SMT-3 Manual, pgs 27-47

Question 1

601. In Danneels et al 2001, what was the Group 3 treatment?

Answer 1

601. Same as 2 except concentric/eccentric movements were interrupted each time by a 5 sec. isometric contraction.

Question 2

602. In Danneels et al 2001, what was the only group to increase LM?

Answer 2

602. Group 3 only L3-L5
     Ab Hollow P=0.014 Concentric/eccentric without iso p=0.008
     Concentric/eccentric and iso p=0.002

Question 3

603. What did Danneels et al. 2001 conclude?

Answer 3

603.

1) Stability exercises (Abd. Hollowing) or even concentric/eccentric dynamic training have no significant effect on CSA of LM.
2) LM atrophy can be reversed
3) Static Isometric holding was critical for hypertrophy
4) To increase muscle mass in LM an intensive 70% MVC is needed with isometric holding stabilization training.

Question 4

604. Who attempted to determine a training protocol for LM?

Answer 4

604. Mayer et al. 2005

Question 5

605. What muscles were measured in Mayer et al 2005?

Answer 5

605. Lumbar Multifidus
     Quadratus Lumborum
     Iliocostalis Lumborum
     Longissimis Thoracis

Question 6

606. What determined metabolic activity in muscle for Mayer et al 2005?

Answer 6

606. Contrast shifts in T2 MRI

Question 7

607. What occurred in the pre-treatment for Mayer et al 2005?

Answer 7

607. 3 MVCs for 4 seconds with torso parallel to ground in Roman chair used to calculate 40%/50%/70% intensity load.

Question 8

608. What was the treatment protocol for Mayer et al 2005?

Answer 8

608. Dynamic trunk extension on Roman chair from 75 degrees flexion to 15 degrees extension hands on opposite shoulder. Each rep was 4 seconds (2 concentric, 2 eccentric – like Danneels et al 2001). 3 sets of 10 with 1 minute rest between sets, MRI measure, then subjects rested supine for 50 minutes before beginning next exercise load progression to ensure at least a 95% recovery of muscle (Fisher et al 1990).

Question 9

609. In Mayer et al 2005, which muscle responded to all three intensities?

Answer 9

609. LM, then erector spinae and QL (P

Question 10

610. In Mayer et al 2005, what percent was LM the most active of the four muscles?

Answer 10

610. 50%

Question 11

611. In Mayer et al 2005, what percent was QL not very active?

Answer 11

611. 40%

Question 12

612. How do you create 40% MVC load according to Mayer et al 2005?

Answer 12

612. Upper BW for most will be 40% (only need to add 3.5kg = 7.7lbs)
     - Females add 1.8kg = 3.6lbs
     - Males add 4.2kg = 9.24lbs

Question 13

613. Who compared specific core stab exercises to general exercise?

Answer 13

613. Koumantakis et al 2005.

Question 14

615. What were the dependent variables for Koumantakis et al 2005?

Answer 14

615. Pain and disability, cognitive status 8 weeks and 3 months post intervention.

Question 17

614. What population did Koumantakis et al 2005 use?

Answer 17

614. S/S recurrent sub-acute or chronic NS- LBP excluded if:
     1) Previous spinal surgery.
     2) Nerve root pain signs.
     3) Serious spinal pathology.
     4) Spondylolysis or spondylolisthesis.

Question 19

622. Morton 1999 found what was needed for the LM?

Answer 19

622. Stabilization training for LM was less affective on its own than when combined with a course of manipulative therapy.

Question 19

617. What was the Group 2 treatment for Koumantakis et al 2005?

Answer 19

617. General exercise 1. Exercise for ext. paraspinal and flexor abdominus 60%-70% MVC intensity.

Question 19

616. What was the Group 1 treatment for Koumantakis et al 2005?

Answer 19

616. General exercise combined with Richardson et al 1999 protocol for “Drawing In” maneuver progressed to 10 second hold x 10 reps with 30% MVC (palpated during contraction??? – not possible). Tactile and auditory facilitation of pelvic floor muscles. TVA and LM co-contraction in Quadruped, supine, sitting and standing.

Question 20

618. How was Group 1 progressed in Koumantakis et al 2005?

Answer 20

618. Weeks 3-5 spine and/or limb movements into light functional tasks:
     1)Leg slides in crook-lying
     2)Hip horizontal abduction in crook-lying
     Weeks 6-8 heavier functional tasks:
     1)Bridging with single leg extension
     2)Single leg extension in 4 point kneeling
     3)Double and single leg bridging on theraball
     4)Alternating arms and legs in 4 point kneeling
     5)Co-contraction of Transversus Abdominis and Lumbar multifidi maintaining lumbar spine stability during walking and other activities.

Question 21

619. What else did both groups receive for Koumantakis et al 2005?

Answer 21

619. 8 week exercise intervention of 2x/week lasting 45-60 minutes per session:
     - The Back Book (written advice)
     - Home program – do exercises at home for ½ hour 3x/week.

Question 22

620. What were Koumantakis et al results?

Answer 22

620. Similar outcomes at 3 month follow up for both groups on all outcome measures.
     - Improved self-reported disability (RMDQ) in general exercise group at 8 weeks but no longer present at 3 months.
     - No difference between 2 exercise approaches (specific stabilization vs. general ex.).

Question 23

623. What 4 aspects did Macedo et al 2009 compare to motor control exercise?

Answer 23

623.
MCE vs. Minimal intervention (GP or no intervention)
MCE vs. MT

Question 23

621. What were Koumantakis et al conclusions?

Answer 23

621. 1) General exercise decreased disability in short term (8 weeks) to greater extent than stabilization exercises.
     2) Specific stabilization exercises DO NOT provide any other benefit for LBP who have no clinical signs of spinal instability.
     3) Activity through safe exercising and Not particular type of exercise.
     4) General exercise group exercised in half the time because they exercised 60%-70% instead of 30% MVC.