The effect of different physical activity levels on muscle fiber size and type distribution of lumbar multifidus. A biopsy study on low back pain patient groups and healthy control subjects

Eur J Phys Rehabil Med. 2009 Dec;45(4):459-67. Epub 2009 Nov 5.


Aim: Previous studies examining the multifidus fiber characteristics among low back pain (LBP) patients have not considered the variable of physical activity. The present study sought to investigate the muscle fiber size and type distribution of the lumbar multifidus muscle among LBP patient groups with different physical activity levels and healthy controls.

Methods: Sixty-four patients were assigned to one of three groups named according to the physical activity level, determined for each patient by the International Physical Activity Questionnaire. These were low (LPA), medium (MPA) and high (HPA) physical activity groups. A control group comprising of 17 healthy individuals was also recruited. Muscle biopsy samples were obtained from the multifidus muscle at the level L4-L5.

Results: contrast with the control group, LBP patient groups showed a significantly higher Type II fiber distribution as well as reduced diameter in both fiber types (P<0.05). The physical activity level did not have an effect on multifidus characteristics since no significant differences were observed in fiber type and diameter (P>0.05) among LPA, MPA and HPA patient groups. Various pathological conditions were detected which were more pronounced in LBP groups compared to the control (P<0.05). Males had a larger fiber diameter compared to females for both fiber types (P<0.05).

Conclusions: The results showed that the level of physical activity did not affect muscle fiber size and type distribution among LBP patients groups. These findings suggest that not only inactivity but also high physical activity levels can have an adverse effect on the multifidus muscle fiber characteristics.

MeSH terms

  • Adult
  • Body Mass Index
  • Case-Control Studies
  • Exercise*
  • Female
  • Humans
  • Life Style
  • Low Back Pain / pathology*
  • Low Back Pain / physiopathology*
  • Lumbar Vertebrae
  • Male
  • Middle Aged
  • Motor Activity*
  • Muscle Fibers, Fast-Twitch / pathology*
  • Muscle Fibers, Slow-Twitch / pathology*
  • Sex Factors