The lumbar multifidus: does the evidence support clinical beliefs?

Abstract:

:The contribution of the trunk muscles to spinal stability is well established. There is convincing evidence for the role of multifidus in spinal stability. Recently, emphasis has shifted to the deep fibres of this muscle (DM) and five key clinical beliefs have arisen: (i) that DM stabilizes the lumbar spine whereas the superficial fibres of lumbar multifidus (SM) and the erector spinae (ES) extend and/or rotate the lumbar spine, (ii) that DM has a greater percentage of type I (slow twitch) muscle fibres than SM and ES, (iii) that DM is tonically active during movements of the trunk and gait, whereas SM and ES are phasically active, (iv) that DM and the transversus abdominis (TrA) co-contract during function, and (v) that changes in the lumbar paraspinal muscles associated with LBP affect DM more than SM or ES. This paper reviews the biomechanical, electromyographic, histochemical and morphological data that underpin these beliefs. Although there is support for the importance of the lumbar multifidus and the specific contribution of this muscle to intervertebral control, several of the clinical beliefs have little or no support and require further evaluation. These findings have implications for clinical practice.

journal_name

Man Ther

journal_title

Manual therapy

authors

MacDonald DA,Moseley GL,Hodges PW

doi

10.1016/j.math.2006.02.004

subject

Has Abstract

pub_date

2006-11-01 00:00:00

pages

254-63

issue

4

eissn

1356-689X

issn

1532-2769

pii

S1356-689X(06)00033-6

journal_volume

11

pub_type

杂志文章,评审
  • Kinesiology tape does not promote vertical jumping performance: A deceptive crossover trial.

    abstract:BACKGROUND:Kinesiology tape (KINTAPE) is one of the most common adhesive therapeutic tapes. Apart from clinical applications, KINTAPE claims to be able to enhance functional performance by muscle activity facilitation. However, emerging evidence suggests that the isokinetic muscle strength remains similar when the plac...

    journal_title:Manual therapy

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.math.2015.06.001

    authors: Cheung RT,Yau QK,Wong K,Lau P,So A,Chan N,Kwok C,Poon KY,Yung PS

    更新日期:2016-02-01 00:00:00

  • Sensorimotor disturbances in chronic neck pain--range of motion, peak velocity, smoothness of movement, and repositioning acuity.

    abstract::The purpose of this pilot study was to evaluate sensorimotor functions in patients with chronic neck pain with objective and quantitative methods. A group of 16 patients with chronic idiopathic neck pain of insidious onset or whiplash associated disorders (WAD) was compared to an equally sized group of healthy subject...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1016/j.math.2006.10.002

    authors: Sjölander P,Michaelson P,Jaric S,Djupsjöbacka M

    更新日期:2008-05-01 00:00:00

  • Validating clinical reasoning: a question of perspective, but whose perspective?

    abstract::This paper explores the notion of validity from different perspectives and addresses its integration with clinical reasoning. Whilst valuing the evidence-based practice (EBP) perspective in our quest for validation of practice, the authors posit that other perspectives may provide added value through their potential f...

    journal_title:Manual therapy

    pub_type: 杂志文章,评审

    doi:10.1016/s1356-689x(02)00077-2

    authors: Downing AM,Hunter DG

    更新日期:2003-05-01 00:00:00

  • Challenging presumptions: is reciprocal inhibition truly reciprocal? A study of reciprocal inhibition between knee extensors and flexors in humans.

    abstract::Reciprocal inhibition (RI) between different muscles has been used as an explanation for the effect of some treatments. Consequently, there may be a presumption that RI is bi-directional and equal between every agonist antagonist muscle pair. That is, the strength of RI from agonist to antagonist is equal to that from...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1016/j.math.2010.03.004

    authors: Hamm K,Alexander CM

    更新日期:2010-08-01 00:00:00

  • Effects of passive correction of scapular position on pain, proprioception, and range of motion in neck-pain patients with bilateral scapular downward-rotation syndrome.

    abstract::The effects of passive correction of scapular position (PCSPT) on pain, proprioception, and range of motion (ROM) were investigated in neck-pain patients with bilateral scapular downward-rotation (SDR). Fifteen neck-pain patients with bilateral SDR were recruited from a workplace based work-conditioning center. The in...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1016/j.math.2011.05.011

    authors: Ha SM,Kwon OY,Yi CH,Jeon HS,Lee WH

    更新日期:2011-12-01 00:00:00

  • What do patients value about spinal manipulation and home exercise for back-related leg pain? A qualitative study within a controlled clinical trial.

    abstract:BACKGROUND:Patient perceptions may influence the effectiveness and utilization of healthcare interventions, particularly for complex health conditions such as sciatica or back-related leg pain (BRLP). OBJECTIVES:To explore BRLP patients' perceptions of spinal manipulative therapy (SMT) and home exercise with advice (H...

    journal_title:Manual therapy

    pub_type: 临床试验,杂志文章

    doi:10.1016/j.math.2016.09.008

    authors: Maiers M,Hondras MA,Salsbury SA,Bronfort G,Evans R

    更新日期:2016-12-01 00:00:00

  • The assessment of vibration sense in the musculoskeletal examination: Moving towards a valid and reliable quantitative approach to vibration testing in clinical practice.

    abstract::Impairment of vibration sense is an early sign of nerve pathology. A range of devices can evaluate vibration sense, with moderate to excellent reliability demonstrated for the Somedic Vibrameter. However, devices are expensive and time-consuming for use in practice, and tuning forks are used but not supported by rigor...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1016/j.math.2011.01.008

    authors: O' Conaire E,Rushton A,Wright C

    更新日期:2011-06-01 00:00:00

  • High variability of the subjective visual vertical test of vertical perception, in some people with neck pain - Should this be a standard measure of cervical proprioception?

    abstract:BACKGROUND:Subjective visual vertical (SVV) assesses visual dependence for spacial orientation, via vertical perception testing. Using the computerized rod-and-frame test (CRFT), SVV is thought to be an important measure of cervical proprioception and might be greater in those with whiplash associated disorder (WAD), b...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1016/j.math.2014.08.005

    authors: Treleaven J,Takasaki H

    更新日期:2015-02-01 00:00:00

  • The central nervous system--an additional consideration in 'rotator cuff tendinopathy' and a potential basis for understanding response to loaded therapeutic exercise.

    abstract::Tendinopathy is a term used to describe a painful tendon disorder but despite being a well-recognised clinical presentation, a definitive understanding of the pathoaetiology of rotator cuff tendinopathy remains elusive. Current explanatory models, which relate to peripherally driven nocioceptive mechanisms secondary t...

    journal_title:Manual therapy

    pub_type: 杂志文章,评审

    doi:10.1016/j.math.2013.07.005

    authors: Littlewood C,Malliaras P,Bateman M,Stace R,May S,Walters S

    更新日期:2013-12-01 00:00:00

  • Orofacial manual therapy improves cervical movement impairment associated with headache and features of temporomandibular dysfunction: a randomized controlled trial.

    abstract::There is evidence that temporomandibular disorder (TMD) may be a contributing factor to cervicogenic headache (CGH), in part because of the influence of dysfunction of the temporomandibular joint on the cervical spine. The purpose of this randomized controlled trial was to determine whether orofacial treatment in addi...

    journal_title:Manual therapy

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.math.2012.12.005

    authors: von Piekartz H,Hall T

    更新日期:2013-08-01 00:00:00

  • Assessment of pelvic floor muscle function in women with and without low back pain using transabdominal ultrasound.

    abstract::Pelvic floor muscle (PFM) dysfunction has been recently associated with the development of low back pain (LBP). Transabdominal ultrasound imaging has been established as an appropriate method for visualizing and measuring PFM function. No study has directly evaluated PFM function in individuals with and without LBP. T...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1016/j.math.2009.12.005

    authors: Arab AM,Behbahani RB,Lorestani L,Azari A

    更新日期:2010-06-01 00:00:00

  • Development of a data collection tool to profile osteopathic practice: use of a nominal group technique to enhance clinician involvement.

    abstract:INTRODUCTION:Little is known about the profile of osteopathic care in the United Kingdom (UK). To address this, a standardised data collection (SDC) tool was developed to record patient-based data within private practice. METHODS:The development of the SDC tool took place within a national network of research groups (...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1016/j.math.2013.08.006

    authors: Fawkes CA,Leach CM,Mathias S,Moore AP

    更新日期:2014-04-01 00:00:00

  • What do physiotherapists consider to be the best sitting spinal posture?

    abstract::While sitting is a common aggravating factor in low back pain (LBP), the best sitting posture remains unclear. This study investigated the perceptions of 295 physiotherapists in four different European countries on sitting posture. Physiotherapists selected their perceived best sitting posture from a sample of nine op...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1016/j.math.2012.04.007

    authors: O'Sullivan K,O'Sullivan P,O'Sullivan L,Dankaerts W

    更新日期:2012-10-01 00:00:00

  • Diagnosis and classification of chronic low back pain disorders: maladaptive movement and motor control impairments as underlying mechanism.

    abstract::Low back pain (LBP) is a very common but largely self-limiting condition. The problem arises however, when LBP disorders do not resolve beyond normal expected tissue healing time and become chronic. Eighty five percent of chronic low back pain (CLBP) disorders have no known diagnosis leading to a classification of 'no...

    journal_title:Manual therapy

    pub_type: 杂志文章,评审

    doi:10.1016/j.math.2005.07.001

    authors: O'Sullivan P

    更新日期:2005-11-01 00:00:00

  • Shoulder pain: differential diagnosis with mechanical diagnosis and therapy extremity assessment - a case report.

    abstract::Mechanical Diagnosis and Therapy (MDT) is now probably the only non-specific classification system that can be used with both spinal and non-spinal patients. Derangement syndrome, which presents with rapid changes in symptoms or mechanical response with the use of repeated movements, appears to be common in both spina...

    journal_title:Manual therapy

    pub_type: 杂志文章,评审

    doi:10.1016/j.math.2012.06.011

    authors: Menon A,May S

    更新日期:2013-08-01 00:00:00

  • Outcomes of osteopathic manual treatment for chronic low back pain according to baseline pain severity: results from the OSTEOPATHIC Trial.

    abstract:PURPOSE:To assess response to osteopathic manual treatment (OMT) according to baseline severity of chronic low back pain (LBP). METHODS:The OSTEOPATHIC Trial used a randomized, double-blind, sham-controlled, 2×2 factorial design to study OMT for chronic LBP. A total of 269 (59%) patients reported low baseline pain sev...

    journal_title:Manual therapy

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.math.2013.05.006

    authors: Licciardone JC,Kearns CM,Minotti DE

    更新日期:2013-12-01 00:00:00

  • Voluntary activation of quadriceps femoris in patients with unilateral anterior cruciate ligament rupture within 6 months of injury: A cross-sectional observational study.

    abstract:BACKGROUND:Deficits in quadriceps femoris strength and voluntary activation have been well documented in chronic anterior cruciate ligament (ACL) injuries, but less is known about the acute or early phase after injury. OBJECTIVES:The aim of this study was to evaluate and compare the levels of quadriceps voluntary acti...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1016/j.math.2015.11.007

    authors: Trees A,Dixon J,Howe TE

    更新日期:2016-04-01 00:00:00

  • Does tape facilitate or inhibit the lower fibres of trapezius?

    abstract::The application of tape to the skin overlying the lower fibres of trapezius is generally thought to facilitate this muscle. However, this facilitation has not been thoroughly investigated. In this study, the effect of tape upon trapezius motoneurone pool excitability was assessed using the trapezius H reflex. The ampl...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1054/math.2002.0485

    authors: Alexander CM,Stynes S,Thomas A,Lewis J,Harrison PJ

    更新日期:2003-02-01 00:00:00

  • The validity of clinical measures of patella position.

    abstract::Patellar taping is regarded as an important element of the treatment of patellofemoral joint pain. Key to the successful use of patellar taping is the assessment of patella position. The reliability and validity of the techniques used to assess patella position has been questioned. The aim of the study was to assess t...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1016/j.math.2006.06.013

    authors: McEwan I,Herrington L,Thom J

    更新日期:2007-08-01 00:00:00

  • Neovascularity in patellar tendinopathy and the response to eccentric training: a case report using Power Doppler ultrasound.

    abstract::This report describes the case of an amateur soccer player with chronic patellar tendinopathy who underwent ultrasound imaging before and after engaging in an 8-week programme of eccentric exercise. On initial assessment, greyscale ultrasound imaging demonstrated tendon thickening and reduced echogenicity, while Power...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1016/j.math.2012.09.001

    authors: McCreesh KM,Riley SJ,Crotty JM

    更新日期:2013-12-01 00:00:00

  • Motion analysis study of a scapular orientation exercise and subjects' ability to learn the exercise.

    abstract::Exercises to retrain the orientation of the scapula are often used by physiotherapists to optimise shoulder girdle function. The movements and muscle activity required to assume this position have not yet been quantified. Further, patients often find this a difficult exercise to learn accurately, with no data being av...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1016/j.math.2007.07.008

    authors: Mottram SL,Woledge RC,Morrissey D

    更新日期:2009-02-01 00:00:00

  • A perspective for considering the risks and benefits of spinal manipulation in patients with low back pain.

    abstract::The purpose of this study was to determine if patients who do not receive manipulation for their low back pain (LBP) are at an increased risk for worsening disability compared to patients receiving an exercise intervention without manipulation. One hundred and thirty-one consecutive patients with LBP were randomly ass...

    journal_title:Manual therapy

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.math.2005.09.002

    authors: Childs JD,Flynn TW,Fritz JM

    更新日期:2006-11-01 00:00:00

  • An investigation into the effects of a unilaterally applied lumbar mobilisation technique on peripheral sympathetic nervous system activity in the lower limbs.

    abstract::Physiotherapeutic management of lumbar disorders often utilises specific segmental joint mobilisation techniques; however, there is only limited evidence of any neurophysiological effects and much of this has focused on the cervical spine and upper limbs. This study aims to extend the knowledge base underpinning the u...

    journal_title:Manual therapy

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.math.2007.05.015

    authors: Perry J,Green A

    更新日期:2008-12-01 00:00:00

  • Conceptual models for implementing biopsychosocial theory in clinical practice.

    abstract::The integration of the biopsychosocial model into manual therapy practice is challenging for clinicians, especially for those who have not received formal training in biopsychosocial theory or its application. In this masterclass two contemporary models of health and disability are presented along with a model for org...

    journal_title:Manual therapy

    pub_type: 杂志文章,评审

    doi:10.1054/math.2001.0426

    authors: Jones M,Edwards I,Gifford L

    更新日期:2002-02-01 00:00:00

  • Initial development of a device for controlling manually applied forces.

    abstract:UNLABELLED:In both simulation and manual therapy studies, substantial variability has been shown when therapists attempt to replicate an applied force. Knowledge about the forces employed during treatment could reduce this variability. In the current project, a prototype for a mobilizing device incorporating a dynamome...

    journal_title:Manual therapy

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.math.2006.06.009

    authors: Waddington GS,Adams RD

    更新日期:2007-05-01 00:00:00

  • An exploration of familial associations in spinal posture defined using a clinical grouping method.

    abstract::The primary aim of this study was to examine familial associations in spinal posture, defined using postural angles and a clinical classification method. A secondary aim was to investigate the reliability of clinical postural classification. Postural angles were calculated from sagittal photographs, while two experien...

    journal_title:Manual therapy

    pub_type: 临床试验,杂志文章

    doi:10.1016/j.math.2011.05.002

    authors: Seah SH,Briggs AM,O'Sullivan PB,Smith AJ,Burnett AF,Straker LM

    更新日期:2011-10-01 00:00:00

  • Effectiveness of the end-range mobilization and scapular mobilization approach in a subgroup of subjects with frozen shoulder syndrome: a randomized control trial.

    abstract::Treatment strategies targeting abnormal shoulder kinematics may prevent pathology or if the pathology develops, shorten its duration. We examined the effectiveness of the end-range mobilization/scapular mobilization treatment approach (EMSMTA) in a subgroup of subjects with frozen shoulder syndrome (FSS). Based on the...

    journal_title:Manual therapy

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.math.2011.08.006

    authors: Yang JL,Jan MH,Chang CW,Lin JJ

    更新日期:2012-02-01 00:00:00

  • Pelvic girdle pain, clinical tests and disability in late pregnancy.

    abstract::The objective of this cross-sectional study was to explore the associations between pain locations, responses to the posterior pelvic pain provocation (P4) test, responses to the active straight leg raise (ASLR) test and disability in late pregnancy. 283 women in gestation week 30 (mean age 31.3 years; 59% nullipara) ...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1016/j.math.2010.01.006

    authors: Robinson HS,Mengshoel AM,Bjelland EK,Vøllestad NK

    更新日期:2010-06-01 00:00:00

  • Cranio-cervical flexor muscle impairment at maximal, moderate, and low loads is a feature of neck pain.

    abstract::Impairment of the cranio-cervical flexor (CCF) muscles is a feature of painful cervical spine disorders. The aim of this study was to investigate if CCF muscle impairment is present over a range of contraction intensities (maximal, moderate, low) in neck pain sufferers compared to individuals with no history of neck p...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1016/j.math.2006.02.010

    authors: O'Leary S,Jull G,Kim M,Vicenzino B

    更新日期:2007-02-01 00:00:00

  • The influence of high and low heeled shoes on EMG timing characteristics of the lumbar and hip extensor complex during trunk forward flexion and return task.

    abstract:BACKGROUND:Recent studies suggest that wearing high-heel shoes increases the risk of developing certain musculoskeletal pain conditions. In this study we sought to examine whether heel height alters lumbar and hip extensor muscle timing characteristics during a standardized trunk flexion task. METHODS:Thirty-one young...

    journal_title:Manual therapy

    pub_type: 杂志文章

    doi:10.1016/j.math.2013.03.004

    authors: Mika A,Clark BC,Oleksy Ł

    更新日期:2013-12-01 00:00:00