p soas, which is less commonly used in clinical practice.
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Multifidus size and symmetry among chronic LBP and healthy asymptomatic subjects.

TL;DR: The results of this study support previous findings that the pattern of multifidus muscle atrophy in chronic LBP patients is localized rather than generalized and between side asymmetry may be seen in chronicLBP patients presenting with a unilateral pain distribution.
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