Increased stiffness is evidenced in the deep but not superficial lumbar multifidus muscle in professional athletes with chronic low back pain.

IF 3.6 2区 医学 Q1 REHABILITATION Archives of physical medicine and rehabilitation Pub Date : 2024-11-21 DOI:10.1016/j.apmr.2024.11.004
Emma Feng Ming Zhou, Arnold Yu Lok Wong, Guohui Lin, Jianhui Fang, Tao Wen, Juhua Peng, Siu Ngor Fu
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Abstract

Objectives: Elevated lumbar multifidus stiffness has been observed in populations with chronic low back pain (LBP). However, the modulation of deep (DLM) and superficial (SLM) lumbar multifidus stiffness, considering their distinct structural characteristics and functions, remains unaddressed, especially in athletes. This study aimed to compare differences in DLM and SLM stiffness in professional athletes from different sports with and without chronic LBP.

Design: Cross-sectional study.

Setting: This study was conducted at a provincial sports training centre.

Participants: Ninety-nine professional athletes (age: 18-27 years) from weightlifting, badminton, and track and field teams were recruited. Thirty-eight had chronic bilateral LBP.

Interventions: Not applicable.

Main outcome measures: Ultrasound shear wave elastography (SWE) measured Young's modulus (stiffness indicator) of DLM and SLM at the L4/5 facet joint level. Two-way analysis of variance examined the effects of chronic LBP and sport type on DLM and SLM stiffness while considering proper confounders. Significance was set at p < 0.05.

Results: Athletes with chronic LBP demonstrated significantly higher DLM stiffness on the dominant (by 17.73%, mean difference (MD) = 2.52kPa, p = 0.001) and non-dominant sides (by 13.54%, MD = 1.83kPa, p = 0.046) compared to pain-free counterparts. SLM stiffness varied significantly among the three athlete groups. Post-hoc analyses revealed greater SLM stiffness on the non-dominant side in weightlifters than in badminton players (by 51.76%, MD = 8.97kPa, p = 0.010) or track and field athletes (by 72.01%, MD = 11.01kPa, p = 0.008).

Conclusions: Chronic LBP and sport type significantly impact multifidus muscle stiffness, suggesting the need for targeted clinical assessments and reconditioning strategies focusing on DLM for chronic LBP and SLM for athletes in trunk extension-intensive sports.

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在患有慢性腰痛的职业运动员中,腰部深层多裂肌的僵硬度增加,而浅层多裂肌的僵硬度没有增加。
研究目的在慢性腰痛(LBP)患者中观察到腰部多裂肌僵硬度升高。然而,考虑到深层(DLM)和浅层(SLM)腰部多裂肌僵硬度的不同结构特征和功能,它们之间的调节作用仍未得到解决,尤其是在运动员中。本研究旨在比较患有和未患有慢性腰椎间盘突出症的不同运动项目专业运动员的深层腰肌和浅层腰肌僵硬度的差异:设计:横断面研究:研究在一家省级体育训练中心进行:招募了来自举重队、羽毛球队和田径队的 99 名专业运动员(年龄:18-27 岁)。干预措施:不适用:主要结果测量:超声剪切波弹性成像(SWE)测量了L4/5面关节水平的DLM和SLM的杨氏模量(硬度指标)。双向方差分析检验了慢性枸杞多糖症和运动类型对 DLM 和 SLM 硬度的影响,同时考虑了适当的混杂因素。显著性以 p < 0.05 为标准:与无痛运动员相比,患有慢性腰椎间盘突出症的运动员优势侧(17.73%,平均差(MD)= 2.52kPa,p = 0.001)和非优势侧(13.54%,MD = 1.83kPa,p = 0.046)的DLM僵硬度明显更高。三组运动员的SLM僵硬度差异很大。事后分析显示,与羽毛球运动员(51.76%,MD = 8.97kPa,p = 0.010)或田径运动员(72.01%,MD = 11.01kPa,p = 0.008)相比,举重运动员非优势侧的SLM僵硬度更高:结论:慢性腰椎间盘突出症和运动类型对多裂肌僵硬度有显著影响,这表明需要对慢性腰椎间盘突出症患者进行有针对性的临床评估,并制定有针对性的康复策略,重点关注DLM,以及躯干伸展密集型运动中运动员的SLM。
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来源期刊
CiteScore
6.20
自引率
4.70%
发文量
495
审稿时长
38 days
期刊介绍: The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities. Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.
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