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Article: Reduced thoracolumbar fascia shear strain in human chronic low back pain

TitleReduced thoracolumbar fascia shear strain in human chronic low back pain
Authors
Issue Date2011
PublisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcmusculoskeletdisord/
Citation
Bmc Musculoskeletal Disorders, 2011, v. 12 How to Cite?
AbstractBackground: The role played by the thoracolumbar fascia in chronic low back pain (LBP) is poorly understood. The thoracolumbar fascia is composed of dense connective tissue layers separated by layers of loose connective tissue that normally allow the dense layers to glide past one another during trunk motion. The goal of this study was to quantify shear plane motion within the thoracolumbar fascia using ultrasound elasticity imaging in human subjects with and without chronic low back pain (LBP). Methods. We tested 121 human subjects, 50 without LBP and 71 with LBP of greater than 12 months duration. In each subject, an ultrasound cine-recording was acquired on the right and left sides of the back during passive trunk flexion using a motorized articulated table with the hinge point of the table at L4-5 and the ultrasound probe located longitudinally 2 cm lateral to the midline at the level of the L2-3 interspace. Tissue displacement within the thoracolumbar fascia was calculated using cross correlation techniques and shear strain was derived from this displacement data. Additional measures included standard range of motion and physical performance evaluations as well as ultrasound measurement of perimuscular connective tissue thickness and echogenicity. Results: Thoracolumbar fascia shear strain was reduced in the LBP group compared with the No-LBP group (56.4% 3.1% vs. 70.2% 3.6% respectively, p <.01). There was no evidence that this difference was sex-specific (group by sex interaction p =.09), although overall, males had significantly lower shear strain than females (p =.02). Significant correlations were found in male subjects between thoracolumbar fascia shear strain and the following variables: perimuscular connective tissue thickness (r = -0.45, p <.001), echogenicity (r = -0.28, p <.05), trunk flexion range of motion (r = 0.36, p <.01), trunk extension range of motion (r = 0.41, p <.01), repeated forward bend task duration (r = -0.54, p <.0001) and repeated sit-to-stand task duration (r = -0.45, p <.001). Conclusion: Thoracolumbar fascia shear strain was ∼20% lower in human subjects with chronic low back pain. This reduction of shear plane motion may be due to abnormal trunk movement patterns and/or intrinsic connective tissue pathology. There appears to be some sex-related differences in thoracolumbar fascia shear strain that may also play a role in altered connective tissue function. © 2011Langevin et al; licensee BioMed Central Ltd.
Persistent Identifierhttp://hdl.handle.net/10722/167064
ISSN
2015 Impact Factor: 1.684
2015 SCImago Journal Rankings: 0.881
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLangevin, HMen_US
dc.contributor.authorFox, JRen_US
dc.contributor.authorKoptiuch, Cen_US
dc.contributor.authorBadger, GJen_US
dc.contributor.authorGreenan Naumann, ACen_US
dc.contributor.authorBouffard, NAen_US
dc.contributor.authorKonofagou, EEen_US
dc.contributor.authorLee, WNen_US
dc.contributor.authorTriano, JJen_US
dc.contributor.authorHenry, SMen_US
dc.date.accessioned2012-09-28T04:02:28Z-
dc.date.available2012-09-28T04:02:28Z-
dc.date.issued2011en_US
dc.identifier.citationBmc Musculoskeletal Disorders, 2011, v. 12en_US
dc.identifier.issn1471-2474en_US
dc.identifier.urihttp://hdl.handle.net/10722/167064-
dc.description.abstractBackground: The role played by the thoracolumbar fascia in chronic low back pain (LBP) is poorly understood. The thoracolumbar fascia is composed of dense connective tissue layers separated by layers of loose connective tissue that normally allow the dense layers to glide past one another during trunk motion. The goal of this study was to quantify shear plane motion within the thoracolumbar fascia using ultrasound elasticity imaging in human subjects with and without chronic low back pain (LBP). Methods. We tested 121 human subjects, 50 without LBP and 71 with LBP of greater than 12 months duration. In each subject, an ultrasound cine-recording was acquired on the right and left sides of the back during passive trunk flexion using a motorized articulated table with the hinge point of the table at L4-5 and the ultrasound probe located longitudinally 2 cm lateral to the midline at the level of the L2-3 interspace. Tissue displacement within the thoracolumbar fascia was calculated using cross correlation techniques and shear strain was derived from this displacement data. Additional measures included standard range of motion and physical performance evaluations as well as ultrasound measurement of perimuscular connective tissue thickness and echogenicity. Results: Thoracolumbar fascia shear strain was reduced in the LBP group compared with the No-LBP group (56.4% 3.1% vs. 70.2% 3.6% respectively, p <.01). There was no evidence that this difference was sex-specific (group by sex interaction p =.09), although overall, males had significantly lower shear strain than females (p =.02). Significant correlations were found in male subjects between thoracolumbar fascia shear strain and the following variables: perimuscular connective tissue thickness (r = -0.45, p <.001), echogenicity (r = -0.28, p <.05), trunk flexion range of motion (r = 0.36, p <.01), trunk extension range of motion (r = 0.41, p <.01), repeated forward bend task duration (r = -0.54, p <.0001) and repeated sit-to-stand task duration (r = -0.45, p <.001). Conclusion: Thoracolumbar fascia shear strain was ∼20% lower in human subjects with chronic low back pain. This reduction of shear plane motion may be due to abnormal trunk movement patterns and/or intrinsic connective tissue pathology. There appears to be some sex-related differences in thoracolumbar fascia shear strain that may also play a role in altered connective tissue function. © 2011Langevin et al; licensee BioMed Central Ltd.en_US
dc.languageengen_US
dc.publisherBioMed Central Ltd. The Journal's web site is located at http://www.biomedcentral.com/bmcmusculoskeletdisord/en_US
dc.relation.ispartofBMC Musculoskeletal Disordersen_US
dc.titleReduced thoracolumbar fascia shear strain in human chronic low back painen_US
dc.typeArticleen_US
dc.identifier.emailLee, WN: wnlee@hku.hken_US
dc.identifier.authorityLee, WN=rp01663en_US
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1186/1471-2474-12-203en_US
dc.identifier.pmid21929806-
dc.identifier.scopuseid_2-s2.0-80052850948en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-80052850948&selection=ref&src=s&origin=recordpageen_US
dc.identifier.volume12en_US
dc.identifier.isiWOS:000295783700001-
dc.publisher.placeUnited Kingdomen_US
dc.identifier.scopusauthoridLangevin, HM=6701818924en_US
dc.identifier.scopusauthoridFox, JR=7404283264en_US
dc.identifier.scopusauthoridKoptiuch, C=50461919500en_US
dc.identifier.scopusauthoridBadger, GJ=7005759297en_US
dc.identifier.scopusauthoridGreenan Naumann, AC=53163873000en_US
dc.identifier.scopusauthoridBouffard, NA=6504410528en_US
dc.identifier.scopusauthoridKonofagou, EE=7005877325en_US
dc.identifier.scopusauthoridLee, WN=51964186500en_US
dc.identifier.scopusauthoridTriano, JJ=7004252769en_US
dc.identifier.scopusauthoridHenry, SM=7202313449en_US

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