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Predictors of clinical success with stabilization exercise are associated with lower levels of lumbar multifidus intramuscular adipose tissue in patients with low back pain

Hebert, J.J., Le Cara, E.C., Koppenhaver, S.L., Hoffman, M.D., Marcus, R.L., Dempsey, A.R. and Albert, W.J. (2018) Predictors of clinical success with stabilization exercise are associated with lower levels of lumbar multifidus intramuscular adipose tissue in patients with low back pain. Disability and Rehabilitation . In Press.

Link to Published Version: https://doi.org/10.1080/09638288.2018.1506510
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Abstract

Purpose: Investigate the construct validity of prognostic factors purported to predict clinical success with stabilization exercise for low back pain by exploring their associations with lumbar multifidus composition.

Methods: Patients with low back pain were recruited from a hospital imaging department. The presence of fivepredictors (age <40 years, positive prone instability test, aberrant trunk flexion movements, straight leg raise range of motion >91°, spinal hypermobility) were identified by standardized physical examination. Predictors were grouped by total positive findings and status on a clinical prediction rule. The proportion of lower lumbar multifidus intramuscular adipose tissue was measured with 3.0 T magnetic resonance imaging. Univariate and multivariate associations were examined with linear regression and reported with standardized beta coefficients (β) and 95% confidence intervals.

Results: Data from 62 patients (11 female) with mean (SD) age of 45.2 (11.8) years were included. Total number of predictors (β[95% CI] = −0.37[−0.61,−0.12]; R2 = 0.12), positive prediction rule status (β[95% CI] = −0.57[−0.79,−0.35]; R2 = 0.30), and age <40 years were associated with lower intramuscular adipose tissue (β[95% CI] = −0.55[−0.77,−0.33]; R2 = 0.27). No other individual factors were associated with lumbar multifidus intramuscular adipose tissue.

Conclusions: These findings support the construct validity of the grouped prognostic criteria. Future research should examine the clinical utility of these criteria.

Publication Type: Journal Article
Murdoch Affiliation: School of Psychology and Exercise Science
Publisher: Taylor & Francis
Copyright: © 2018 Informa UK Limited
URI: http://researchrepository.murdoch.edu.au/id/eprint/42899
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