The Fifth Clinical College of Guangzhou University of Chinese Medicine, Guangzhou 510000, China.
Baishui Town Health Center, Zhanyi District, Qujing 655000, China.
Biomed Res Int. 2020 Feb 18;2020:7649157. doi: 10.1155/2020/7649157. eCollection 2020.
There is limited research on the changes of biomechanical characteristics of the lumbar extensor myofascia in elderly patients with chronic low back pain. This study aimed to compare the biomechanical properties of the lumbar extensor myofascia in elderly patients with chronic low back pain and healthy people when resting and to analyze the relationship between the Japanese Orthopedic Association (JOA) score, visual analog scale (VAS) score, Cobb angle, and disease course and the biomechanical characteristics of the lumbar extensor myofascia. This case-control study included 40 elderly patients with chronic low back pain and 40 healthy volunteers. MyotonPRO was used to measure the biomechanical properties of the bilateral lumbar extensor myofascia (at L3/L4 level) in all participants, and the reliability of the MyotonPRO test was measured. Cobb angle was measured from lumbar computed tomography or magnetic resonance imaging data. JOA and VAS scores were used to evaluate lumbar function and pain. We found that muscle tone, stiffness, and elasticity of the left and right lumbar extensor myofascia in patients with chronic low back pain were very reliable among different operators. The average lumbar extensor muscle tone and stiffness were significantly higher in patients with chronic low back pain than those in healthy controls. The average elasticity of the lumbar extensor myofascia of patients with chronic low back pain was significantly lower than that of the healthy controls. The JOA score was negatively correlated, while the VAS score was positively correlated with the mean values of tone, stiffness, and elasticity of the bilateral lumbar extensor myofascia (logarithmic decrement). Disease course had no significant correlation with muscle tone, stiffness, and elasticity of the lumbar extensor myofascia. No significant correlation was found between Cobb angle and muscle tone, stiffness, and elasticity of the lumbar extensor myofascia in either group.
关于慢性下腰痛老年患者腰椎伸肌筋膜生物力学特性变化的研究较少。本研究旨在比较慢性下腰痛老年患者与健康人在休息时腰椎伸肌筋膜的生物力学特性,并分析日本骨科协会(JOA)评分、视觉模拟评分(VAS)、Cobb 角、病程与腰椎伸肌筋膜生物力学特性的关系。本病例对照研究纳入了 40 例慢性下腰痛老年患者和 40 例健康志愿者。所有参与者均使用 MyotonPRO 测量双侧腰椎伸肌筋膜(L3/L4 水平)的生物力学特性,并测量了 MyotonPRO 测试的可靠性。从腰椎 CT 或磁共振成像数据中测量 Cobb 角。使用 JOA 和 VAS 评分评估腰椎功能和疼痛。我们发现,慢性下腰痛患者左右侧腰椎伸肌筋膜的肌肉张力、硬度和弹性在不同操作者之间具有很好的可重复性。慢性下腰痛患者的平均腰椎伸肌张力和硬度均显著高于健康对照组。慢性下腰痛患者的腰椎伸肌筋膜平均弹性显著低于健康对照组。JOA 评分与双侧腰椎伸肌筋膜的张力、硬度和弹性的平均值呈负相关(对数递减),而 VAS 评分与双侧腰椎伸肌筋膜的张力、硬度和弹性的平均值呈正相关。病程与腰椎伸肌筋膜的张力、硬度和弹性无显著相关性。两组中 Cobb 角与腰椎伸肌筋膜的张力、硬度和弹性均无显著相关性。