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Lumbar muscle dysfunction during remission of unilateral recurrent nonspecific low-back pain: evaluation with muscle functional MRI

Roseline D'hooge UGent, Barbara Cagnie UGent, Geert Crombez UGent, Guy Vanderstraeten UGent, Eric Achten UGent and Lieven Danneels UGent (2013) CLINICAL JOURNAL OF PAIN. 29(3). p.187-194
abstract
Objectives: After cessation of a low back pain (LBP) episode, alterations in trunk muscle behavior despite recovery from pain have been hypothesized to play a pathogenic role in recurrence of LBP. This study aimed to identify the presence of lumbar muscle dysfunction during remission of recurrent LBP, while performing a low-load trunk extension movement. Methods: Thirteen participants with unilateral recurrent LBP were tested at least one month after cessation of the previous LBP episode and were compared to a healthy control group without any history of LBP (n=13). Also, differences between previously painful and non-painful sides were examined. Muscle functional magnetic resonance imaging (MRI), based on quantitative T2-imaging, was used to examine muscle tissue characteristics (T2-rest), and muscle recruitment (T2-shift) during prone trunk extension. The lumbar Multifidus (MF), Erector Spinae (ES), Quadratus Lumborum (QL) and Psoas (PS) were bilaterally visualized on 2 lumbar levels using a T2-weighted (spin-echo multi-contrast, SE_MC) MRI-sequence. Results: Linear Mixed Model analysis revealed a significantly lower T2-rest (p=0.044) and a significantly higher T2-shift (p=0.034) solely for the MF in the LBP group compared to the control group. No significant differences between pain-sides were found. Discussion: Lower T2-rest values have been suggested to correlate with a conversion of the MF fiber typing towards the glycolytic muscle spectrum. Elevated T2-shifts correspond with increased levels of metabolic activity in the MF in the LBP group, for which several hypotheses can be put forward. Taken together, these findings provide innovative evidence of concurrent alterations in Multifidus structure and activity in individuals with unilateral recurrent LBP, despite being pain-free and functionally recovered.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
MULTIFIDUS MUSCLE, muscle functional magnetic resonance imaging, trunk extension, low-back pain, lumbar paraspinal muscles, recurrence, TRUNK MUSCLES, SKELETAL-MUSCLE, FIBER-TYPE, SPINE, ACTIVATION, STABILITY, RECOVERY, INCREASE, NMR
journal title
CLINICAL JOURNAL OF PAIN
Clin. J. Pain
volume
29
issue
3
pages
187 - 194
Web of Science type
Article
Web of Science id
000314630600001
JCR category
ANESTHESIOLOGY
JCR impact factor
2.703 (2013)
JCR rank
8/29 (2013)
JCR quartile
2 (2013)
ISSN
0749-8047
DOI
10.1097/AJP.0b013e31824ed170
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
3035148
handle
http://hdl.handle.net/1854/LU-3035148
date created
2012-10-26 13:13:01
date last changed
2015-06-17 10:17:27
@article{3035148,
  abstract     = {Objectives: After cessation of a low back pain (LBP) episode, alterations in trunk muscle behavior despite recovery from pain have been hypothesized to play a pathogenic role in recurrence of LBP. This study aimed to identify the presence of lumbar muscle dysfunction during remission of recurrent LBP, while performing a low-load trunk extension movement. Methods: Thirteen participants with unilateral recurrent LBP were tested at least one month after cessation of the previous LBP episode and were compared to a healthy control group without any history of LBP (n=13). Also, differences between previously painful and non-painful sides were examined. Muscle functional magnetic resonance imaging (MRI), based on quantitative T2-imaging, was used to examine muscle tissue characteristics (T2-rest), and muscle recruitment (T2-shift) during prone trunk extension. The lumbar Multifidus (MF), Erector Spinae (ES), Quadratus Lumborum (QL) and Psoas (PS) were bilaterally visualized on 2 lumbar levels using a T2-weighted (spin-echo multi-contrast, SE\_MC) MRI-sequence. Results: Linear Mixed Model analysis revealed a significantly lower T2-rest (p=0.044) and a significantly higher T2-shift (p=0.034) solely for the MF in the LBP group compared to the control group. No significant differences between pain-sides were found. Discussion: Lower T2-rest values have been suggested to correlate with a conversion of the MF fiber typing towards the glycolytic muscle spectrum. Elevated T2-shifts correspond with increased levels of metabolic activity in the MF in the LBP group, for which several hypotheses can be put forward. Taken together, these findings provide innovative evidence of concurrent alterations in Multifidus structure and activity in individuals with unilateral recurrent LBP, despite being pain-free and functionally recovered.},
  author       = {D'hooge, Roseline and Cagnie, Barbara and Crombez, Geert and Vanderstraeten, Guy and Achten, Eric and Danneels, Lieven},
  issn         = {0749-8047},
  journal      = {CLINICAL JOURNAL OF PAIN},
  keyword      = {MULTIFIDUS MUSCLE,muscle functional magnetic resonance imaging,trunk extension,low-back pain,lumbar paraspinal muscles,recurrence,TRUNK MUSCLES,SKELETAL-MUSCLE,FIBER-TYPE,SPINE,ACTIVATION,STABILITY,RECOVERY,INCREASE,NMR},
  language     = {eng},
  number       = {3},
  pages        = {187--194},
  title        = {Lumbar muscle dysfunction during remission of unilateral recurrent nonspecific low-back pain: evaluation with muscle functional MRI},
  url          = {http://dx.doi.org/10.1097/AJP.0b013e31824ed170},
  volume       = {29},
  year         = {2013},
}

Chicago
D’hooge, Roseline, Barbara Cagnie, Geert Crombez, Guy Vanderstraeten, Eric Achten, and Lieven Danneels. 2013. “Lumbar Muscle Dysfunction During Remission of Unilateral Recurrent Nonspecific Low-back Pain: Evaluation with Muscle Functional MRI.” Clinical Journal of Pain 29 (3): 187–194.
APA
D’hooge, R., Cagnie, B., Crombez, G., Vanderstraeten, G., Achten, E., & Danneels, L. (2013). Lumbar muscle dysfunction during remission of unilateral recurrent nonspecific low-back pain: evaluation with muscle functional MRI. CLINICAL JOURNAL OF PAIN, 29(3), 187–194.
Vancouver
1.
D’hooge R, Cagnie B, Crombez G, Vanderstraeten G, Achten E, Danneels L. Lumbar muscle dysfunction during remission of unilateral recurrent nonspecific low-back pain: evaluation with muscle functional MRI. CLINICAL JOURNAL OF PAIN. 2013;29(3):187–94.
MLA
D’hooge, Roseline, Barbara Cagnie, Geert Crombez, et al. “Lumbar Muscle Dysfunction During Remission of Unilateral Recurrent Nonspecific Low-back Pain: Evaluation with Muscle Functional MRI.” CLINICAL JOURNAL OF PAIN 29.3 (2013): 187–194. Print.