Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain - The relationship to pain and disability
Changes in the cross-sectional area of multifidus and psoas in patients with unilateral back pain - The relationship to pain and disability
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DOI：
10.1097/01.brs.0000144405.11661.eb
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发表时间：
2004-11-15
期刊：
影响因子：
3
通讯作者：
Jackson, D
中科院分区：
文献类型：
--
作者：
Barker, KL;Shamley, DR;Jackson, D
研究设计.前瞻性、横断面观察性研究。目的。本研究的目的是确定在MRI扫描上观察到的腰大肌和多裂肌萎缩与单侧下腰痛患者的症状、报告的病理、疼痛或残疾之间是否存在相关性。目前的物理治疗实践往往是基于局部脊柱稳定肌肉锻炼;大多数注意力都集中在腹横肌和多裂肌上，而对腰肌的关注相对较少。招募了50名连续出现于背痛分诊诊所的单侧腰痛持续超过12周的患者。测量肌肉的横截面积（CSA）。记录症状持续时间、疼痛等级、自我报告的功能和神经压迫的存在。数据分析比较有症状和无症状侧的CSA。两侧CSA差异有统计学意义（P < 0.001）。患侧腰大肌CSA下降百分比与疼痛评分（rho = 0.608，P < 0.01）、神经根受压（rho = 0.812，P < 0.01）和症状持续时间（rho = 0.886，P < 0.01）呈正相关。多裂肌横截面积的减少与痉挛持续时间有关。多裂肌萎缩已被用作脊柱稳定锻炼的依据之一。腰大肌和多裂肌同时萎缩的证据表明，未来的研究领域应该是腰大肌的选择性运动训练，这在临床实践中不太常用。
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.