Gabel CP, Mokhtarinia HR, Melloh M, Mateo S. Slacklining as therapy to address non-specific low back pain in the presence of multifidus arthrogenic muscle inhibition. World J Orthop 2021; 12(4): 178-196 [PMID: 33959482 DOI: 10.5312/wjo.v12.i4.178]
Corresponding Author of This Article
Charles Philip Gabel, BPhty, MSc, PhD, Director, Department of Physiotherapy, Access Physiotherapy, PO Box 760, Coolum Beach 4573, QLD, Australia. cp.gabel@bigpond.com
Research Domain of This Article
Rehabilitation
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Orthop. Apr 18, 2021; 12(4): 178-196 Published online Apr 18, 2021. doi: 10.5312/wjo.v12.i4.178
Slacklining as therapy to address non-specific low back pain in the presence of multifidus arthrogenic muscle inhibition
Charles Philip Gabel, Hamid Reza Mokhtarinia, Markus Melloh, Sébastien Mateo
Charles Philip Gabel, Department of Physiotherapy, Access Physiotherapy, Coolum Beach 4573, QLD, Australia
Hamid Reza Mokhtarinia, Department of Ergonomics, University of Social Welfare and Rehabilitation Sciences, Tehran 0001, Iran
Hamid Reza Mokhtarinia, Department of Physiotherapy, University of Social Welfare and Rehabilitation Sciences, Tehran 0001, Iran
Markus Melloh, School of Health Professions, Zurich University of Applied Sciences, Winterthur 8310, Switzerland
Sébastien Mateo, INSERM U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Université de Lyon, Lyon 69000, France
Author contributions: Gabel CP proposed the concept and outline; Melloh M provided vital input for the manuscript content with specific relevance to NSLBP, physiology, clinical guidelines and current medical management, references and editing of the manuscript; Mokhtarinia HR provided vital input for the manuscript content with specific relevance to NSLBP physiotherapy and rehabilitation, physiology, references and editing of the manuscript; and Mateo S provided specific vital input regarding the neurological perspectives of rehabilitation, physiology referencing and editing of the manuscript; all authors contributed to writing the manuscript.
Conflict-of-interest statement: All authors state that they have no conflict of interest in any areas.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Charles Philip Gabel, BPhty, MSc, PhD, Director, Department of Physiotherapy, Access Physiotherapy, PO Box 760, Coolum Beach 4573, QLD, Australia. cp.gabel@bigpond.com
Received: November 27, 2020 Peer-review started: November 27, 2020 First decision: December 24, 2020 Revised: January 18, 2021 Accepted: March 13, 2021 Article in press: March 13, 2021 Published online: April 18, 2021
Core Tip
Core Tip: Non-specific low back pain (NSLBP) is the leading problematic musculoskeletal condition for individuals and society. With no consensus definition, depleted lumbar multifidus stabilization is recognized with fatty infiltration and wasting, where arthrogenic muscle inhibition is a probable cause. With no gold-standard therapy, management consensus recommends cost-effective, self-administered, exercise-based multi-modal approaches. ‘Slacklining’ addresses these criteria as an adjuvant therapeutic rehabilitation exercise, rationalized by a hypothesized over-ride of central down-regulatory induced muscle insufficiency. This allows neuroplasticity, normalized neuro-motor sequencing and muscle re-activation for stabilization. Four neuro-physiological pathways are proposed with further research required into the hypotheses and slacklining’s potential NSLBP rehabilitation role.
