Spine stabilization exercises are not superior to flexion exercises for ultrasound-detected muscle thickness changes in patients with chronic low back pain and lumbar spondylolisthesis.

Abstract

Introduction: exercise programs can reduce pain and improve functionality in patients with degenerative spondylolisthesis and chronic low back pain. However, there is still no consensus surrounding the superiority of any specific routine for exercise-induced trophic changes of lumbar muscles. The aim was to compare the changes in the primary lumbar stabilizing muscle thickness after spine stabilization exercises and flexion exercises in patients with spondylolisthesis and chronic low back pain.

Material and methods: prospective, longitudinal and comparative study was carried out. Twenty-one treatment-naive patients with a diagnosis of both chronic low back pain and degenerative spondylolisthesis over the age of 50 were included. A physical therapist taught participants either spine stabilization exercises or flexion exercises to execute daily at home. The thickness of the primary lumbar muscles was measured through ultrasound (at rest and contraction) at baseline and three months. A Mann-Whitney U test and Wilcoxon signed-rank test were performed for comparisons, and Spearman's rank correlation coefficients were calculated for associations.

Results: we did not find statistically between the exercise programs: all patients presented significant changes in the thickness of the multifidus muscle but in none of the other evaluated muscles.

Conclusion: there is no difference between spine stabilization exercises and flexion exercises after three months in terms of the changes in muscle thickness evaluated by ultrasound.