van Amstel Robbert N, Jaspers Richard T, Pool-Goudzwaard Annelies L
Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherlands.
Fysio Science Department, Fysio Physics Group, IJsselstein, Netherlands.
Front Physiol. 2022 Nov 23;13:1067816. doi: 10.3389/fphys.2022.1067816. eCollection 2022.
Low back pain (LBP), associated with spine, pelvis, and hip mobility impairments can be caused by tight muscle contractions, to protect sensitized lumbar fasciae. Fascia tissue manipulations are used to treat lumbar fascia in LBP. The effect of fascia tissue manipulations through lumbodorsal skin displacement (SKD) on mobility is inconclusive likely depending on the location and displacement direction of the manipulation. This study aimed to assess whether lumbodorsal SKD affects the flexion -and extension range of motion (ROM), in healthy subjects. Furthermore, we aimed to test the effect of SKD at different locations and directions. Finally, to assess intertester and intratester reliability of SKD. Effects of SKD were tested in a motion capture, single-blinded, longitudinal, experimental study. Sixty-three subjects were randomly assigned to SKD- or sham group. SKD group was subjected to either mediolateral directed SKD during flexion or extension movement, a sham. The thoracic, lumbar, and hip angles and finger floor distance were measured to assess the change in ROM. Statistics indicated that the effect size in instantaneously change of flexion -and extension ROM by SKD was large (Effect size: flexion η = 0.12-0.90; extension η = 0.29-0.42). No significant effect was present in the sham condition. Flexion ROM decreased whereas the extension ROM increased, depending on SKD location- and displacement direction ( < 0.05). The ICC indicates a good intertester and intratester reliability (resp. ICC = 0.81-0.93; ICC = 0.70-0.84). Lumbodorsal SKD affects the flexion- and extension spine, pelvis, and hip range of motion. The effects of SKD are direction- and location dependent as well as movement (flexion/extension) specific. Lumbodorsal SKD during flexion and extension may be useful to determine whether or not a patient would benefit from fascia tissue manipulations. Further research is required to obtain insight into the mechanisms which the SKD affects ROM and muscle activation, in healthy, asymptomatic-LBP, and LBP subjects.
与脊柱、骨盆和髋关节活动障碍相关的下背痛（LBP）可能由肌肉紧张收缩引起，以保护敏感的腰部筋膜。筋膜组织手法用于治疗LBP中的腰部筋膜。通过腰背部皮肤移位（SKD）进行的筋膜组织手法对活动度的影响尚无定论，这可能取决于手法的位置和移位方向。本研究旨在评估腰背部SKD是否会影响健康受试者的屈伸活动范围（ROM）。此外，我们旨在测试不同位置和方向的SKD的效果。最后，评估SKD的测试者间和测试者内可靠性。在一项动作捕捉、单盲、纵向实验研究中测试了SKD的效果。63名受试者被随机分配到SKD组或假手术组。SKD组在屈伸运动期间接受向中外侧的SKD，假手术组则进行假操作。测量胸、腰和髋关节角度以及手指到地面的距离，以评估ROM的变化。统计表明，SKD引起的屈伸ROM瞬间变化的效应大小较大（效应大小：屈曲η = 0.12 - 0.90；伸展η = 0.29 - 0.42）。在假手术条件下没有显著影响。根据SKD的位置和移位方向，屈曲ROM降低而伸展ROM增加（P < 0.05）。组内相关系数（ICC）表明测试者间和测试者内可靠性良好（分别为ICC = 0.81 - 0.93；ICC = 0.70 - 0.84）。腰背部SKD会影响脊柱、骨盆和髋关节的屈伸活动范围。SKD的效果取决于方向、位置以及运动（屈曲/伸展）类型。屈伸过程中的腰背部SKD可能有助于确定患者是否会从筋膜组织手法中受益。需要进一步研究以深入了解SKD影响ROM和肌肉激活的机制，包括健康、无症状LBP和LBP受试者。
