Lin W.-J.1, Chen Y.-J.1, Chu M.-M.1, Shau Y.-W.2, Wang C.-L.3, Wang S.-F.1
1National Taiwan University, School of Physical Therapy, Taipei, Taiwan, 2Industrial Technology Research Institute, Biomedical Technology and Device Research Laboratories, Taipei, Taiwan, 3National Taiwan University Hospital, Department of Orthopedic Surgery, Taipei, Taiwan
Background: Since recurrent low back pain (LBP) is frequently occurred, structure such as fascia might play a substantial role in lumbar stability which is not stressed in the Panjabi's model. Changed fascia properties such as lateral raphe (LR) stiffness may come from abnormal mechanisms of hydraulic effect and force transmission, and inappropriate proprioception input.
Purpose: The purposes of this study were to compare the LR stiffness under resting and abdominal drawing-in maneuver (ADIM, defined as contraction of transverse abdominal muscle) conditions between asymptomatic participants and patients with unilateral LBP.
Methods: Patients with unilateral LBP (n=22, 29.7±6.7 y/o) and asymptomatic participants (n=20, 26.5±4.1 y/o) were recruited in the main study. The shear wave elastography (SuperSonic Imagine, Aix en Provence, France) with 5-12MHz linear transducer was used to measure the LR stiffness. Two-way repeated measures ANCOVA was used to analysis the difference of LR stiffness between asymptomatic participants and patients with unilateral LBP in resting and ADIM condition.
Results: There was significant interaction between groups and conditions (F=15.762，p= 0.0005). Post hoc for group demonstrated that LR stiffness was greater in LBP group during ADIM (LBP: 26.12±12.87 kPa; asymptomatic: 19.40±8.07 kPa, p=0.001).
Conclusion(s): The increase of LR stiffness of painful and non-painful sides under the ADIM condition in patients with unilateral LBP was greater than that in asymptomatic participants.
Implications: The present results indicate myofascial tension imbalance in patients with LBP and support the concept of tension imbalance in relation to fascial abnormality in patients with LBP.
Funding acknowledgements: MOST-103-2314-B-002-022
Topic: Musculoskeletal: spine
Ethics approval: NTUH 201312147RINB
All authors, affiliations and abstracts have been published as submitted.
