Non-specific low back pain (NS-LBP) is known to cause respiratory dysfunction. In this study, we investigated alterations in breathing, respiratory strength and endurance, core stability, diaphragm mobility, and chest expansion among patients with NS-LBP and healthy individuals. The specific aim of the study was to correlate between respiratory function and other variables among NS-LBP patients. Thirty four patients with NS-LBP were matched with 34 healthy participants before undergoing total faulty breathing scale, spirometer, respiratory pressure meter, chest expansion, ultrasound, and pressure biofeedback measurements. There were signs of faulty breathing in the NS-LBP patients when compared to the healthy participants. Diaphragmatic mobility and respiratory muscle endurance were lower in the NS-LBP group. Chest expansion exhibited a significant decrease at the level of the fourth intercostal space in the NS-LBP group, but respiratory muscle strength and core stability were not significant between the two groups. Positive correlations were found to be fairly significant regarding respiratory muscle strength. The findings of this study indicated altered respiratory characteristics in the NS-LBP patients, and suggested that they would improve through respiratory exercises.

Background and Objective: Ultrasound measurement of Diaphragmatic Mobility (DM) has been shown to be a reliable measurement tool among healthy subjects. However, the measures of reliability are needed prior to clinical use of this device among Non-Specific Low Back Pain (NS-LBP). Therefore, the aim of the study was to investigate the relative and absolute reliability of DM using Real Time Ultrasound (RTUS) among subjects with NS-LBP. Materials and Methods: Nine subjects with NS-LBP (23.33 ± 1.58) years old were recruited. A qualified examiner performed measurement of DM using RTUS by placing transducer on the right subcostal region in semi-fowler's position with 30 degree elevation of the trunk. The test-retest measures were re-assessed with 24 hour interval between sessions. Results: There was no systematic errors between the test-retest measures (p>0.05). Intra rater reliability showed ICC value of 0.92, which indicates an excellent reliability. The SEMs of the measurement was 2.56 mm and the MDC of 7.09mm. Conclusion:The RTUS for assessing DM provides an excellent intra-rater reliability which may be used as an assessment technique for clinical evaluation of DM in adults with NS-LBP. The SEMs and MDC reported may also allow for accurate interpretation of DM assessments in NS-LBP.

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I n t r o d u c t i o n : Diaphragm Mobility (DM) assessment is gaining interest in the field of medicine and in the healthcare sector. Despite its clinical usage, the measure of reliability in assessing DM is not clearly known. A i m : To critically appraise the evidence describing the reliability measures of DM assessment using any of the diagnostic modalities. M a t e r i a l a n d m e t h o d s : A systematic search across five databases was carried out from January 1990 to September 2016. Quality Appraisal of Reliability Studies (QUAREL) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were used to assess the risk of bias and for rating the quality of the evidence. In addition, levels of evidence grading which synthesize all the included articles for grading were also used. R e s u l t s a n d d i s c u s s i o n : Four papers were included for assessing both intra-rater and inter-rater reliability using ultrasound and radiography. Three papers reported ICC measures of reliability, with one paper reporting CV% of reliability. The results demonstrate that, overall, lower levels of evidence exist among the selected articles between moderate and good for intra-rater reliability and good for inter-rater reliability measures. The synthesis of all the included articles demonstrated that, overall, moderate evidence exists. C o n c l u s i o n s : There were moderate-to-good reliability measures with a low risk of bias in both the forms of reliability for assessing diaphragmatic mobility.