Association of low back pain with muscle stiffness and muscle mass of the lumbar back muscles, and sagittal spinal alignment in young and middle-aged medical workers

The paraspinal compartment acts as a bone–muscle composite beam of the spine. The elastic properties of the paraspinal muscles play a critical role in spine stabilization. These properties depend on the subjects’ posture, and they may be drastically altered by low back pain. Supersonic shear wave elastography can be used to provide quantitative stiffness maps (elastograms), which characterize the elastic properties of the probed tissue. The aim of this study was to challenge shear wave elastography sensitivity to postural stiffness changes in healthy paraspinal muscles. The stiffness of the main paraspinal muscles (longissimus, iliocostalis, multifidus) was measured by shear wave elastography at the lumbosacral level (L3 and S1) for six static postures performed by volunteers. Passive postures (rest, passive flexion, passive extension) were performed in a first shear wave elastography session, and active postures (upright, bending forward, bending backward) with rest posture for reference were performed in a second session. Measurements were repeated three times for each posture. Sixteen healthy young adults were enrolled in the study. Non‐parametric paired tests, multiple analyses of covariance, and intra‐class correlations were implemented for analysis. Shear wave elastography showed good to excellent reliability, except in the multifidus at S1, during bending forward, and in the multifidus at L3, during bending backward. Yet, during bending forward, only poor quality was recorded for nine volunteers in the longissimus. Significant intra‐ and inter‐muscular changes were observed with posture. Stiffness significantly increased for the upright position and bending forward with respect to the reference values recorded in passive postures. In conclusion, shear wave elastography allows reliable assessment of the stiffness of the paraspinal muscles except in the multifidus at S1 and longissimus, during bending forward, and in the multifidus at L3, during bending backward. It reveals a different biomechanical behaviour for the multifidus, the longissimus, and the iliocostalis.

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“…Recently, Masaki et al. () reported significantly higher stiffness in the multifidus in low back pain than in the control group.…”

Section: Introductionmentioning

confidence: 95%

Posture‐related stiffness mapping of paraspinal muscles

et al. 2019

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“…ere is no previous study we could refer to that analyzed the biomechanical properties of the lumbar myofascial tissue in elderly patients with CLBP, nor did we find any study on the correlation between the lumbar lordosis angle, Japanese Orthopedic Association (JOA) score, and the biomechanical properties of the lumbar extensor myofascia. e biomechanical properties of the paraspinal muscles and fascia are mostly assessed by manual palpation, and this is used to assist in diagnosis and evaluation of therapeutic effect [18,19]. However, the reliability of manual palpation in clinical application has always been doubted [20,21].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Biomechanical Properties of the Lumbar Extensor Myofascia in Elderly Patients with Chronic Low Back Pain and That in Healthy People

Zhu²,

et al. 2020

BioMed Research International

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There is limited research on the changes of biomechanical characteristics of the lumbar extensor myofascia in elderly patients with chronic low back pain. This study aimed to compare the biomechanical properties of the lumbar extensor myofascia in elderly patients with chronic low back pain and healthy people when resting and to analyze the relationship between the Japanese Orthopedic Association (JOA) score, visual analog scale (VAS) score, Cobb angle, and disease course and the biomechanical characteristics of the lumbar extensor myofascia. This case-control study included 40 elderly patients with chronic low back pain and 40 healthy volunteers. MyotonPRO was used to measure the biomechanical properties of the bilateral lumbar extensor myofascia (at L3/L4 level) in all participants, and the reliability of the MyotonPRO test was measured. Cobb angle was measured from lumbar computed tomography or magnetic resonance imaging data. JOA and VAS scores were used to evaluate lumbar function and pain. We found that muscle tone, stiffness, and elasticity of the left and right lumbar extensor myofascia in patients with chronic low back pain were very reliable among different operators. The average lumbar extensor muscle tone and stiffness were significantly higher in patients with chronic low back pain than those in healthy controls. The average elasticity of the lumbar extensor myofascia of patients with chronic low back pain was significantly lower than that of the healthy controls. The JOA score was negatively correlated, while the VAS score was positively correlated with the mean values of tone, stiffness, and elasticity of the bilateral lumbar extensor myofascia (logarithmic decrement). Disease course had no significant correlation with muscle tone, stiffness, and elasticity of the lumbar extensor myofascia. No significant correlation was found between Cobb angle and muscle tone, stiffness, and elasticity of the lumbar extensor myofascia in either group.

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“…The relationships between the occurrence of NCLBP and the other variables (including the BMI, height, weight and pelvic asymmetry parameters) were explored by Spearman correlation with the occurrences of NCLBP as ordinal data (the participants with NCLBP were marked as 1, and the controls were marked as 0). Adapting the methods used in the previous study (28), the age, BMI, height, weight, and pelvic asymmetry parameters were used as the independent variables in the logistic regression analysis.…”

Section: Discussionmentioning

confidence: 99%

Pelvic asymmetry as a risk factor for nonspecific chronic low back pain

Yu¹,

Huang²,

Zhang³

et al. 2020

Preprint

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KEYWORDSpelvic asymmetry, low back pain, photographic assessment, pelvic posture 3 Abstract Background Empirical evidence that identifies the pelvic asymmetry in which movement plane that contribute to non-specific chronic low back pain (NCLBP) is currently lacking.Objective To establish the reliability of the Global Postural System (GPS) in assessing pelvic asymmetry and identify the association between pelvic asymmetry parameters and the occurrence of NCLBP in young adults.Design A cross-sectional, regression study.Methods People who aged between 18 and 30 and were diagnosed with NCLBP were recruited.Healthy individuals who were matched for age, gender, and education level were recruited as controls and for the reliability analysis. Reliability was assessed by the ICC (3, k), standard error and minimal detectable difference. Bivariate correlation analysis and logistic regression analysis were used to determine the risk factors.Results Twenty-eight healthy participants and 28 people with NCLBP were recruited. Moderate to excellent ICCs were observed for the inter-rater and intra-rater reliability of most postural parameters.The bivariate correlation analysis indicated that age, body mass index and pelvic asymmetry parameters were related to the occurrence of NCLBP. Pelvic angle asymmetry (odd ratio=1.17), and asymmetry of the distance between the posterior superior iliac spine and the floor (odd ratio=1.21)were significant risk factors of NCLBP.Limitation This study did not explore the causal relationship between pelvic asymmetry in the sagittal plane/pelvic asymmetry in the transverse plane and the occurrence of NCLBP. The interpretation of the results may not be generalized beyond the sample population.Conclusions The GPS is a reliable method to assess pelvic asymmetry in a clinical setting. The pelvic asymmetry parameters obtained from the GPS are likely to assist in the early identification of the potential occurrence of NCLBP.

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Association of low back pain with muscle stiffness and muscle mass of the lumbar back muscles, and sagittal spinal alignment in young and middle-aged medical workers

Abstract: The results of this study suggest that LBP is associated with muscle stiffness of the lumbar multifidus muscle in young and middle-aged medical workers.

Cited by 78 publications

References 39 publications

Posture‐related stiffness mapping of paraspinal muscles

Posture‐related stiffness mapping of paraspinal muscles

Analysis of Biomechanical Properties of the Lumbar Extensor Myofascia in Elderly Patients with Chronic Low Back Pain and That in Healthy People

Pelvic asymmetry as a risk factor for nonspecific chronic low back pain

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