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Influence of paravertebral muscles training on brain plasticity and postural control in chronic low back pain

  • Hugo Massé-Alarie EMAIL logo , Louis-David Beaulieu , Richard Preuss and Cyril Schneider


Background and purpose

Isometric activation (ISOM) of deep multifidi muscles (MF) can influence postural adjustments and primary motor cortex (M1) function in chronic low back pain (CLBP). In order to better understand how ISOM impacts on CLBP condition, the present study contrasted ISOM aftereffects on Ml function, MF postural activation and pain with another training, the global activation of paravertebral muscles (GLOB, hip extension). The main objective of this study was to compare the effects of ISOM and GLOB (3-week training each) on MF postural activation and Ml function in a CLBP population.


Twenty-four people with CLBP were randomly allocated to ISOM and GLOB groups for a 3- week daily practice. Pre/post-training after-effects were assessed by the onset of superficial MF (MF-S) activation during ballistic limb movements (bilateral shoulder flexion in standing; unilateral hip extension in prine lying), MF-S corticomotor control tested by transcranial magnetic stimulation of M1, and assessment of pain, kinesiophobia and disability by standardized questionnaires.


Both ISOM and GLOB improved pain and disability. However, only ISOM influenced Ml function (decreased corticospinal excitability and increased intracortical inhibition), fastened MF-S postural activation and decreased kinesiophobia.


Changes of corticospinal excitability and of MF-S postural adjustments suggest that ISOM better influenced brain plasticity. Future studies should further test whether our novel findings relate to an influence of the exercises on the lumbopelvic control of different muscles and on cognitive function. Clinically, individual’s evaluation remains warranted before prescribing one or the other of these two conventional exercises for reducing pain.


This original study presents how motor control exercises can influence brain plasticity and postural control in chronic low back pain. This knowledge will impact on the decision of clinicians to prescribe specific exercises with a view of improving motor control in this musculoskeletal condition.

DOI of refers to article:

Corresponding author at: Centre de recherche du CHU de Québec, Neuroscience Division, RC-9800, 2705 Blvd. Laurier, Quebec City, Canada G1V 4G2. Tel.: +1 418 525 4444x47539; fax: +1 418 654 2753


The authors acknowledge the financial support from the Canadian Foundation for Innovation (CS equipment), the Fonds de Recherche du Québec - Santé (HMA and LDB PhD studentships) and the Canadian Institutes of Health Research (HMA studentship).

  1. Conflict of interest

    Conflict of interest statement: None.

  2. Disclosures: None.


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Received: 2015-11-18
Revised: 2016-02-19
Accepted: 2016-03-17
Published Online: 2016-07-01
Published in Print: 2016-07-01

© 2016 Scandinavian Association for the Study of Pain

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