Evidence synthesis showed limited evidence supporting poor baseline transversus abdominis contraction thickness ratio as a treatment effect modifier favoring motor control exercise .
Limited evidence supported that high baseline transversus abdominis lateral slide was associated with higher pain intensity after various exercise interventions at 1-year follow-up .
However , there was limited evidence for the absence of relation between the contraction thickness ratio of transversus abdominis or anticipatory onset of lateral abdominal muscles at baseline and the short- or long-term LBP intensity after exercise interventions .
There was conflicting evidence for a relation between baseline percent thickness change of lumbar multifidus during contraction and the clinical outcomes of patients after various conservative treatments .
Although individual reports suggest that baseline morphometry or activity of transversus abdominis or lumbar multifidus predict clinical outcome of low back pain ( LBP ) , a related systematic review is unavailable .
Therefore , this review summarized evidence regarding the predictive value of these muscular characteristics .
Spine stabilisation exercises in the treatment of chronic low back pain: a good clinical outcome is not associated with improved abdominal muscle function
Introduction Various studies have shown that spine stabilisation exercise therapy elicits improvements in symptoms/disability in patients with chronic non-specific low back pain ( cLBP ) . However , few have corroborated the intended mechanism of action by examining whether clinical improvements ( 1 ) are greater in patients with functional deficits of the targeted muscles and ( 2 ) correlate with post-treatment improvements in abdominal muscle function . Methods Pre and directly after 9 weeks ’ therapy , 32 cLBP patients ( 44.0 ± 12.3 years ) rated their LBP intensity ( 0–10 ) and disability ( 0–24 , Rol and –Morris ; RM ) and completed psychological question naires . At the same timepoints , the voluntary activation of transversus abdominis ( TrA ) , obliquus internus and obliquus externus during “ abdominal-hollowing ” and the anticipatory ( “ feedforward ” ) activation of these muscles during rapid arm movements were measured using M-mode ultrasound with tissue Doppler imaging . Results Pre-therapy to post-therapy , RM decreased from 8.9 ± 4.7 to 6.7 ± 4.3 , and average pain , from 4.7 ± 1.7 to 3.5 ± 2.3 ( each P < 0.01 ) . The ability to voluntarily activate TrA increased by 4.5 % ( P = 0.045 ) whilst the anticipatory activation of the lateral abdominal muscles showed no significant change ( P > 0.05 ) . There was no significant correlation between the change in RM scores after therapy and either baseline values for voluntary ( r = 0.24 , P = 0.20 ) or anticipatory activation ( r = 0.04 , P = 0.84 ) , or their changes after therapy ( voluntary , r = 0.08 , P = 0.66 ; anticipatory , r = 0.16 , P = 0.40 ) . In multiple regression , only a reduction in catastrophising ( P = 0.0003 ) and in fingertip – floor distance ( P = 0.0006 ) made unique contributions to explaining the variance in the reduction in RM scores . Conclusion Neither baseline lateral abdominal muscle function nor its improvement after a programme of stabilisation exercises was a statistical predictor of a good clinical outcome . It is hence difficult to attribute the therapeutic result to any specific effects of the exercises on these trunk muscles . The association between changes in catastrophising and outcome serves to encourage further investigation on larger groups of patients to clarify whether stabilisation exercises have some sort of “ central ” effect , unrelated to abdominal muscle function per se
Evidence synthesis showed limited evidence supporting poor baseline transversus abdominis contraction thickness ratio as a treatment effect modifier favoring motor control exercise .
Limited evidence supported that high baseline transversus abdominis lateral slide was associated with higher pain intensity after various exercise interventions at 1-year follow-up .
However , there was limited evidence for the absence of relation between the contraction thickness ratio of transversus abdominis or anticipatory onset of lateral abdominal muscles at baseline and the short- or long-term LBP intensity after exercise interventions .
There was conflicting evidence for a relation between baseline percent thickness change of lumbar multifidus during contraction and the clinical outcomes of patients after various conservative treatments .
Although individual reports suggest that baseline morphometry or activity of transversus abdominis or lumbar multifidus predict clinical outcome of low back pain ( LBP ) , a related systematic review is unavailable .
Therefore , this review summarized evidence regarding the predictive value of these muscular characteristics .