Reduced thoracolumbar fascia shear strain in human chronic low back pain

BMC Musculoskeletal Disorders

Research Article

John J Triano¹  Gary J Badger²  James R Fox³  Cathryn Koptiuch³  Nicole A Bouffard³  Helene M Langevin⁴  Sharon M Henry⁵  Elisa E Konofagou⁶  Wei-Ning Lee⁶  Ann C Greenan- Naumann⁷ 

[1] Canadian Memorial Chiropractic College, Toronto, ON, Canada;Department of Medical Biostatistics, University of Vermont, Burlington VT, USA;Department of Neurology, University of Vermont, Burlington VT, USA;Department of Neurology, University of Vermont, Burlington VT, USA;Department of Orthopedics & Rehabilitation, University of Vermont, Burlington VT, USA;Department of Rehabilitation & Movement, Science, University of Vermont, Burlington VT, USA;Departments of Biomedical Engineering and Radiology, Columbia University, New York, NY, USA;Orthopaedic Specialty Center, Fletcher Allen Health Care, Burlington VT, USA;

关键词: Shear Strain;    Task Duration;    Trunk Flexion;    Tissue Displacement;    Thoracolumbar Fascia;   

DOI  :  10.1186/1471-2474-12-203

 received in 2011-05-20, accepted in 2011-09-19,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundThe role played by the thoracolumbar fascia in chronic low back pain (LBP) is poorly understood. The thoracolumbar fascia is composed of dense connective tissue layers separated by layers of loose connective tissue that normally allow the dense layers to glide past one another during trunk motion. The goal of this study was to quantify shear plane motion within the thoracolumbar fascia using ultrasound elasticity imaging in human subjects with and without chronic low back pain (LBP).MethodsWe tested 121 human subjects, 50 without LBP and 71 with LBP of greater than 12 months duration. In each subject, an ultrasound cine-recording was acquired on the right and left sides of the back during passive trunk flexion using a motorized articulated table with the hinge point of the table at L4-5 and the ultrasound probe located longitudinally 2 cm lateral to the midline at the level of the L2-3 interspace. Tissue displacement within the thoracolumbar fascia was calculated using cross correlation techniques and shear strain was derived from this displacement data. Additional measures included standard range of motion and physical performance evaluations as well as ultrasound measurement of perimuscular connective tissue thickness and echogenicity.ResultsThoracolumbar fascia shear strain was reduced in the LBP group compared with the No-LBP group (56.4% ± 3.1% vs. 70.2% ± 3.6% respectively, p < .01). There was no evidence that this difference was sex-specific (group by sex interaction p = .09), although overall, males had significantly lower shear strain than females (p = .02). Significant correlations were found in male subjects between thoracolumbar fascia shear strain and the following variables: perimuscular connective tissue thickness (r = -0.45, p <.001), echogenicity (r = -0.28, p < .05), trunk flexion range of motion (r = 0.36, p < .01), trunk extension range of motion (r = 0.41, p < .01), repeated forward bend task duration (r = -0.54, p < .0001) and repeated sit-to-stand task duration (r = -0.45, p < .001).ConclusionThoracolumbar fascia shear strain was ~20% lower in human subjects with chronic low back pain. This reduction of shear plane motion may be due to abnormal trunk movement patterns and/or intrinsic connective tissue pathology. There appears to be some sex-related differences in thoracolumbar fascia shear strain that may also play a role in altered connective tissue function.

【 授权许可】

CC BY   
© Langevin et al; licensee BioMed Central Ltd. 2011