LUMBAR MULTIFIDUS MUSCLES FUNCTION AMONG PATIENTS WITH LOW BACK PAIN: VIRTUAL REALITY VERSUS STABILIZATION EXERCISES.

Introduction:

Low back pain (LBP) is still a significant concern for the public. Health concerns in affluent nations despite advances in our understanding of spinal illnesses. The issue is significant because of its socioeconomic and psychological implications and the shortcomings of many suggested preventive or cure measures (Almazrou et al., 2020; Schmidt et al., 2020). Up to 75% of people will experience low back discomfort at some point with some extent of functional difficulties (De Souza et al., 2019).

With its distinct stabilizing function, the multifidus muscle, which spans the lumbosacral junction and is situated medially in the back, gives the spinal column dynamic stability (Zwambag et al., 2019). It is crucial to remember that people with low back pain may have a multifidus muscle problem, which includes critical structural alterations such as atrophy and the replacement of muscular tissue with fatty infiltrates (Shahidi et al., 2017). A lack of proprioception and abnormal recruitment patterns are two further motor control deficiencies noted (Chua et al., 2022; Shahidi et al., 2023).

Several studies have linked Multifidus muscle atrophy to LBP in both acute and chronic stages (Maas et al., 2018). This muscle loss is not due to atrophy from lack of usage; multifidus activity is reflexively inhibited (Masse-Alarie et al., 2016a). Atrophy of the spinal muscles can lead to instability and recurrent back problems (Massé-Alarie et al., 2016b). Appropriate lumbosacral position sensing depends on the multifidus muscles' muscle spindles. Lower back pain (LBP) sufferers typically have a less accurate and exact sense of their position than healthy individuals. Multifidus muscle atrophy may result in muscle spindle dysfunction, which can limit muscle spindle input and impair segmental stability and spinal proprioception (Crawford et al., 2019; Gabel et al., 2021).

Computer technology, virtual reality (VR), employs sensory feedback to provide users with an experience that mimics real-life activities and events. People can improve their motor abilities in a fashion that mimics the real world by using a three-dimensional virtual environment (Park et al., 2019). Virtual reality systems are well known for their distinctive qualities of interactivity and immersion. Utilizing several sense channels, such as sight, hearing, and touch, requires interaction. The degree of interaction with the virtual environment, on the other hand, is related to immersion (Coburn et al., 2017; Papadopoulos et al., 2021). To influence the cognitive processes involved in motor control, one needs a sense of "degree of presence," or awareness of one's existence in a certain scenario. Virtual reality technology makes the development of interactive training regimens that target various muscles, joints, coordinated movements, or the complete body easier (Levac et al., 2019; Tieri et al., 2018). There is currently a dearth of research on how VR affects the function of the multifidus muscles in people with LBP.