Gender Differences in Spinal Morphological Attributes among Young Adults: A Preliminary Study / Jurnal Sains Kesihatan Malaysia

There is limited information regarding gender differences in spinal morphological attributes among healthy young adultsalthough alterations have been reported to influence postural changes, mainly with forward-bending and extensionpostures. The aim of this preliminary study was to examine gender differences in spinal morphological attributes oflumbar extensor muscles that includes its muscle fibre angles, thickness, endurance and thoracolumbar curvature amongyoung adults. Nineteen male and 26 female healthy young adults (aged 21-24 years) matched for age, body mass indexand physical activity levels participated in this preliminary study. Fibre angles and thickness of lumbar extensor muscleswere examined using ultrasonography. Lumbar extensor muscle endurance and thoracolumbar curvatures were assessedusing Sorenson’s test and a flexible ruler respectively. Paired t-test showed a significant mean difference (p < 0.01)between the right and left fibre angles. However, no significant mean difference (p = 0.50) was found between the rightand left muscle thickness. Results of independent t-test showed a significant difference (p < 0.01) in muscle thicknessbetween males and females. No significant differences were shown in right fibre angle (p = 0.12), left fibre angle (p =0.89), muscle endurance (p = 0.46), thoracic curvature (p = 0.76) and lumbar curvature (p = 0.06) between genders.There were no gender differences in spinal morphological attributes except for lumbar extensor muscle thickness inyoung adults age between 21 to 24. This study data may be useful as an initial reference norm of spinal morphologicalattributes among young adults. Further studies may be required to examine the factors that may influence changes inspinal morphological attributes among healthy adults.

Relationship between Lumbar Extensor Muscle Degeneration Classification and Osteoporotic Vertebral Compression Fracture

STUDY DESIGN: Retrospective study. OBJECTIVES: To investigate the reliability of the lumbar extensor muscle degeneration classification as an indicator of potential risk for osteoporotic vertebral compression fractures (OVCF). SUMMARY OF LITERATURE REVIEW: Fatty degeneration of lumbar extensor muscles has attracted increased interest in the literature as a risk factor for OVCF. MATERIALS AND METHODS: Ninety-one patients with OVCF (group 1) and 60 patients without OVCF (group 2) were investigated. Magnetic resonance imaging was used to measure and to analyze the muscle mass and fatty degeneration of the lumbar extensor muscle. The degree of fatty degeneration of the lumbar extensor muscle was classified into 4 stages: less than 10%, 10%–25%, 25%–50%, and more than 50%. RESULTS: Fatty degeneration of the lumbar extensor muscle and the bone mineral density T-score were 29.66%±12.28% and −3.56±1.13 in group 1 and 24.04%±13.29% and −2.27±1.46 in group 2, which were statistically significant differences (p < 0.05). Logistic regression analysis revealed that as the fatty degeneration of the lumbar extensor muscle increased, the risk of OVCF increased (odds ratio [OR]=1.21; p=0.01). The risk of OVCF increased as the lumbar extensor muscle degeneration classification scores increased (OR=13.53; p=0.02). Furthermore, as the muscle mass of the multifidus decreased, lumbar lordosis and sacral inclination decreased (β=0.33; p=0.01 and β=0.25; p=0.04, respectively). However, no factor affected thoracic kyphosis. CONCLUSIONS: Fatty degeneration of the lumbar extensor muscle was correlated with OVCF. A lumbar extensor muscle degeneration classification higher than stage 3 should be considered a risk factor of OVCF.

Comparisons of Spinal Stabilization Exercise and Lumbar Extensor Strengthening Exercise in Chronic Low Back Pain

OBJECTIVE: To compare the effects of spinal stabilization exercise against with lumbar extensor strengthening exercise. METHOD: Sixty patients with chronic low back pain were enrolled into the study and randomly classified into three groups. Groups were treated with spinal stabilization exercise (Group 1), lumbar extensor strengthening exercise using a MedX machine (Group 2), or with a combination program (Group 3) for 8 weeks. Patients were not given any other treatment modalities. Isometric peak torque of the lumbar extensors, pain rating score (PRS), Medical Outcomes Study Short Form-36 (SF-36) score, and the Oswestry low back pain disability questionnaire (OLBPD-Q) were assessed at 0, 4, and 8 weeks of exercise. RESULTS: 1) After 8 weeks, all groups showed incremental improvements in maximal isometric torque of the lumbar extensors and exhibited improvement in SF-36, PRS, and OLBD-Q scores (p<0.05). 2) There were no significant differences in the degree of improvement among the three groups after 8 weeks of exercise. 3) The percentage of patients with scores of good or excellent in Group 3 was higher than in Groups 1 and 2 according to all evaluation tools. CONCLUSION: In the treatment of chronic low back pain, all exercise groups showed decreased pain, improved quality of life, and increased lumbar extensor strength regardless of the exercise type employed. We suggest that exercise programs in general are effective for the treatment of chronic low back pain and a combination exercise program seems to be most beneficial.

The Effect of Back Extensor Strengthening Exercise on Chronic Low Back Pain and Bone Mineral Density

OBJECTIVE: To evaluate the effects of back extensor strengthening exercise on improving the pain, activities of daily living (ADL) and bone mineral density in the chronic low back pain patients. METHOD: 21 patients with chronic low back pain participated in back school program. Before program, measurement of lumbar extensor strength with MedX(R) (Ocala, USA), visual analogue scale (VAS) for pain, level of ADL and bone mineral density (BMD) with DEXA (Lunar(R), GE, USA) were done. For 12 weeks subjects had received the training for strengthening of back extensor and then, checked up with the above variables again. RESULTS: The results were as follows: 1) After 12 weeks of lumbar extensor strengthening program, isometric lumbar extensor strength was increased significantly (p<0.01), 2) VAS and ADL were significantly improved from 5.1 to 3.3, and 8.1 to 9.9, respectively (p<0.01), 3) BMD of lumbar spine were significantly improved from 1.1 to 0.8 (p<0.05) CONCLUSION: Twelve weeks lumbar extensor strengthening program with pelvic stabilization may be the effective therapeutic program for patients with chronic low back pain.

Effect of Lumbar Extensor Strengthening in Chronic Low Back Pain Patients

OBJECTIVE: To evaluate the effects of strengthening exercise for isolated lumbar extensor muscles on chronic low back pain patients. METHOD: 28 patients with chronic low back pain in back school program participated in this study. Initially, isometric lumbar extensor strength, 10 point of Visual analog scale (VAS) and questionnaires related to self-experienced symptoms and daily activity (ADL) were checked. Isometric lumbar extensor strength test and strengthening exercise were performed with MedXTM lumbar extensor machine, which was designed to stabilize the pelvis. After 8 weeks of training program, isometric lumbar extensor strength & other pain related variables were checked again in the same way. RESULTS: The results were as follows: 1) After 8 weeks of lumbar extensor strengthening program, isometric lumbar extensor strength was increased at all the measured points significantly (p<0.01). 2) VAS and ADL were improved from 6.7 to 3.7, and from 6.9 to 9.1 respectively (p<0.05). CONCLUSION: 8 weeks of lumbar extensor strengthening program with pelvic stabilization was effective therapeutic tools for patients with chronic low back pain.