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The assessment of abdominal and multifidus muscles and their role in physical function in older adults: a systematic review


Cuellar, WA and Wilson, A and Blizzard, CL and Otahal, P and Callisaya, ML and Jones, G and Hides, JA and Winzenberg, TM, The assessment of abdominal and multifidus muscles and their role in physical function in older adults: a systematic review, Physiotherapy, 103, (1) pp. 21-39. ISSN 0031-9406 (2017) [Refereed Article]

Copyright Statement

Copyright 2016 Chartered Society of Physiotherapy

DOI: doi:10.1016/


Background: Age-related changes in the trunk (abdominal and lumbar multifidus) muscles and their impact on physical function in older adults are not clearly understood.

Objectives: To systematically summarize studies of these trunk muscles in older adults.

Data Sources: Cochrane Library, Pubmed, EMBASE and CINAHL were searched using terms for abdominal and MF muscles and measurement methods.

Study Selection: Two reviewers independently assessed studies and included those reporting measurements of abdominal muscles and/or MF by ultrasound, computerised tomography, magnetic resonance imaging or electromyography in of adults aged ≥ 50 years.

Data Synthesis: A best evidence synthesis was performed.

Results: Best evidence synthesis revealed limited evidence for detrimental effects of ageing or spinal conditions on trunk muscles, and conflicting evidence for decreased physical activity or stroke having detrimental effects on trunk muscles. Thicknesses of rectus abdominis, internal oblique and external oblique muscles were 36%-48% smaller for older than younger adults. Muscle quality was poorer among people with moderate-extreme low back pain and predicted physical function outcomes.

Limitations: Study heterogeneity precluded meta-analysis.

Conclusion: Overall, the evidence base in older people has significant limitations, so the role of physiotherapy interventions aimed at these muscles remains unclear. The results point to areas in which further research could lead to clinically useful outcomes. These include determining the role of the trunk muscles in the physical function of older adults and disease; developing and testing rehabilitation programs for older people with spinal conditions and lower back pain; and identifying modifiable factors that could mitigate age-related changes.

Item Details

Item Type:Refereed Article
Keywords:Systematic review, Older adults, Physical function, Trunk muscles, Abdominal muscles, Multifidus muscles
Research Division:Biomedical and Clinical Sciences
Research Group:Clinical sciences
Research Field:Geriatrics and gerontology
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Health related to ageing
UTAS Author:Cuellar, WA (Dr William Cuellar)
UTAS Author:Wilson, A (Dr Anitra Wilson)
UTAS Author:Blizzard, CL (Professor Leigh Blizzard)
UTAS Author:Otahal, P (Mr Petr Otahal)
UTAS Author:Callisaya, ML (Dr Michele Callisaya)
UTAS Author:Jones, G (Professor Graeme Jones)
UTAS Author:Winzenberg, TM (Professor Tania Winzenberg)
ID Code:111002
Year Published:2017 (online first 2016)
Web of Science® Times Cited:17
Deposited By:Menzies Institute for Medical Research
Deposited On:2016-08-25
Last Modified:2017-11-20

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