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腰痛患者的腰部肌肉僵硬与无症状对照者不同,与疼痛和残疾有关,但与常见的体格检查结果无关。

Lumbar muscle stiffness is different in individuals with low back pain than asymptomatic controls and is associated with pain and disability, but not common physical examination findings.

机构信息

Baylor University Doctoral Program in Physical Therapy, Waco, TX, USA.

U.S. Army-Baylor University Doctoral Program in Physical Therapy, San Antonio, TX, USA.

出版信息

Musculoskelet Sci Pract. 2020 Feb;45:102078. doi: 10.1016/j.msksp.2019.102078. Epub 2019 Nov 1.


DOI:10.1016/j.msksp.2019.102078
PMID:31704551
Abstract

BACKGROUND: Lumbar muscle dysfunction is commonly implicated in low back pain (LBP). Shear-wave elastography (SWE) uses ultrasound technology to quantify absolute soft tissue stiffness (shear modulus), thereby allowing for estimation of individual muscle contraction and function. OBJECTIVES: To compare resting and contracted stiffness of lumbar spine musculature in individuals with and without LBP using SWE. A secondary aim was to explore for relationships between common self-report and physical examination measures and resting and contracted muscle stiffness in individuals with LBP. DESIGN: Cross-sectional. METHODS: Shear modulus of the lumbar musculature was measured in 60 participants with LBP and 60 asymptomatic controls (120 total) using SWE. The lumbar erector spinae were imaged at rest only, while the lumbar multifidus was imaged at rest and during contraction. Before imaging, participants with LBP underwent a standardized clinical examination including a brief history, self-report questionnaires, and a physical examination. Lumbar muscle shear modulus was compared between participants with LBP and asymptomatic controls using ANCOVA. Potential associations between shear modulus and selected self-report and physical examination measures were assessed using correlation analysis. RESULTS: Stiffness of the erector spinae and lumbar multifidus at rest (but not during contraction) was greater in participants with LBP than in asymptomatic controls (p < 0.05). Many of the self-report measures, but none of the physical examination findings were associated with muscle stiffness. CONCLUSION: Resting lumbar muscle stiffness is greater in individuals with LBP than asymptomatic controls and is associated with self-reported pain and disability, but not physical exam findings.

摘要

背景:腰部肌肉功能障碍常与下腰痛(LBP)有关。剪切波弹性成像(SWE)使用超声技术来量化绝对软组织硬度(剪切模量),从而可以估计个体肌肉的收缩和功能。

目的:使用 SWE 比较有和无 LBP 的个体的腰部脊柱肌肉的休息和收缩时的僵硬程度。次要目的是探索 LBP 个体的常见自我报告和体格检查措施与休息和收缩肌肉僵硬之间的关系。

设计:横断面研究。

方法:使用 SWE 测量 60 名有 LBP 和 60 名无症状对照者(共 120 名)的腰部脊柱肌肉的剪切模量。腰椎竖脊肌仅在休息时进行成像,而腰椎多裂肌在休息和收缩时进行成像。在成像之前,LBP 参与者接受了标准化的临床检查,包括简要病史、自我报告问卷和体格检查。使用协方差分析比较 LBP 参与者和无症状对照组之间的腰椎肌肉剪切模量。使用相关分析评估剪切模量与选定的自我报告和体格检查措施之间的潜在关联。

结果:与无症状对照组相比,LBP 参与者的竖脊肌和腰椎多裂肌在休息时(但不是收缩时)的僵硬度更大(p<0.05)。许多自我报告的措施,但没有一项体格检查结果与肌肉僵硬有关。

结论:与无症状对照组相比,LBP 个体的休息时腰部肌肉僵硬度更大,与自我报告的疼痛和残疾有关,但与体格检查结果无关。

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[2]
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BMC Sports Sci Med Rehabil. 2025-5-3

[3]
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Pain Ther. 2025-4

[4]
Shear wave elastography based analysis of changes in fascial and muscle stiffness in patients with chronic non-specific low back pain.

Front Bioeng Biotechnol. 2024-11-15

[5]
Ultrasound elastography of back muscle biomechanical properties: a systematic review and meta-analysis of current methods.

Insights Imaging. 2024-8-14

[6]
Targeted multifidus muscle activation reduces fibrosis of multifidus muscle following intervertebral disc injury.

Eur Spine J. 2024-6

[7]
Changes of trunk muscle stiffness in individuals with low back pain: a systematic review with meta-analysis.

BMC Musculoskelet Disord. 2024-2-19

[8]
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Sensors (Basel). 2024-1-31

[9]
Differential Effects of Classical vs. Sports Massage on Erector Spinae and Upper Trapezius Muscle Stiffness: A Shear-Wave Elastography Study in Young Women.

Sports (Basel). 2024-1-9

[10]
Physically Active Adults with Low Back Pain do not Demonstrate Altered Deadlift Mechanics: A Novel Application of Myotonometry to Estimate Inter-Muscular Load Sharing.

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