BACKGROUND AND OBJECTIVE

Low back pain is one of the most common work-related musculoskeletal disorders. Healthcare workers are prone to low back pain because of the nature of their profession. Low back pain may be related to lumbar multifidi atrophy or instability and poor core stability. Core stability can be assessed using the unilateral hip bridge endurance test. This cross-sectional study aims to determine the correlation between unilateral hip bridge endurance (UHBE) and sonologic characteristics of the bilateral L4-L5 lumbar multifidus muscles of physically active allied healthcare professionals.

Forty (40) physically active healthcare professionals (mean age = 31.3 ± 6.39 years, mean height = 161.17 ± 8.45 cm, mean weight = 61.88 ± 13.58 kg, mean BMI = 23.61 ± 3.68 kg/m2) were recruited via purposive sampling. The participants answered online versions of the Global Physical Activity Questionnaire (GPAQ) and Oswestry Disability Index. They subsequently underwent the UHBE test and ultrasound assessment of the L4-L5 multifidi. Multiplied anteroposterior (AP) and lateral linear (L) measurements were used to estimate L4-L5 multifidi size. The Pearson test was used to test for correlation between the primary outcomes of the study.

There was no statistically significant correlation between Lumbar Multifidi CSA and UHBE Scores (r = -0.172, p > 0.05), and between Lumbar Multifidi CSA% Difference and UHBE Scores (r = -0.140, p > 0.05). However, results showed a very weak negative correlation between the Lumbar Multifidi CSA% Difference and UHBE Scores.

There is no definite evidence showing a correlation between core stability tests such as the unilateral hip bridge test scores and sonologic characteristics of the lumbar multifidi. However, lumbar multifidi symmetry may have a role with core stability. The correlation between core stability tests and lumbar multifidus morphology should be further investigated.

PURPOSE: This study examined the effectiveness of iliopsoas self-stretching on the hip extension angle, gluteus maximus (GM) activity, and pelvic compensated angle during prone hip extension (PHE) in subjects with iliopsoas shortness. METHODS: Twenty-healthy subjects with iliopsoas shortness were recruited. Electromyography (EMG) was used to examine erector spinae (ES), multifidus (MF), GM, and biceps femoris (BF) while performing PHE. An electromagnetic tracking motion analysis device was used to measure the pelvic compensations. The pelvic compensations while performing PHE were considered to be anterior tilting and rotation. A modified Thomas test was used to monitor the hip extension angle before and after iliopsoas self-stretching. A paired t-test was used to investigate the significant difference after iliopsoas self-stretching during PHE. The level of statistical significance was set to α=0.05. RESULTS: Muscle activity of GM and hip extension angle were significantly greater after iliopsoas self-stretching compared to that before iliopsoas self-stretching during PHE (p < 0.05). BF and pelvic rotation angle were significantly lower after iliopsoas self-stretching compared to that before iliopsoas self-stretching during PHE (p < 0.05). The muscle activity of ES was not significantly different between PHE before and after iliopsoas self-stretching (p>0.05). CONCLUSION: Iliopsoas self-stretching can be effective in selectively strengthening the GM muscles with minimized pelvic compensation in subjects with iliopsoas shortness.
Compensation and Redress ; Electromyography ; Hip ; Magnets ; Muscles ; Paraspinal Muscles

PURPOSE: This study was conducted to investigate the effects of blood flow restriction and different support surfaces for bridge exercises on the thickness of the transverse abdominis and multifidus, which are trunk-stabilizing muscles. METHODS: The study's subjects were 45 adults who were divided into three groups that performed bridge exercises over a six-week period on their respective support surfaces after blood flow restriction. Changes in the thickness of the subjects' transverse abdominis and multifidus muscles were measured using ultrasonography before the experiment, then three and six weeks after the experiment. The changes in each variable over time were analyzed using a repeated-measures analysis of variance (ANOVA). RESULTS: The transverse abdominis showed significant differences in muscle thickness with regard to time and the interaction between time and each group (p<0.05), but no significant differences with regard to changes among groups (p>0.05). The multifidus showed significant differences in muscle thickness with regard to time, the interaction between time and each group, and changes between groups (p<0.05). CONCLUSION: Blood flow restriction and different support surfaces for bridge exercises led to significant differences in the thickness of the transverse abdominis and multifidus. This study's results may be used as the basis for future studies and for rehabilitation in clinical practice.
Adult ; Exercise ; Humans ; Muscles ; Paraspinal Muscles ; Rehabilitation ; Ultrasonography

OBJECTIVE: To determine the optimal number of muscles to detect lumbosacral radiculopathies. METHOD: Electrodiagnostic data of 152 patients who had been diagnosed as lumbosacral radiculopathy with the findings of operative record were obtained retrospectively. The findings of needle electromyography were reviewed and the frequency of abnormal spontaneous activities in L5 and S1 myotomes was investigated. We selected 8 individual muscles which had high sampling rate. These muscles were combined into different muscle screens and the detection rates were calculated that the frequency with which one or more muscles in the screen displayed abnormal spontaneous activity was divided by the total number of radiculopathies. RESULTS: The detection rates of lumbosacral radiculopathy were compared according to the number of muscle screens. Including paraspinal muscle, the detection rate of 6 muscle screens was higher than 5 muscle screens (p<0.05), but there was no significant difference of detection rate between 6 muscle screens and 7 muscle screens. The detection rates of each muscle screens without paraspinal muscle were lower than those including paraspinal muscle for all screens (p<0.05). CONCLUSION: Although there is controversy about selection of muscles, six muscle screen including paraspinal muscles may be optimal number for detecting lumbosacral radiculopathy.
Electromyography ; Humans ; Muscles* ; Needles ; Paraspinal Muscles ; Radiculopathy* ; Retrospective Studies

PURPOSE: To investigate whether bone mineral density(BMD) occurs in association with fatty replacement oflower paraspinal muscles and whether it relates with the area ratio(Ps/V) of psoas muscle(Ps) divided by adjacentvertebral body(V). MATERIALS AND METHODS: For the evaluation of osteoporosis, 100 females underwent quantitativeCT. At L1,L2 and L3 levels, the fatty replacement of lower paraspinal muscles was numerically graded and therelationship between this and BMD of the vertebral body was evaluated. The correlation between BMD and Ps/V at L2and L3 levels was also evaluated, as was the relationship between the thickness of subcutaneous fat tissue at L1,L2 and L3 levels. RESULTS: BMD showed significant inverse correlations with the grade of the fatty replacement oflower paraspinal muscles at L1(p<.01), L2 level and L3 level(p<.001). In particular, significant differenceswere established between grade 0 and 2 (p<.05) at L1 level, and between grade 0 and 2, and 1 and 2 (p<.05) at L2and L3 levels. There was markedly low correlation (gamma=.33) between BMD and Ps/V at L3 level(p<.001) and lowercorrelation (gamma=.22) at L2 level(p<.05). At L2 and L3 levels, there was no correlation between the thickness ofsubcutanous fat tissue and BMD or Ps/V. CONCLUSION: The present study demonstrates that there was significantinverse correlation between BMD and fatty replacement of lower paraspinal muscles, and low correlation between BMDand Ps/V.
Bone Density* ; Female ; Humans ; Osteoporosis ; Paraspinal Muscles* ; Spine* ; Subcutaneous Fat

Analgesia ; Anesthetics, Local ; Humans ; Nephrolithotomy, Percutaneous ; Nerve Block ; Paraspinal Muscles

OBJECTIVE: To investigate changes in lumbar multifidus (LM) and deep lumbar stabilizing abdominal muscles (transverse abdominis [TrA] and obliquus internus [OI]) during transcutaneous neuromuscular electrical stimulation (NMES) of lumbar paraspinal L4-L5 regions using real-time ultrasound imaging (RUSI). METHODS: Lumbar paraspinal regions of 20 healthy physically active male volunteers were stimulated at 20, 50, and 80 Hz. Ultrasound images of the LM, TrA, OI, and obliquus externus (OE) were captured during stimulation at each frequency. RESULTS: The thicknesses of superficial LM and deep LM as measured by RUSI were greater during NMES than at rest for all three frequencies (p<0.05). The thicknesses in TrA, OI, and OE were also significantly greater during NMES of lumbar paraspinal regions than at rest (p<0.05). CONCLUSION: The studied transcutaneous NMES of the lumbar paraspinal region significantly activated deep spinal stabilizing muscle (LM) and the abdominal lumbar stabilizing muscles TrA and OI as evidenced by RUSI. The findings of this study suggested that transcutaneous NMES might be useful for improving spinal stability and strength in patients having difficulty initiating contraction of these muscles.
Abdominal Muscles ; Electric Stimulation* ; Humans ; Male ; Muscles* ; Paraspinal Muscles ; Ultrasonography ; Volunteers

OBJECTIVE: To measure lumbar multifidus muscles by ultrasonography and to study its correlation with the isometric peak touque of back. METHOD: Bilateral L5 and S1 multifidus muscle sizes of 18 healthy volunteers were measured in prone position by ultrasonography with 7.5 MHz, 40 mm-length probe. Multifidus muscles were identified using anatomic landmark-spinous process and lamina and vertical and horizontal diameter were measured. Boundary of muscle was traced and cross sectional area was measured. Lumbar spinal range of motion (ROM) and isometric peak torque of three axes-flexion/ extension, rotation and lateral flexion-were measured by Isostation B-200R back muscle tester. RESULTS: Multifidus muscle cross sectional areas were well correlated with isometric peak torque in all direction of movements. Muscle size and lumbar spine ROM showed no correlation. CONCLUSION: Ultrasonographic measure of lumbar multifidus muscles could be a useful tool to estimate back muscle function.
Back Muscles ; Healthy Volunteers ; Muscles* ; Paraspinal Muscles* ; Prone Position ; Range of Motion, Articular ; Spine ; Torque* ; Ultrasonography

Electrodiagnostic studies were carried out in 31 patients with neurological complications of AHC, who were seen at Seoul National University Hospital from August 1981 to February 1982. Age of the patients ranged from 14 to 62 years. Both velocity and distal latency of motor and sensory conduction were normal in the nerves innervating the affected muscles. During the acute phase of motor paralysis, there was an absence of electrical activity in completely paralysed muscles. In partially denervated muscles, there were polyphasic motor unit potentials of normal duration and amplitrde on weak contraction and reduced interference on maximal effort. From the third or fourth week onwards, fibrillation potentials and positive sharp waves at rest were observed in paraspinal muscles in most cases. All the above findings were supporting the view that the principal site of involvement for the paralytic phenomena is at the level of the anterior horn cells or anterior roots.
Anterior Horn Cells ; Conjunctivitis, Acute Hemorrhagic* ; Humans ; Muscles ; Paralysis ; Paraspinal Muscles ; Seoul

OBJECTIVE: To investigate risk factors for S1 screw loosening after lumbosacral fusion, including spinopelvic parameters and paraspinal muscles. METHODS: We studied with 156 patients with degenerative lumbar disease who underwent lumbosacral interbody fusion and pedicle screw fixation including the level of L5-S1 between 2005 and 2012. The patients were divided into loosening and non-loosening groups. Screw loosening was defined as a halo sign larger than 1 mm around a screw. We checked cross sectional area of paraspinal muscles, mean signal intensity of the muscles on T2 weight MRI as a degree of fatty degeneration, spinopelvic parameters, bone mineral density, number of fusion level, and the characteristic of S1 screw. RESULTS: Twenty seven patients showed S1 screw loosening, which is 24.4% of total. The mean duration for S1 screw loosening was 7.3+/-4.1 months after surgery. Statistically significant risk factors were increased age, poor BMD, 3 or more fusion levels (p<0.05). Among spinopelvic parameters, a high pelvic incidence (p<0.01), a greater difference between pelvic incidence and lumbar lordotic angle preoperatively (p<0.01) and postoperatively (p<0.05). Smaller cross-sectional area and high T2 signal intensity in both multifidus and erector spinae muscles were also significant muscular risk factors (p<0.05). Small converging angle (p<0.001) and short intraosseous length (p<0.05) of S1 screw were significant screw related risk factors (p<0.05). CONCLUSION: In addition to well known risk factors, spinopelvic parameters and the degeneration of paraspinal muscles also showed significant effects on the S1 screw loosening.
Bone Density ; Humans ; Incidence ; Lumbosacral Region ; Magnetic Resonance Imaging ; Muscles ; Paraspinal Muscles* ; Risk Factors ; Spinal Fusion