Effects of the “standing posture with flexion of the trunk” on the lumbar multifidus tropism in patients with chronic low back pain. A randomized, controlled pilot study study.

Introduction Global Postural Reeducation (GPR) is a physical therapy procedure aiming to restore a balanced activity among different muscles and improve postural alignment. The aim of this study is to investigate the effects of a GPR posture called “standing posture with flexion of the trunk” on the thickness of the lumbar multifidus (LM) muscle, pain and disability, in patients complaining of chronic low back pain. Materials and methods Fourteen subjects were randomized in two arms. Both groups attended 10 supervised physical therapy sessions, the experimental group also performed 10 “standing posture with flexion of the trunk” and repeated this posture as home self-treatment during one month. The LM thickness was measured with an ultrasound device at baseline, at the end of the treatment (T1) and at 1-month follow-up (T2). The Numerical Rating Scale and the Roland & Morris Disability Questionnaire were used to measure pain and disability. Conclusion No statistically significant difference was found within- and between-groups concerning pain and LM thickness. The experimental group showed a clinically and statistically significant improvement on disability at T1 (-3.71, p=0.018) and T2 (-2.97, p=0.042) follow-ups. This pilot study did not show any significant effect of the “standing posture with flexion of the trunk” on LM thickness