Masaki Mitsuhiro, Aoyama Tomoki, Murakami Takashi, Yanase Ko, Ji Xiang, Tateuchi Hiroshige, Ichihashi Noriaki
Department of Physical Therapy, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata 950-3198, Japan; Institute for Human Movement and Medical Sciences, Niigata University of Health and Welfare, 1398 Shimami-cho, Kita-ku, Niigata 950-3198, Japan.
Department of Physical Therapy, Human Health Sciences, Graduate School of Medicine, Kyoto University, 53 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan.
Clin Biomech (Bristol). 2017 Nov;49:128-133. doi: 10.1016/j.clinbiomech.2017.09.008. Epub 2017 Sep 14.
Muscle stiffness of the lumbar back muscles in low back pain (LBP) patients has not been clearly elucidated because quantitative assessment of the stiffness of individual muscles was conventionally difficult. This study aimed to examine the association of LBP with muscle stiffness assessed using ultrasonic shear wave elastography (SWE) and muscle mass of the lumbar back muscle, and spinal alignment in young and middle-aged medical workers.
The study comprised 23 asymptomatic medical workers [control (CTR) group] and 9 medical workers with LBP (LBP group). Muscle stiffness and mass of the lumbar back muscles (lumbar erector spinae, multifidus, and quadratus lumborum) in the prone position were measured using ultrasonic SWE. Sagittal spinal alignment in the standing and prone positions was measured using a Spinal Mouse. The association with LBP was investigated by multiple logistic regression analysis with a forward selection method. The analysis was conducted using the shear elastic modulus and muscle thickness of the lumbar back muscles, and spinal alignment, age, body height, body weight, and sex as independent variables.
Multiple logistic regression analysis showed that muscle stiffness of the lumbar multifidus muscle and body height were significant and independent determinants of LBP, but that muscle mass and spinal alignment were not. Muscle stiffness of the lumbar multifidus muscle in the LBP group was significantly higher than that in the CTR group.
The results of this study suggest that LBP is associated with muscle stiffness of the lumbar multifidus muscle in young and middle-aged medical workers.
由于传统上难以对个体肌肉的僵硬度进行定量评估，因此下腰痛（LBP）患者的腰背肌僵硬度尚未得到明确阐释。本研究旨在探讨超声剪切波弹性成像（SWE）评估的肌肉僵硬度、腰背肌肌肉量以及脊柱排列与年轻及中年医务工作者LBP之间的关联。
本研究纳入了23名无症状医务工作者[对照组（CTR组）]和9名患有LBP的医务工作者（LBP组）。采用超声SWE测量俯卧位时腰背肌（竖脊肌、多裂肌和腰方肌）的肌肉僵硬度和肌肉量。使用脊柱鼠标测量站立位和俯卧位时的矢状面脊柱排列。采用向前选择法通过多元逻辑回归分析研究与LBP的关联。分析时将腰背肌的剪切弹性模量和肌肉厚度、脊柱排列、年龄、身高、体重和性别作为自变量。
多元逻辑回归分析显示，多裂肌的肌肉僵硬度和身高是LBP的显著且独立的决定因素，但肌肉量和脊柱排列不是。LBP组多裂肌的肌肉僵硬度显著高于CTR组。
本研究结果表明，年轻及中年医务工作者的LBP与多裂肌的肌肉僵硬度有关。
