Mixed
In patients with chronic low back pain, stabilisation training combined with dynamic-static resistance training (incorporating a 5-second static hold between concentric and eccentric phases) significantly increases the cross-sectional area of the lumbar multifidus muscle, whereas stabilisation training alone or stabilisation combined with pure dynamic resistance does not.
If you have chronic back pain and multifidus atrophy, gentle stabilisation exercises or standard dynamic lifting alone will not rebuild the muscle. You need a specific protocol: combine stabilisation with resistance training at 70% of your one-rep max, performing 15-18 reps, but crucially, insert a 5-second static hold between the lifting and lowering phases. This 'dynamic-static' approach is required to trigger hypertrophy in the deep back muscles.
The CSA of the multifidus muscle was significantly increased at all levels after training in group 3. In contrast, no significant differences were found in groups 1 and 2. The static holding component between the concentric and eccentric phase was found to be critical in inducing muscle hypertrophy during the first 10 weeks.
Why this rating
Randomized clinical trial with objective CT imaging, but small sample size (n=59) and short duration (10 weeks).
Source
Effects of three different training modalities on the cross sectional area of the lumbar multifidus muscle in patients with chronic low back pain
Lieven Danneels et al. · British Journal of Sports Medicine · 2001
DOI 10.1136/bjsm.35.3.186
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