Abstract
Purpose: Increased fatty infiltration in paraspinal muscles has been recognized as a feature of muscle quality loss in people with Low Back Pain (LBP) and is highly associated with the severity of LBP and dysfunction. Reducing fatty infiltration has been recognized as a rehabilitation aim. An earlier systematic review published in 2014 revealed conflicting evidence for the reversibility of paraspinal muscle quality by means of exercise and no updates have been published since. A new systematic literature search is warranted. Method: Pubmed, CINAHL and Embase were searched from inception to July 2022. Randomized, non-randomized controlled trials (RCT and non-RCT) and single-arm trials were included if they reported the effect of exercise on paraspinal fatty infiltration in people with LBP. Effect sizes and statistical power were calculated for (1) exercise versus control, and (2) pre-post exercise changes. Available data from the RCTs were pooled via meta-analysis when appropriate. Otherwise, data were synthesized qualitatively. Results: Two RCTs, one non-RCT and three single-arm trials met the selection criteria. Data were not pooled due to substantial clinical heterogeneity. Effect sizes from the RCTs revealed no significant difference for exercise versus control. One single-arm trial with high risk of bias demonstrated a significant pre-post difference with moderate effect size, but only at one (T12-L1) of the investigated levels. Conclusion: Moderate quality evidence is available that paraspinal fatty infiltration is not reversible with exercise in people with LBP. More larger RCT’s are needed to draw firmer conclusions.
| Original language | English |
|---|---|
| Pages (from-to) | 787-796 |
| Number of pages | 10 |
| Journal | European Spine Journal |
| Volume | 32 |
| Issue number | 3 |
| Early online date | 2 Dec 2022 |
| DOIs | |
| Publication status | Published - Mar 2023 |
Bibliographical note
Funding Information:Kenneth A. Weber II received funding from National Institute of Neurological Disorders and Stroke (grants K23NS104211 and L30NS108301). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The sponsors played no role in the study design, data collection, decision to publish, or preparation of the report.
Publisher Copyright:
© 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Funding
Kenneth A. Weber II received funding from National Institute of Neurological Disorders and Stroke (grants K23NS104211 and L30NS108301). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The sponsors played no role in the study design, data collection, decision to publish, or preparation of the report.
| Funders | Funder number |
|---|---|
| National Institute of Neurological Disorders and Stroke | L30NS108301, K23NS104211 |
| National Institute of Neurological Disorders and Stroke |
Keywords
- Adipose tissue
- Morphology
- Physical Therapy
- Rehabilitation
