Brandl Andreas, Wilke Jan, Egner Christoph, Reer Rüdiger, Schmidt Tobias, Schleip Robert
Department of Sports Medicine, Institute for Human Movement Science, Faculty for Psychology and Human Movement Science, University of Hamburg, Hamburg, Germany.
Department for Medical Professions, Diploma Hochschule, Bad Sooden-Allendorf, Germany.
Front Med (Lausanne). 2023 Jun 5;10:1177146. doi: 10.3389/fmed.2023.1177146. eCollection 2023.
Alterations in posture, lumbopelvic kinematics, and movement patterns are commonly seen in patients with low back pain. Therefore, strengthening the posterior muscle chain has been shown to result in significant improvement in pain and disability status. Recent studies suggest that thoracolumbar fascia (TLF) has a major impact on the maintenance of spinal stability and paraspinal muscle activity, and thus is likely to have an equal impact on deadlift performance.
Aim of the study was to evaluate the role of thoracolumbar fascia deformation (TFLD) during spinal movement in track and field athletes (TF) as well as individuals with and without acute low back pain (aLBP).
A case-control study was performed with = 16 aLBP patients (cases) and two control groups: untrained healthy individuals (UH, = 16) and TF ( = 16). Participants performed a trunk extension task (TET) and a deadlift, being assessed for erector spinae muscle thickness (EST) and TLFD using high-resolution ultrasound imaging. Mean deadlift velocity (VEL) and deviation of barbell path (DEV) were measured by means of a three-axis gyroscope. Group differences for TLFD during the TET were examined using ANOVA. Partial Spearman rank correlations were calculated between TLFD and VEL adjusting for baseline covariates, EST, and DEV. TLFD during deadlifting was compared between groups using ANCOVA adjusting for EST, DEV, and VEL.
TLFD during the TET differed significantly between groups. TF had the largest TLFD (-37.6%), followed by UH (-26.4%), while aLBP patients had almost no TLFD (-2.7%). There was a strong negative correlation between TLFD and deadlift VEL in all groups (r = -0.65 to -0.89) which was highest for TF ( = -0.89). TLFD during deadlift, corrected for VEL, also differed significantly between groups. TF exhibited the smallest TLFD (-11.9%), followed by aLBP patients (-21.4%), and UH (-31.9%).
TFLD maybe a suitable parameter to distinguish LBP patients and healthy individuals during lifting tasks. The cause-effect triangle between spinal movement, TFLD and movement velocity needs to be further clarified.
https://drks.de/register/de/trial/DRKS00027074/, German Clinical Trials Register DRKS00027074.
姿势、腰骶部运动学和运动模式的改变在腰痛患者中很常见。因此，加强后肌链已被证明能显著改善疼痛和功能障碍状况。最近的研究表明，胸腰筋膜（TLF）对维持脊柱稳定性和椎旁肌活动有重大影响，因此可能对硬拉表现有同样的影响。
本研究的目的是评估胸腰筋膜变形（TFLD）在田径运动员（TF）以及有和没有急性腰痛（aLBP）的个体脊柱运动过程中的作用。
进行了一项病例对照研究，有16例aLBP患者（病例组）和两个对照组：未经训练的健康个体（UH，16例）和TF（16例）。参与者进行躯干伸展任务（TET）和硬拉，使用高分辨率超声成像评估竖脊肌厚度（EST）和TFLD。通过三轴陀螺仪测量平均硬拉速度（VEL）和杠铃路径偏差（DEV）。使用方差分析检查TET期间TFLD的组间差异。在调整基线协变量、EST和DEV后，计算TFLD与VEL之间的偏斯皮尔曼等级相关性。使用协方差分析在调整EST、DEV和VEL后比较组间硬拉期间的TFLD。
TET期间的TFLD在组间有显著差异。TF的TFLD最大（-37.6%），其次是UH（-26.4%），而aLBP患者几乎没有TFLD（-2.7%）。所有组中TFLD与硬拉VEL之间均存在强负相关（r = -0.65至-0.89），其中TF的相关性最高（r = -0.89）。校正VEL后，硬拉期间的TFLD在组间也有显著差异。TF的TFLD最小（-11.9%），其次是aLBP患者（-21.4%），UH（-31.9%）。
TFLD可能是在举重任务中区分腰痛患者和健康个体的合适参数。脊柱运动、TFLD和运动速度之间的因果关系三角需要进一步阐明。
https://drks.de/register/de/trial/DRKS00027074/，德国临床试验注册DRKS00027074。
