Tornblom Audrey, Naghdi Neda, Rye Meaghan, Montpetit Chanelle, Fortin Maryse
Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, QC, Canada.
School of Health, Concordia University, Montreal, QC, Canada.
Front Physiol. 2024 Aug 26;15:1336544. doi: 10.3389/fphys.2024.1336544. eCollection 2024.
Exercise therapy is the primary endorsed form of conservative treatment for chronic low back pain (LBP). However, there is still conflicting evidence on which exercise intervention is best. While motor control exercise can lead to morphological and functional improvements of lumbar multifidus muscle in individuals with chronic LBP, the effects of exercise prescription on multifidus stiffness assessed via shear wave elastography are still unknown. The primary aim of this study is to determine the effects of a combined motor control and isolated lumbar extension (MC + ILEX) intervention on lumbar multifidus muscle stiffness.
A total of 25 participants aged 18 to 65 were recruited from local orthopedic clinics and the university community with moderate to severe non-specific chronic LBP. Participants performed a 12-week MC + ILEX intervention program. Stiffness of the lumbar multifidus muscle (primary outcome) at L4 and L5 was obtained at baseline, 6-week, and 12-week using shear wave elastography. Changes in stiffness ratio (e.g., ratio of lumbar multifidus muscle stiffness from rest to contracted) were also assessed at both time points. Pre to post-intervention changes in lumbar multifidus muscle stiffness were assessed using a one-way repeated measure ANOVA.
Following the 12-week intervention, there were no statistically significant changes in lumbar multifidus muscle stiffness at rest on the right side at L4 ( = 0.628) and the left side at L4 and L5 ( = 0.093, = 0.203), but a statistically significant decrease was observed on the right side at L5 ( = 0.036). There was no change in lumbar multifidus muscle stiffness ratio.
This study provides preliminary evidence to suggest that a 12-week MC + ILEX intervention had minimal effect on lumbar multifidus muscle stiffness in individuals with chronic LBP. Further investigations are needed to confirm our findings and clarify the relationship between muscle stiffness and functional outcomes.
运动疗法是慢性下腰痛（LBP）保守治疗的主要推荐形式。然而，关于哪种运动干预效果最佳，仍存在相互矛盾的证据。虽然运动控制训练可使慢性下腰痛患者的腰多裂肌在形态和功能上得到改善，但通过剪切波弹性成像评估运动处方对多裂肌僵硬度的影响仍不明确。本研究的主要目的是确定运动控制与孤立性腰椎伸展（MC + ILEX）联合干预对腰多裂肌僵硬度的影响。
从当地骨科诊所和大学社区招募了25名年龄在18至65岁之间、患有中度至重度非特异性慢性下腰痛的参与者。参与者进行了为期12周的MC + ILEX干预计划。在基线、第6周和第12周时，使用剪切波弹性成像获取L4和L5水平腰多裂肌的僵硬度（主要结果）。同时在两个时间点评估僵硬度比值的变化（例如，腰多裂肌从休息到收缩时的僵硬度比值）。采用单向重复测量方差分析评估干预前后腰多裂肌僵硬度的变化。
经过12周的干预后，L4右侧（P = 0.628）、L4左侧和L5左侧的腰多裂肌静息僵硬度无统计学显著变化（P = 0.093，P = 0.203），但L5右侧观察到有统计学显著降低（P = 0.036）。腰多裂肌僵硬度比值无变化。
本研究提供了初步证据，表明为期12周的MC + ILEX干预对慢性下腰痛患者的腰多裂肌僵硬度影响极小。需要进一步研究来证实我们的发现，并阐明肌肉僵硬度与功能结果之间的关系。
