The assessment of abdominal and multifidus muscles and their role in physical function in older adults: a systematic review.
BACKGROUND
Age-related changes in the trunk (abdominal and lumbar multifidus) muscles and their impact on physical function of older adults are not clearly understood.


OBJECTIVE
To systematically summarise studies of these trunk muscles in older adults.


METHODS
Cochrane Library, Pubmed, EMBASE and CINAHL were searched using terms for abdominal and MF muscles and measurement methods.


METHODS
Two reviewers independently assessed studies and included those reporting measurements of abdominal muscles and/or MF by ultrasound, computed tomography, magnetic resonance imaging or electromyography of adults aged ≥50 years.


RESULTS
A best evidence synthesis was performed.


RESULTS
Best evidence synthesis revealed limited evidence for detrimental effects of ageing or spinal conditions on trunk muscles, and conflicting evidence for decreased physical activity or stroke having detrimental effects on trunk muscles. Thicknesses of rectus abdominis, internal oblique and external oblique muscles were 36% to 48% smaller for older than younger adults. Muscle quality was poorer among people with moderate-extreme low back pain and predicted physical function outcomes.


CONCLUSIONS
Study heterogeneity precluded meta-analysis.


CONCLUSIONS
Overall, the evidence base in older people has significant limitations, so the role of physiotherapy interventions aimed at these muscles remains unclear. The results point to areas in which further research could lead to clinically useful outcomes. These include determining the role of the trunk muscles in the physical function of older adults and disease; developing and testing rehabilitation programmes for older people with spinal conditions and lower back pain; and identifying modifiable factors that could mitigate age-related changes.
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; School of Medicine, University of Tasmania, Hobart, Tasmania, Australia. Electronic address: William.Cuellar@utas.edu.au.
W A
WA
Cuellar
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
A
A
Wilson
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
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CL
Blizzard
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
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Otahal
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Southern Clinical School, Monash Medical Centre, Monash University, Clayton, Victoria, Australia.
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Callisaya
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
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Jones
Centre for Musculoskeletal Research, Mary Mackillop Institute for Health Research, Australian Catholic University, Brisbane, Queensland, Australia.
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JA
Hides
Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia; Faculty of Health, University of Tasmania, Hobart, Tasmania, Australia.
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TM
Winzenberg
D000009:Abdominal Muscles / Q000000981:diagnostic imaging / Q000502:physiology*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology*; D015444:Exercise / Q000502:physiology; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000503:physiopathology; D008161:Lumbosacral Region / Q000502:physiology; D008297:Male; D008875:Middle Aged; D064170:Paraspinal Muscles / Q000000981:diagnostic imaging / Q000502:physiology*; D017568:Rectus Abdominis / Q000502:physiology; D012737:Sex Factors; D020521:Stroke / Q000503:physiopathology; D060726:Torso / Q000000981:diagnostic imaging / Q000502:physiology*
Abdominal muscles; Multifidus muscles; Older adults; Physical function; Systematic review; Trunk muscles