John, Mel and all,
Here are some of the research on TrAbdominus and Multifidus that I have read
so far on this issue. Hopefully it will shed some more light on the
discussion on core stability.
Hides, Jull and Richardson., "Long-term effects of specific stabilizing
exercises for first-episode low back pain" Spine 2001, vol 1, No 26:e243-248
Hides, Richardson, Jull., "Multifidus recovery is not automatic after
resolution of acute, first-episode low back pain." Spine 1996, Vol 21, No
23:pp2763-69
O'Sullivan, Twomey., "Evaluation of specific stabilizing exercise in the
treatment of chronic low back pain with radiological diagnosis of
spondylolysis or spondylolisthesis." Spine 1997, 24:pp2959-2967.
Jull, Richardson, "Muscle control - pain control. What exercises would you
prescribe?" Manual Therapy 1995, Vol 1:pp2-10
O'Sullivan, Twomey, Allison., "altered patterns of abdominal muscle
activation in patients with chronic back pain" Austrlaian Journal of
Physiotherapy 1997;43(2):91
I think I agree more with John in saying that the studies on Transversus
Abdominus has focused on segmental instability and low back pain. Mel is
quite right in saying that most people with low back pain spontaneously
resolve without treatment, but Julie Hides has shown through a one year
prospective study that despite a reduction in pain, Multifidus activation
does not occur spontaneously. I don't think they have ever said that this is
the answer to chronic low back pain; instead, Jull and Richardson state that
"this may be the missing link in the management of lumbar disabilities."
also, I do not think I have read anything suggesting that local
stabilization strategies can work in isolation. If one reads Jull and
Richardson 1995 article (above "Muscle control - pain control. What
exercises would you prescribe?"), it does state that although it is good to
activate these muscle in static position, the ultimate aim is to incorporate
this into functional and meaningful activities.
I have enjoyed this discussion and learning the different perspectives
everyone have on this issue.
Henry***
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