Association between history and physical examination factors and change in lumbar multifidus muscle thickness after spinal manipulation in patients with low back pain

Authors

Shane L. Koppenhaver, U.S. Army-Baylor University, Murdoch University
Julie M. Fritz, University of Utah
Jeffery J. Hebert, Murdoch University
Greg N. Kawchuk, University of Alberta
Eric C. Parent, Murdoch University, Glenrose Rehabilitation Hospital
Norman W. Gill, U.S. Army-Baylor University
John D. Childs, Keesler Air Force BaseFollow
Deydre S. Teyhen, U.S. Army-Baylor University

Document Type

Article

Date of this Version

2012

Citation

Journal of Electromyography and Kinesiology 22, 2012

Comments

U.S Government work

Abstract

Understanding the clinical characteristics of patients with low back pain (LBP) who display improved lumbar multifidus (LM) muscle function after spinal manipulative therapy (SMT) may provide insight into a potentially synergistic interaction between SMT and exercise. Therefore, the purpose of this study was to identify the baseline historical and physical examination factors associated with increased contracted LM muscle thickness one week after SMT. Eighty-one participants with LBP underwent a baseline physical examination and ultrasound imaging assessment of the LM muscle during submaximal contraction before and one week after SMT. The relationship between baseline examination variables and 1-week change in contracted LMthickness was assessed using correlation analysis and hierarchicalmultiple linear regression. Four variables best predicted themagnitude of increases in contractedLMmuscle thickness afterSMT.When combined, these variables suggest that patients with LBP, (1) that are fairly acute, (2) have at least amoderately good prognosiswithout focal and irritable symptoms, and (3) exhibit signs of spinal instability, may be the best candidates for a combined SMT and lumbar stabilization exercise (LSE) treatment approach.