ArticleThe spine journal : official journal of the North American Spine Society2015
The evaluation of lumbar multifidus muscle function via palpation: reliability and validity of a new clinical test.
Article in The spine journal : official journal of the North American Spine Society, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 25 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Changing Trunk Muscle Activation in Patients With Recurrent Low Back Pain in Remission
Test-retest Reliability and Agreement of Trunk Muscle Activation in Pain-free Persons
Who cites it
25 citing papers in PubMed, 51 citations in OpenAlex.
- Letter to the Editor Re: "Lumbar multifidus muscle morphology on MRI after restorative neurostimulation for chronic low back pain: a single centre case series using the Goutallier classification" by Whittle et al. (Eur Spine J [2026]: DOI: 10.1007/s00586-026-09863-8).European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Real-world two-year durability of restorative neurostimulation for treatment of multifidus dysfunction in patients with chronic low back pain: an observational German cohort study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Observational
- Lumbar multifidus muscle morphology on MRI after restorative neurostimulation for chronic low back pain: a single centre case series using the Goutallier classification.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Multifidus Dysfunction and Chronic Low Back Pain: Systematic Review and Meta-analysis of the Supporting Data for Accurate Diagnosis and Successful Treatment Outcomes Associated With Restorative Neurostimulation.International journal of spine surgery · 2025Article
- Review of Guidelines for Implantable Peripheral Nerve Stimulation (PNS) in the Management of Chronic Pain.Current pain and headache reports · 2025Review
- Restorative Neurostimulation Therapy Compared to Optimal Medical Management: A Randomized Evaluation (RESTORE) for the Treatment of Chronic Mechanical Low Back Pain due to Multifidus Dysfunction.Pain and therapy · 2025Article
- Restorative Neurostimulation for Patients with Mechanical Chronic Low Back Pain and Impaired Neuromuscular Control of the Lumbar Spine | A New Treatment Paradigm.Journal of pain research · 2025Review
- A Primer on Anatomy, Biophysics, Pathology, Imaging and Treatment of the Intervertebral Disc and the Anterior Spinal Column: The Discogenic, Intervertebral, Spinal Column (DISC) ASPN Workgroup.Journal of pain research · 2025Article
- Precision Rehabilitation After Neurostimulation Implantation for Multifidus Dysfunction in Nociceptive Mechanical Chronic Low Back Pain.Archives of rehabilitation research and clinical translation · 2024Article
- Multifidus dysfunction and restorative neurostimulation: a scoping review.Pain medicine (Malden, Mass.) · 2023Article
- International Society for the Advancement of Spine Surgery Statement: Restorative Neurostimulation for Chronic Mechanical Low Back Pain Resulting From Neuromuscular Instability.International journal of spine surgery · 2023Article
- A guide for standardized interpretation of lumbar multifidus ultrasonography; an observational study.BMC musculoskeletal disorders · 2022Observational
- How I do it? Full endoscopic lumbar rhizotomy for chronic facet joint pain due to failed back surgery syndrome.Acta neurochirurgica · 2022Article
- Restorative Neurostimulation: A Clinical Guide for Therapy Adoption.Journal of pain research · 2022Review
- Reliability and validity of manual palpation for the assessment of patients with low back pain: a systematic and critical review.Chiropractic & manual therapies · 2021Review
- Effect of Ultrasound-Guided Hydrorelease of the Multifidus Muscle on Acute Low Back Pain.Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine · 2021Article
- Inconsistent descriptions of lumbar multifidus morphology: A scoping review.BMC musculoskeletal disorders · 2020Article
- REHABILITATION CONSIDERATIONS FOR SPONDYLOLYSIS IN THE YOUTH ATHLETE.International journal of sports physical therapy · 2020Article
- Quantitative Analysis Concerning Atrophy and Fat Infiltration of the Multifidus Muscle with Magnetic Resonance Spectroscopy in Chronic Low Back Pain.Spine surgery and related research · 2019Article
- Optimizing treatment protocols for spinal manipulative therapy: study protocol for a randomized trial.Trials · 2018Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
Abstract
background contextThe lumbar multifidus muscle provides an important contribution to lumbar spine stability, and the restoration of lumbar multifidus function is a frequent goal of rehabilitation. Currently, there are no reliable and valid physical examination procedures available to assess lumbar multifidus function among patients with low back pain. PURPOSE: To examine the inter-rater reliability and concurrent validity of the multifidus lift test (MLT) to identify lumbar multifidus dysfunction among patients with low back pain. STUDY DESIGN/
settingA cross-sectional analysis of reliability and concurrent validity performed in a university outpatient research facility. PATIENT SAMPLE: Thirty-two persons aged 18 to 60 years with current low back pain and a minimum modified Oswestry disability score of 20%. Study participants were excluded if they reported a history of lumbar spine surgery, lumbar radiculopathy, medical red flags, osteoporosis, or had recently been treated with spinal manipulation or trunk stabilization exercises. OUTCOME MEASURES: Concurrent measures of lumbar multifidus muscle function at the L4-L5 and L5-S1 levels were obtained with the MLT (index test) and real-time ultrasound imaging (reference standard).
methodsThe inter-rater reliability of the MLT was examined by measuring the level of agreement between two blinded examiners. Concurrent validity of the MLT was investigated by comparing clinicians' judgments with real-time ultrasound imaging measures of lumbar multifidus function.
resultsInter-rater reliability of the MLT was substantial to excellent (κ=0.75 to 0.81, p≤.01) and free from errors of bias and prevalence. When performed at L4-L5 or L5-S1, the MLT demonstrated evidence of concurrent validity through its relationship with the reference standard results at L4-L5 (rbis=0.59-0.73, p≤.01). The MLT generally failed to demonstrate a relationship with the reference standard results from the L5-S1 level.
conclusionsOur results provide preliminary evidence supporting the reliability and validity of the MLT to assess lumbar multifidus function at the L4-L5 spinal level. Additional research examining the measurement properties and utility of this test should be undertaken before confident implementation with patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.