Matsuda R1, Kumamoto T2, Seko T2, Miura S3, Hamamoto T1
1Sinnsapporo Neurosurgical Hospital, Department of Rehabilitation, Sapporo, Japan, 2Hokkaido Chitose College of Rehabilitation, Division of Physical Therapy, Department of Rehabilitation, Faculty of Health Science, Chitose, Japan, 3Hokusei Hospital, Department of Rehabilitation, Chitose, Japan
Background: Lumbar pain involves dysfunction of lumbar multifidus muscle and circulatory disorder due to elevated intramuscular pressure. Trunk extension exercise in the standing position is recommended as exercise therapy.
Purpose: This study aims to set a lumbar muscle fatigue model for ischemic nonspecific lumbar pain and to investigate trunk extension-induced physiological changes of the multifidus muscle using blood circulation dynamics.
Methods: Nineteen healthy volunteers (mean ± standard deviation: age 21.0 ± 2.5 years; BMI, 24.8 ± 2.5) were included in this study. Exclusion criteria included history of musculoskeletal disorder and central nervous system disease. To place an endurance load to low back muscles, participants underwent a 60-second Sorensen fatigue test (SFT). Participants were randomly assigned to one of the following two groups: Ex group performing trunk extension exercise as an exercise task after SFT (11 individuals); and n-Ex group holding the standing position as an exercise task for the same period of time as in the Ex group after SFT (8 individuals). With the palms of the hands placed on the posterior surfaces of the iliac crests, participants in the Ex group were asked to extend the trunk as much as possible from standing position. Then, the participants were asked to return to the standing position and remain standing; this was counted as one set of the trunk extension exercise. Five sets of this exercise were repeated, with each posture held for 10 seconds. Blood circulation dynamics were measured with a near-infrared tissue oxygen monitor (Pocket NIRS Duo, DynaSense Inc.). Blood circulation dynamics were measured on the left side of the multifidus muscles at a point 2 cm lateral to the spinous process of the fifth lumbar vertebra. Levels of oxygenated hemoglobin (Oxy-Hb), deoxygenated hemoglobin (deOxy-Hb), and total hemoglobin (total-Hb) in multifidus muscle were measured in the standing position before SFT (pre) and after the exercise task (post), and pre and post values for each group were statistically compared using paired t-test with the statistics software program R (version 2.8.1). The significant level was set at 5%.
Results: Significant differences were noted for Oxy-Hb (pre: 0.013, post: 0.065) and total-Hb (pre: 0.016, post: 0.083) in the Ex group (p = 0.031, 0.040). In the n-Ex group, a significant difference (p = 0.046) was found for Oxy-Hb (pre: 0.004, post: 0.025), but not for total-Hb. There was no significant difference in deOxy-Hb both Ex group and n-Ex group.
Conclusion(s): Significant increases in Oxy-Hb and total-Hb were observed in the Ex group, suggesting that trunk extension exercise may contribute to improvement of blood circulation dynamics in muscle fatigue.
Implications: Trunk extension exercise can be expected to alleviate ischemic lumbar pain due to muscle fatigue.
Keywords: Low back pain, Near-infrared spectroscopy, Hemodynamics
Funding acknowledgements: This study was supported by JSPS KAKENHI Grant Number JP17K01517.
Purpose: This study aims to set a lumbar muscle fatigue model for ischemic nonspecific lumbar pain and to investigate trunk extension-induced physiological changes of the multifidus muscle using blood circulation dynamics.
Methods: Nineteen healthy volunteers (mean ± standard deviation: age 21.0 ± 2.5 years; BMI, 24.8 ± 2.5) were included in this study. Exclusion criteria included history of musculoskeletal disorder and central nervous system disease. To place an endurance load to low back muscles, participants underwent a 60-second Sorensen fatigue test (SFT). Participants were randomly assigned to one of the following two groups: Ex group performing trunk extension exercise as an exercise task after SFT (11 individuals); and n-Ex group holding the standing position as an exercise task for the same period of time as in the Ex group after SFT (8 individuals). With the palms of the hands placed on the posterior surfaces of the iliac crests, participants in the Ex group were asked to extend the trunk as much as possible from standing position. Then, the participants were asked to return to the standing position and remain standing; this was counted as one set of the trunk extension exercise. Five sets of this exercise were repeated, with each posture held for 10 seconds. Blood circulation dynamics were measured with a near-infrared tissue oxygen monitor (Pocket NIRS Duo, DynaSense Inc.). Blood circulation dynamics were measured on the left side of the multifidus muscles at a point 2 cm lateral to the spinous process of the fifth lumbar vertebra. Levels of oxygenated hemoglobin (Oxy-Hb), deoxygenated hemoglobin (deOxy-Hb), and total hemoglobin (total-Hb) in multifidus muscle were measured in the standing position before SFT (pre) and after the exercise task (post), and pre and post values for each group were statistically compared using paired t-test with the statistics software program R (version 2.8.1). The significant level was set at 5%.
Results: Significant differences were noted for Oxy-Hb (pre: 0.013, post: 0.065) and total-Hb (pre: 0.016, post: 0.083) in the Ex group (p = 0.031, 0.040). In the n-Ex group, a significant difference (p = 0.046) was found for Oxy-Hb (pre: 0.004, post: 0.025), but not for total-Hb. There was no significant difference in deOxy-Hb both Ex group and n-Ex group.
Conclusion(s): Significant increases in Oxy-Hb and total-Hb were observed in the Ex group, suggesting that trunk extension exercise may contribute to improvement of blood circulation dynamics in muscle fatigue.
Implications: Trunk extension exercise can be expected to alleviate ischemic lumbar pain due to muscle fatigue.
Keywords: Low back pain, Near-infrared spectroscopy, Hemodynamics
Funding acknowledgements: This study was supported by JSPS KAKENHI Grant Number JP17K01517.
Topic: Musculoskeletal: spine; Musculoskeletal; Orthopaedics
Ethics approval required: Yes
Institution: Hokkaido Chitose College of Rehabilitation
Ethics committee: Research Ethics Committee Hokkaido Chitose College of Rehabilitation
Ethics number: 18001
All authors, affiliations and abstracts have been published as submitted.
