Emma Feng Ming Zhou, Arnold Yu Lok Wong, Guohui Lin, Jianhui Fang, Tao Wen, Juhua Peng, Siu Ngor Fu
{"title":"在患有慢性腰痛的职业运动员中，腰部深层多裂肌的僵硬度增加，而浅层多裂肌的僵硬度没有增加。","authors":"Emma Feng Ming Zhou, Arnold Yu Lok Wong, Guohui Lin, Jianhui Fang, Tao Wen, Juhua Peng, Siu Ngor Fu","doi":"10.1016/j.apmr.2024.11.004","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>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.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>This study was conducted at a provincial sports training centre.</p><p><strong>Participants: </strong>Ninety-nine professional athletes (age: 18-27 years) from weightlifting, badminton, and track and field teams were recruited. Thirty-eight had chronic bilateral LBP.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Ultrasound shear wave elastography (SWE) 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 < 0.05.</p><p><strong>Results: </strong>Athletes with chronic LBP demonstrated significantly higher DLM stiffness on the dominant (by 17.73%, mean difference (MD) = 2.52kPa, p = 0.001) and non-dominant sides (by 13.54%, MD = 1.83kPa, p = 0.046) compared to pain-free counterparts. SLM stiffness varied significantly among the three athlete groups. Post-hoc analyses revealed greater SLM stiffness on the non-dominant side in weightlifters than in badminton players (by 51.76%, MD = 8.97kPa, p = 0.010) or track and field athletes (by 72.01%, MD = 11.01kPa, p = 0.008).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6000,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Increased stiffness is evidenced in the deep but not superficial lumbar multifidus muscle in professional athletes with chronic low back pain.\",\"authors\":\"Emma Feng Ming Zhou, Arnold Yu Lok Wong, Guohui Lin, Jianhui Fang, Tao Wen, Juhua Peng, Siu Ngor Fu\",\"doi\":\"10.1016/j.apmr.2024.11.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>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.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>This study was conducted at a provincial sports training centre.</p><p><strong>Participants: </strong>Ninety-nine professional athletes (age: 18-27 years) from weightlifting, badminton, and track and field teams were recruited. Thirty-eight had chronic bilateral LBP.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Ultrasound shear wave elastography (SWE) 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 < 0.05.</p><p><strong>Results: </strong>Athletes with chronic LBP demonstrated significantly higher DLM stiffness on the dominant (by 17.73%, mean difference (MD) = 2.52kPa, p = 0.001) and non-dominant sides (by 13.54%, MD = 1.83kPa, p = 0.046) compared to pain-free counterparts. SLM stiffness varied significantly among the three athlete groups. Post-hoc analyses revealed greater SLM stiffness on the non-dominant side in weightlifters than in badminton players (by 51.76%, MD = 8.97kPa, p = 0.010) or track and field athletes (by 72.01%, MD = 11.01kPa, p = 0.008).</p><p><strong>Conclusions: </strong>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.</p>\",\"PeriodicalId\":8313,\"journal\":{\"name\":\"Archives of physical medicine and rehabilitation\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":3.6000,\"publicationDate\":\"2024-11-21\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of physical medicine and rehabilitation\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.apmr.2024.11.004\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of physical medicine and rehabilitation","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.apmr.2024.11.004","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
Increased stiffness is evidenced in the deep but not superficial lumbar multifidus muscle in professional athletes with chronic low back pain.
Objectives: 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.
Design: Cross-sectional study.
Setting: This study was conducted at a provincial sports training centre.
Participants: Ninety-nine professional athletes (age: 18-27 years) from weightlifting, badminton, and track and field teams were recruited. Thirty-eight had chronic bilateral LBP.
Interventions: Not applicable.
Main outcome measures: Ultrasound shear wave elastography (SWE) 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 < 0.05.
Results: Athletes with chronic LBP demonstrated significantly higher DLM stiffness on the dominant (by 17.73%, mean difference (MD) = 2.52kPa, p = 0.001) and non-dominant sides (by 13.54%, MD = 1.83kPa, p = 0.046) compared to pain-free counterparts. SLM stiffness varied significantly among the three athlete groups. Post-hoc analyses revealed greater SLM stiffness on the non-dominant side in weightlifters than in badminton players (by 51.76%, MD = 8.97kPa, p = 0.010) or track and field athletes (by 72.01%, MD = 11.01kPa, p = 0.008).
Conclusions: 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.
期刊介绍：
The Archives of Physical Medicine and Rehabilitation publishes original, peer-reviewed research and clinical reports on important trends and developments in physical medicine and rehabilitation and related fields. This international journal brings researchers and clinicians authoritative information on the therapeutic utilization of physical, behavioral and pharmaceutical agents in providing comprehensive care for individuals with chronic illness and disabilities.
Archives began publication in 1920, publishes monthly, and is the official journal of the American Congress of Rehabilitation Medicine. Its papers are cited more often than any other rehabilitation journal.
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