Functional and morphological lumbar multifidus characteristics in subgroups with low back pain in primary care,Musculoskeletal Science and Practice

当前位置： X-MOL 学术 › Musculoskelet. Sci. Pract. › 论文详情

Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)

Functional and morphological lumbar multifidus characteristics in subgroups with low back pain in primary care
Musculoskeletal Science and Practice ( IF 2.2 ) Pub Date : 2021-07-10 , DOI: 10.1016/j.msksp.2021.102429
Anke Hofste ₁ , Remko Soer ₂ , Gerbrand J Groen ₃ , Job van der Palen ₄ , Frank J B Geerdink ₅ , Frits G J Oosterveld ₅ , Henri Kiers ₆ , André P Wolff ₃ , Hermie Hermens ₇

Affiliation

University of Groningen, University Medical Center Groningen, Anesthesiology Pain Center, the Netherlands; Saxion University of Applied Sciences, Faculty Physical Activity and Health, Enschede, the Netherlands.
Saxion University of Applied Sciences, Faculty Physical Activity and Health, Enschede, the Netherlands; University of Groningen, University Medical Center Groningen, Pain Center, the Netherlands.
University of Groningen, University Medical Center Groningen, Anesthesiology Pain Center, the Netherlands; University of Groningen, University Medical Center Groningen, Pain Center, the Netherlands.
Department of Research Methodology, Measurement and Data Analysis, University of Twente, Enschede, Netherlands; Medical School Twente, Medisch Spectrum Twente, Enschede, Netherlands.
Saxion University of Applied Sciences, Faculty Physical Activity and Health, Enschede, the Netherlands.
Institute for Human Movement Studies, University of Applied Sciences Utrecht, Utrecht, the Netherlands.
Department of Biomedical Signals & Systems, Faculty of Electrical Engineering, Mathematics and Computer Science, University of Twente, Enschede, Netherlands; Telemedicine Group, Roessingh Research and Development Enschede, the Netherlands.

Background

Since the contribution of the lumbar multifidus(LM) is not well understood in relation to non-specific low back pain(LBP), this may limit physiotherapists in choosing the most appropriate treatment strategy.

Objectives

This study aims to compare clinical characteristics, in terms of LM function and morphology, between subacute and chronic LBP patients from a large clinical practice cohort compared to healthy controls.

Design

Multicenter case control study.

Method

Subacute and chronic LBP patients and healthy controls between 18 and 65 years of age were included. Several clinical tests were performed: primary outcomes were the LM thickness from ultrasound measurements, trunk range of motion(ROM) from 3D kinematic tests, and median frequency and root mean square values of LM by electromyography measurements. The secondary outcomes Numeric Rating Scale for Pain(NRS) and the Oswestry Disability Index(ODI) were administered. Comparisons between groups were made with ANOVA, p-values<0.05, with Tukey's HSD post-hoc test were considered significant.

Results

A total of 161 participants were included, 50 healthy controls, 59 chronic LBP patients, and 52 subacute LBP patients. Trunk ROM and LM thickness were significantly larger in healthy controls compared to all LBP patients(p < 0.01). A lower LM thickness was found between subacute and chronic LBP patients although not significant(p = 0.11–0.97). All between-group comparisons showed no statistically significant differences in electromyography outcomes (p = 0.10–0.32). NRS showed no significant differences between LBP subgroups(p = 0.21). Chronic LBP patients showed a significant higher ODI score compared to subacute LBP patients(p = 0.03).

Conclusions

Trunk ROM and LM thickness show differences between LBP patients and healthy controls.

中文翻译：

初级保健腰痛亚组的腰椎多裂肌功能和形态学特征

背景

由于腰椎多裂肌 (LM) 对非特异性腰痛 (LBP) 的影响尚不清楚，这可能会限制物理治疗师选择最合适的治疗策略。

目标

本研究旨在比较来自大型临床实践队列的亚急性和慢性 LBP 患者与健康对照组在 LM 功能和形态方面的临床特征。

设计

多中心病例对照研究。

方法

包括亚急性和慢性 LBP 患者以及 18 至 65 岁之间的健康对照。进行了多项临床测试：主要结果是超声测量的 LM 厚度、3D 运动学测试的躯干运动范围 (ROM) 以及肌电图测量的 LM 中值频率和均方根值。次要结果是疼痛数字评定量表 (NRS) 和 Oswestry 残疾指数 (ODI)。使用方差分析进行组间比较，p 值 <0.05，Tukey 的 HSD 事后检验被认为是显着的。

结果

总共包括 161 名参与者，50 名健康对照者，59 名慢性 LBP 患者和 52 名亚急性 LBP 患者。与所有 LBP 患者相比，健康对照组的躯干 ROM 和 LM 厚度显着更大（p < 0.01）。尽管不显着（p = 0.11-0.97），但在亚急性和慢性 LBP 患者之间发现了较低的 LM 厚度。所有组间比较均显示肌电图结果无统计学显着差异（p = 0.10-0.32）。NRS 显示 LBP 亚组之间没有显着差异（p = 0.21）。与亚急性 LBP 患者相比，慢性 LBP 患者的 ODI 评分显着更高（p = 0.03）。