Pelvic Girdle & Low back Pain - Multifidus, the Missing Piece of the Puzzle

Inhoud:
Multifidus is one of the most researched muscles in the body and yet the current evidence does not appear to be reaching the intended target; the patient with recurrent, intermittent episodes of debilitating low back or pelvic girdle pain.

Despite the current evidence on the prevalence of changes in both structure and function of multifidus following an acute injury to the low back/pelvis, it remains challenging for physiotherapists to differentiate (assess), treat and train according to this evidence. Manual assessment skills are required to translate this knowledge into clinical practice.

Multifidus (deepest fibres) is part of the postural muscle system and when it becomes inhibited, atrophied, filled with fat, over time its fibres can convert from slow to fast twitch and fibrosis may appear. Other muscles compensate to provide force closure (control) of the sacroiliac and lumbar joints. These compensation strategies are diverse amongst individuals with low back/pelvic girdle. There is a wide range of individuals that tend to be impacted including:

1. Prenatal and postpartum moms
2. Athletes – elite and recreational level
3. Any individual who has experienced an acute injury to their low back/pelvis at any point in their life (work, motor vehicle, sport, life related injuries).

This PowerTalk is being hosted by Diane Lee, a world leading expert, clinician, and researcher in this field. Contrary to current general opinion, she will present strong arguments to incorporate rehabilitation of multifidus. Throughout the years, she has clinically applied the evidence-based recommendations for both assessment (manually and using ultrasound imaging) and treatment (motor control to strengthening exercises according to the findings from the assessment). In her presentation she will make this accessible for every physiotherapist or pelvic health therapist who wants to attain better long-term results with their patients.

Doelstellingen:
- The known changes in structure and function of multifidus at different time points (the evidence).
- How to identify from the patient’s story when multifidus should be assessed.
- How the load transfer tests of the low back and pelvis direct local assessment of multifidus (sacral vs lumbar fibres and which level of the lumbar spine).
- How to manually assess multifidus and apply clinical reasoning to know if the muscle is inhibited, atrophied, filled with fat, has lost capacity (size) and/or endurance, fibrosed.
- How this information helps to guide motor control training followed by capacity building and strength and endurance training integrated into functional tasks for lifelong self-management of their low back/pelvic girdle pain.

Doelgroep:
Fysiotherapeuten, bekkenfysiotherapeuten en manueel fysiotherapeuten die zich willen verbeteren in het onderzoek en de behandeling van bekkengordel klachten en lage rugklachten, met de specifieke rol van de multifidus hierin.
Er is géén instapniveau vereist.