Since exercises induce acute enhancement of T2 relaxation time of muscle water, which leads to increase in T2 signal intensity of the activated muscles in muscle functional MRI (mfMRI), I want to use mfMRI to detect the alternation of lumbar muscle recruitments in low back pain patients following a physiotherapy treatment.
To achieve this goal, I will request the patients to do a standardized exercise before and after the treatment and conduct 2 immediate post-exercise mfMRI scans. However, I don't know what is the minimal exercise intensity to obtain the detectable augmentation of T2 signal intensity in the target muscles (e.g. lumbar multifidus). Any suggestions?
I´m not sure if I understand your question properly, but I think you need the intensity when muscle glykogen starts to dissociate. So from my point of view you don´t need more than 3minutes - but of a state, in which multifidi continuously work. And I think that it is not easy to activate them in a patient with low back pain. I´m looking forward to your findings... good luck!
Thank you so much for your input. I agree that it may not be feasible for patients with LBP if they are requested to sustain an isometric back muscle contraction for 2 to 3 mins.
Well, I don´t think it´s neccessary to make them work isometricaly. In my opinion isotonic (no static) contraction would be much more suitable and will induce the desired effect as well...
Thanks Julie. Based on your experience with mfMRI, what is the suggested exercise intensity for triggering the activation of multifidus muscle that can be detected in the post-exercise MRI scan? Will you suggest using a contralateral arm lifting task with a dumbbell?
Dear collegues, Let me see if I understand, the pacient is with low back pain? I think there is another way to promote muscle recruitment without promote side effects, using stretcht. See my article using stretcht and Hidroxiproline.
try reading
1 Cagnie, B, M Dolphens, I Peeters, et al., The use of functional MRI to evaluate cervical flexor activity during different cervical flexion exercises. J Appl Physiol, 2008. 104: p. 230-235.
2 Cagnie, B, M Dolphens, I Peeters, et al., Use of muscle functional magnetic resonance imaging to compare cervical flexore activity between patients with whiplash-associated disorders and people who are healthy. Phys Ther, 2010. 90(8): p. 1157-1164.
3 Cagnie, B, J Elliott, S O'Leary, et al., Muscle Functional MRI as an Imaging Tool to Evaluate Muscle Activity. JOSPT, 2011. 41(11): p. 896-903.
4 Dickx, N, B Cagnie, E Achten, et al., Differentiation between deep and superficial fibers of the lumbar multifidus by magnetic resonance imaging. Eur Spine J, 2010. 19: p. 122-128.
5 Dickx, N, R D'Hooge, B Cagnie, et al., Magnetic Resonance Imaging and Electromyography to Measure Lumbar Back Muscle Activity. Spine, 2010. 35(17): p. E836-E842.
You should find your answers in these papers.
Thanks Michael. I have read thise on back MRI assessment earlier. I will take a look at Cagnie's papers. Thanks :)
Michael and Arnold, this is a interesting topic to research. MRI is a good way to study the funcional muscles modification, I think.
It seems promising. We are currently doing 4-5 studies on the use of it in compartment syndrome, MTSS and adductor related groin pain. Watch this space... Cheers.
Very good topic.... How about psoas ? In some acute back pain patient, stretching of psoas decresed their pain.
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