Zhou Emma Feng Ming, Wong Arnold Yu Lok, Lin Guohui, Fang Jianhui, Wen Tao, Peng Juhua, Fu Siu Ngor
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
Department of Rehabilitation, Guangdong Sports Hospital, Guangdong, China.
Arch Phys Med Rehabil. 2025 Jun;106(6):902-909. doi: 10.1016/j.apmr.2024.11.004. Epub 2024 Nov 22.
Elevated lumbar multifidus stiffness has been observed in populations with chronic low back pain (LBP). However, the modulation of deep (DLM) and superficial (SLM) lumbar multifidus stiffness, considering their distinct structural characteristics and functions, remains unaddressed, especially in athletes. This study aimed to compare differences in DLM and SLM stiffness in professional athletes from different sports with and without chronic LBP.
Cross-sectional study.
This study was conducted at a provincial sports training center.
Ninety-nine professional athletes (age: 18-27 years) from weightlifting, badminton, and track and field teams were recruited. Thirty-eight had chronic bilateral LBP.
Not applicable.
Ultrasound shear wave elastography measured Young's modulus (stiffness indicator) of DLM and SLM at the L4/5 facet joint level. Two-way analysis of variance examined the effects of chronic LBP and sport type on DLM and SLM stiffness while considering proper confounders. Significance was set at P<.05.
Athletes with chronic LBP demonstrated significantly higher DLM stiffness on the dominant (by 17.73%, mean difference [MD]=2.52 kPa, P=.001) and nondominant sides (by 13.54%, MD=1.83 kPa, P=.046) compared with pain-free counterparts. SLM stiffness varied significantly among the 3 athlete groups. Post-hoc analyses revealed greater SLM stiffness on the nondominant side in weightlifters than in badminton players (by 51.76%, MD=8.97 kPa, P=.010) or track and field athletes (by 72.01%, MD=11.01 kPa, P=.008).
Chronic LBP and sport type significantly impact multifidus muscle stiffness, suggesting the need for targeted clinical assessments and reconditioning strategies focusing on DLM for chronic LBP and SLM for athletes in trunk extension-intensive sports.
在慢性下腰痛（LBP）人群中观察到腰椎多裂肌僵硬程度升高。然而，考虑到深层（DLM）和浅层（SLM）腰椎多裂肌不同的结构特征和功能，其僵硬程度的调节情况仍未得到解决，尤其是在运动员中。本研究旨在比较有和没有慢性LBP的不同运动项目的职业运动员中DLM和SLM僵硬程度的差异。
横断面研究。
本研究在一个省级体育训练中心进行。
招募了来自举重、羽毛球和田径队的99名职业运动员（年龄：18 - 27岁）。其中38人患有慢性双侧LBP。
不适用。
超声剪切波弹性成像测量L4/5小关节水平DLM和SLM的杨氏模量（僵硬程度指标）。双向方差分析在考虑适当混杂因素的情况下，检验慢性LBP和运动类型对DLM和SLM僵硬程度的影响。显著性设定为P <.05。
与无疼痛的运动员相比，患有慢性LBP的运动员在优势侧（高17.73%，平均差异[MD]=2.52 kPa，P =.001）和非优势侧（高13.54%，MD = 1.83 kPa，P =.046）的DLM僵硬程度明显更高。SLM僵硬程度在3组运动员中差异显著。事后分析显示，举重运动员非优势侧的SLM僵硬程度高于羽毛球运动员（高51.76%，MD = 8.97 kPa，P =.010）或田径运动员（高72.01%，MD = 11.01 kPa，P =.008）。
慢性LBP和运动类型显著影响多裂肌的僵硬程度，这表明需要针对慢性LBP进行以DLM为重点的有针对性的临床评估和康复策略，以及针对躯干伸展强度大的运动项目的运动员进行以SLM为重点的评估和策略。
