title: The relationship of transversus abdominis and lumbar multifidus clinical muscle tests in patients with chronic low back pain.
abstract: BACKGROUND
  Previous research of transversus abdominis (TrA) and multifidus muscle function in the presence of chronic low back pain (LBP) has investigated these muscles in isolation. In clinical practice, it is assumed that a relationship exists between these muscles and so they are often assessed and rehabilitated together. However, no studies have tested or documented this association. This study aimed to examine the relationships between clinical muscle testing and other measures taken in the course of a clinical assessment at a back clinic.
  
  
  METHODS
  This retrospective chart audit examined the files of 82 patients (40 Males, 42 Females) for results of clinical tests of TrA and multifidus muscle contraction, multifidus muscle size measurements and other clinical measures such as distribution of pain and pain on manual examination.
  
  
  RESULTS
  The ability to contract multifidus was related to the ability to contract TrA with the odds of a good contraction of multifidus being 4.5 times higher for patients who had a good contraction of TrA. A poor ability to contract multifidus was related to poor TrA contraction. Patients with unilateral LBP had more multifidus muscle asymmetry (11.6%) than those with bilateral/central pain (0.01%) and had a poor multifidus contraction on the affected side (p < 0.01). No other significant relationships were found.
  
  
  CONCLUSIONS
  Current clinical practice of assessment and rehabilitation of both TrA and multifidus muscles in patients with chronic LBP is supported by the findings of this study. Future studies may investigate if a neurophysiological relationship exists between these muscles.
authors.affiliation: School of Physiotherapy, Australian Catholic University, McAuley at Banyo, Queensland 4014, Australia. julie.hides@acu.edu.au
authors.forename: Julie
authors.initials: J
authors.lastname: Hides
authors.forename: Warren
authors.initials: W
authors.lastname: Stanton
authors.forename: M Dilani
authors.initials: MD
authors.lastname: Mendis
authors.forename: Margot
authors.initials: M
authors.lastname: Sexton
mesh_terms: D000009:Abdominal Muscles / Q000503:physiopathology*; D000328:Adult; D002908:Chronic Disease; D015331:Cohort Studies; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D009119:Muscle Contraction / Q000502:physiology*; D053580:Muscle Strength / Q000502:physiology; D018482:Muscle, Skeletal / Q000503:physiopathology; D010147:Pain Measurement; D010808:Physical Examination / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012720:Severity of Illness Index