Low back pain (LBP), a globally widespread and persistent musculoskeletal disorder, benefits from exercise therapy. However, it remains unclear which type leads to greater changes in paraspinal muscle health. This study aimed to (1) compare the effects of a combined motor control and isolated lumbar extension exercise (MC+ILEX) versus a general exercise (GE) intervention on paraspinal muscle morphology, composition, and function, and (2) examine whether alterations in paraspinal muscle health were correlated with improvements in pain, function, and quality of life. Fifty participants with chronic LBP were randomly assigned to each group and underwent a 12-week supervised intervention program. Magnetic resonance imaging and ultrasound assessments were acquired at baseline, 6 and 12 weeks to examine the impact of each intervention on erector spinae (ES) and multifidus (MF) muscle size (cross-sectional area, CSA), composition, and function at L4-L5 and L5-S1. Self-reported questionnaires were also acquired to assess participant-oriented outcomes. Our findings indicated that the MC+ILEX group demonstrated greater improvements in MF and ES CSA, along with MF thickness at both levels (all p < 0.01). Both groups significantly improved in pain, function, and quality of life. This study provided preliminary results suggesting that an MC+ILEX intervention may improve paraspinal morphology while decreasing pain and disability.

Soccer is a laterally dominant sport owing to the repetitive nature of unilateral kicking. The relationship between functional and body composition asymmetries related to limb dominance in soccer players has yet to be established. When present, asymmetries can increase the risk of injury and low back pain. Our study investigated whether lateral dominance is associated with limb asymmetries in a comprehensive body composition assessment among varsity soccer players. Twenty-seven varsity soccer players (age 20.4 ± 1.7 years old; BMI 22.6 ± 4.6 kg/m²) participated in this study. Body composition was assessed through dual-energy X-ray absorptiometry scans. Results showed low lower limb asymmetry indices in both males (3.82%) and females (3.36%) compared to normal ranges. However, upper limb lean mass exhibited high asymmetry, surpassing thresholds in males (7.3%) and females (4.39%). Significant differences were found in total bone mass among males and total lean body mass among females. Male players exhibited higher asymmetry indices in both arm and trunk mass compared to females. Despite these asymmetries, no significant correlations were found between asymmetry indices and occurrences of lower limb injury or low back pain. The study suggests that while evaluating body composition for injury prevention in soccer shows potential, lateral dominance may be influenced by factors extending beyond sport-specific adaptations.

Skeletal muscle morphometry, quality, and function serve as crucial prognostic indicators across various medical and surgical fields. Sarcopenia, the progressive loss of muscle mass and function, significantly contributes to frailty in individuals with spine pathologies. Abnormalities in spinal muscle mass and function (e.g., sarcopenia) are not only associated with the development of spine-related disorders but also negatively affect quality of life and postoperative outcomes. Tailored treatments and effective pre and post-operative rehabilitation strategies are imperative to mitigate complications, enhance quality of life, and expected survival in patients with diverse spinal pathologies. The intricate relationship between spine pathologies, sarcopenia, and factors like patient-reported health-related quality of life, frailty, surgery-related adverse events, and cost-effectiveness necessitates a comprehensive approach from spine care providers. Recognizing the broader implications of muscle loss on physical function, pain levels, and quality of life is essential for spine care providers to optimize both non-operative and operative care.

Degenerative cervical myelopathy (DCM) is the leading cause of adult spinal cord dysfunction, often requiring surgery. However, the role of postoperative rehabilitation in optimizing patient outcomes remains unclear. What are the effects of postoperative rehabilitation on clinical outcomes following DCM surgery? This systematic review was registered with PROSPERO (CRD42024582484). PubMed, Scopus, and Web of Science were searched through September 2025. Eligible studies included randomized controlled trials (RCTs), and other research on rehabilitation interventions for postoperative outcomes (e.g., function, pain, neurological recovery) in patients undergoing DCM surgery. Studies without confirmed DCM, non-peer-reviewed articles, or lacking a rehabilitation protocol were excluded. Risk of bias was assessed using the RoB 2 and ROBINS-I. Descriptive summaries were conducted, categorizing studies into active, passive, and mixed interventions. The evidence quality was rated using the GRADE approach. Ten studies with a total of 766 patients were included, made up of 5 RCTs and 5 cohort studies. Seven studies had high risk of bias, and three had moderate risk of bias. Mixed rehabilitation interventions combining physical, behavioral, and psychosocial strategies yielded the most consistent improvements in neurological function, quality of life, and self-efficacy. Intervention timing ranged from a few days postoperatively to 6 months. A meta-analysis was not performed due to study heterogeneity. Postoperative rehabilitation for DCM shows promise, particularly with multimodal, goal-oriented, and patient-centered approaches. However, evidence is limited by the high risk of bias, poor methodological detail and lack of standardization.

Background: Intramuscular fat (IMF) accumulation, a feature of myosteatosis, reflects impaired skeletal muscle quality. Chronic systemic inflammation may contribute to IMF accumulation, but this association has not been comprehensively synthesized. Objectives: To systematically evaluate and quantitatively synthesize associations between systemic inflammatory biomarkers and skeletal muscle IMF in adults. Design: Systematic review and meta-analysis conducted according to PRISMA guidelines. Data Sources and Methods: PubMed, Scopus, and Web of Science were searched from inception to November 24, 2025. Eligible adult studies assessed systemic inflammatory biomarkers and IMF using validated methods; studies without validated IMF assessment or extractable association data were excluded. Risk of bias was assessed using design-specific Joanna Briggs Institute critical appraisal tools. Two reviewers independently extracted data. Extractable correlations were pooled using random-effects meta-analysis after Fisher’s Z transformation. Results: Twenty-one studies involving 5,929 participants were included. Pooled associations with IMF were weak for CRP (r ≈ 0.15; [95% CI: 0.04 to 0.25]; [95% PI: −0.18 to 0.45]) and IL-6 (r ≈ 0.20; [95% CI: 0.03 to 0.35]; [95% PI: −0.39 to 0.67]), whereas TNF-α showed a negligible pooled association (r = −0.05; [95% CI: −0.35 to 0.26]; [95% PI: −0.90 to 0.88]). All prediction intervals included the null, indicating uncertainty in associations expected in future comparable studies. Associations appeared more consistent in populations with sustained inflammatory or immune-metabolic burden. Interpretation was limited by substantial heterogeneity, variable IMF assessment methods, inconsistent covariate adjustment, and predominantly observational designs. Conclusion: Systemic inflammatory biomarkers show weak associations with skeletal muscle IMF. Inflammation may contribute to myosteatosis within a multifactorial process, but the small effect sizes suggest limited stand-alone clinical utility.