Osteopathic Research Web

A literature review of chronic low back pain and the role of the diaphragm, multifidus, pelvic floor and transversus abdominis; in such a condition does improvement of function of these muscles through osteopathic manipulative technique and associated spe

Item

Title

A literature review of chronic low back pain and the role of the diaphragm, multifidus, pelvic floor and transversus abdominis; in such a condition does improvement of function of these muscles through osteopathic manipulative technique and associated spe

Author(s)

Olver, M

Abstract

To investigate whether the literature supports the notions that: (1) Improving function of Diaphragm, Pelvic Floor, Multifldus and/ or Transversus Abdominis by osteopathic manipulation or specific exercise techniques, have relevance in patients with Chronic Low Back Pain. (2) Does reducing somatic dysfunction have relevance in improving function of Diaphragm, Pelvic Floor, Multifidus and/ or Transversus Abdominis in individuals with chronic low back pain. (3) Does steopathic intervention/ manipulation have an effect on motor control of Diaphragm, Pelvic Floor, Multifidus and/ or Transversus Abdominis. Methods: A search strategy was initiated on electronic databases Swetwise (with all University of Greenwich publications included), CINAHL (with health sciences research atabases selected) and OSTMED.DR (osteopathic medical digital repository), as well as hand search of European School of Osteopathy library (Maidstone, England) using their Alice search engine and use of a private collection of relevant texts. Both MeSH search terms (Anatomy; Diaphragm; Exercise Therapy; Intervertebral Disk; Low Back Pain; Manipulation, Spinal; Manual Therapy; Musculoskeletal Manipulation; Pelvic Floor) and non-Mesh terms (Chronic Low Back Pain; Co -activation; Exercise; Feed-forward Activation; Function; Improve Function; Intervertebral Disc; Lumbopelvic Stability; Manipulation; Motor Control; Multifidus; Neuromuscular Rehabilitation; Osteopath [truncation of this term was used]; Specific Exercise, Somatic Dysfunction; Spinal Conditioning; Transversus Abdominis, Trunk Motor Control, Trunk Stability) were used in the search strategy. All relevant combinations of these MeSH terms were used, using Boolean logic. All abstracts and literature found using these MeSH terms were examined for suitability for the review with the inclusion and exclusion criteria. The inclusion criteria for articles and literature for consideration in this review are: (1) All literature to be included must be published in English. (2) Primary literature articles criteria; published in 1985-2011 in a peer review journal. (3) Secondary literature criteria; published in 1999-2011 and written by an eminent researcher in the field who has published numerous articles in relevant peer review journals. (4) However the above two criteria do not apply to the use of osteopathic texts, as osteopathic literature will be used to put this research into context of how it can be used or incorporated in osteopathic treatment strategies for patients with chronic low back pain. The exclusion criteria used are: (1) Do not fit either of criteria of the inclusion criteria. (2) The articles/ iterature has no relevance to the aims of this review. References found within the obtained papers or books which met the above criteria, were also used to obtain further relevant papers or sources of literature. Limitations of the Study: Not all articles of interest were available through the European School of Osteopathy interlibrary loan facility. The author also does not have the ability to critique the validity of mathematical modelling studies done, in such studies there validity has been assumed. Time also limited the critiquing of the whole field of specific exercise techniques and their alternative approaches. Findings and Conclusion' (1) There is evidence in the literature that supports the notion that improving function of the diaphragm, pelvic floor, multifidus and/ or transversus abdominis by osteopathic manipulation or specific exercise techniques, have relevance in patients with chronic low back pain. (2) With regard to the reduction of somatic dysfunction as a means to improve the function of the local lumbopelvic stabilizer, no experimental studies seem to exist that look directly at testing this concept. Only clinical experiences seem to suggest that such an approach is valid. However somatic dysfunction seems to be more severe and prevalent in individuals with chronic low back pain than in individuals without chronic low back pain. Thus it is assumed reducing the prevalence of somatic dysfunction in individuals with chronic low back will reduce it. (3) There is preliminary evidence that high velocity low amplitude thrusts have an effect on the motor control of the multifidus and transversus abdominis. This suggest that the same principle may apply to the pelvic floor and respiratory diaphragm.

presented at

European School of Osteopathy

Date Accepted

2012

Date Submitted

22.1.2013 16:23:35

Type

osteo_thesis

Language

English

Submitted by:

62

Pub-Identifier

15233

Inst-Identifier

1229

Keywords

Low back pain, Exercise rehabilitation.

Recommended

0

Item sets

Thesis

Olver, M, “A literature review of chronic low back pain and the role of the diaphragm, multifidus, pelvic floor and transversus abdominis; in such a condition does improvement of function of these muscles through osteopathic manipulative technique and associated spe”, Osteopathic Research Web, accessed April 28, 2024, https://www.osteopathic-research.com/s/orw/item/832