• Lars Berglund, Björn Aasa, Peter Michaelson, and Ulrika Aasa.
• *Department of Community Medicine and Rehabilitation, Umeå University, Sweden †Department of Surgical and Perioperative Sciences, Umeå University, Sweden ‡Norrlandskliniken Health Care Centre, Umeå, Sweden §Division of Health and Rehabilitation, Department of Health Science, Luleå University of Technology, Sweden ¶Umeå School of Sport Sciences, Umeå University, Sweden.
• Spine. 2016 Nov 18.

Study DesignRandomized controlled trial OBJECTIVE.: The aim of this study was to compare the effects of low-load motor control exercises and a high-load lifting exercise, on lumbar multifidus (LM) thickness on either side of the spine and whether the effects are affected by pain intensity or change in pain intensity, among patients with nociceptive mechanical LBP.Summary Of Background DataThere is evidence that patients with low back pain may have a decreased size of the (LM) muscles with an asymmetry between sides in the lower back. It has also been shown that low-load motor control training can affect this asymmetry. It is, however, not known whether a high-load exercise has the same effect.MethodsSixty-five participants diagnosed with nociceptive mechanical low back painwere included and randomized into low-load motor control exercises or a high-load lifting exercise, the deadlift. The LM thickness was measured using rehabilitative ultrasound imaging, at baseline and after a 2-month training period.ResultsThere were no differences between interventions regarding effect on LM muscle thickness. However, the analysis showed a significant effect for asymmetry. The thickness of the LMmuscle on the small side increased significantly compared to the large side in both intervention groups, without influence of pain at baseline, or change in pain intensity.ConclusionsThere was a difference in thickness of the LM muscles between sides. It seems that exercises focusing on spinal alignment may increase the thickness of the LM muscles on the small side, irrespective of exercise load. The increase in LM thickness does not appear to be mediated by either current pain intensity or the magnitude of change in pain intensity.Level Of Evidence2.

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