Current research directly compares combined motor control and isolated extensor strengthening (MC+ILEX) with general exercise (GE) for patients with neck and low back pathologies, focusing on paraspinal muscle health and clinical outcomes. MC+ILEX leads to greater improvements in paraspinal muscle size and thickness, but both approaches similarly improve pain, function, and quality of life. Key Findings from Recent Research Muscle Morphology and Composition MC+ILEX produces g

Strengthening the deep layer musculature of the spine—primarily the multifidus and deep erector spinae—relies on targeted exercise interventions. Motor control exercises, isolated lumbar extension, and general strengthening are the most studied methods, with evidence supporting their role in improving muscle morphology, function, and pain, though structural changes are often modest. Main Strengthening Methods and Evidence Method Evidence & Results Citations Motor Control Exer

The deep layer musculature of the spine, particularly the multifidus and longissimus muscles, plays a critical role in spinal stability, load distribution, and functional outcomes. Alterations in their biomechanical properties—such as reduced force generation, increased stiffness, and fatty infiltration—are strongly linked to spinal disorders, pain, and poor surgical outcomes. Biomechanical Properties and Qualities Force Generation and Stiffness:  Deep paraspinal muscles in p

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