Highlights
- •Greater intramuscular fat is found among older adults with chronic low back pain.
- •Multifidi quality is associated with physical function in adults with back pain.
- •Multifidi muscle size is not associated with physical function in older adults.
Abstract
Objective
To determine whether multifidi size, intramuscular fat, or both, are associated with
self-reported and performance-based physical function in older adults with and without
chronic low back pain (LBP).
Design
Case-control study.
Setting
Individuals participated in a standardized evaluation in a clinical laboratory and
underwent magnetic resonance imaging (MRI) of the lumbar spine at a nearby facility.
Participants
A volunteer sample of community-dwelling older adults (N=106), aged 60 to 85 years,
with (n=57) and without (n=49) chronic LBP were included in this secondary data analysis.
Intervention
Average right-left L5 multifidi relative (ie, total) cross-sectional area (CSA), muscle-fat
infiltration index (MFI) (ie, a measure of intramuscular fat), and relative muscle
CSA (rmCSA) (ie, total CSA minus intramuscular fat CSA) were determined from MRIs.
Linear regression modeling was performed with physical function measures as the dependent
variables. Age, sex, and body mass index were entered as covariates. The main effects
of L5 multifidi MFI and rmCSA, as well as their interaction with group assignment,
were compared as independent variables.
Main Outcome Measures
Medical Outcomes Study 36-Item Short-Form Health Survey physical functioning subscale,
timed Up and Go, gait speed, and fast stair descent performance.
Results
Interaction terms between L5 multifidi MFI and group assignment were found to be significant
contributors to the variance explained in all physical function measures (P≤.012). Neither the main effect nor the interaction with group assignment for L5 multifidi
rmCSA significantly contributed to the variance explained in any of the physical function
measures (P>.012).
Conclusions
Among older adults with chronic LBP of at least moderate intensity, L5 multifidi muscle
composition, but not size, may help to explain physical function.
Keywords
List of abbreviations:
BMI (body mass index), CSA (cross-sectional area), LBP (low back pain), MFI (muscle-fat infiltration index), MRI (magnetic resonance imaging), rCSA (relative cross-sectional area), rmCSA (relative muscle cross-sectional area), SF-36 PFS (Medical Outcomes Study 36-Item Short-Form Health Survey physical functioning subscale), TUG (timed Up and Go)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: August 30, 2016
Footnotes
Supported in part by the National Institutes of Health (grant no. 1K12HD055931-01); the Foundation for Physical Therapy PODS I/II; the Fellowship for Geriatric Research Award from the Academy of Geriatric Physical Therapy; the National Institute of Child Health and Human Development (grant no. R21 HD057274); the National Institute on Aging (grant no. 1R01AG041202-01); and National Institutes of Health (grant no. T32HD007490-15).
Disclosures: J.M.E. has a 35% ownership/investment interest in a medical consulting start up, Pain ID, LLC. The other authors have nothing to disclose.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
