Asymmetric Biomechanical Properties of the Paravertebral Muscle in Elderly Patients With Unilateral Chronic Low Back Pain: A Preliminary Study

Wu, Zugui; Ye, Xiangling; Ye, Zixuan; Hong, Kyung‐Won; Chen, Zehua; Wang, Yi; Li, Congcong; Li, Junyi; Huang, Jinyou; Zhu, Yue; Lu, Yanhong; Wang, Xinyang; Xu, Xuemeng

doi:10.3389/fbioe.2022.814099

Cited by 15 publications

(15 citation statements)

References 57 publications

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“…Parkhurst and Burnett (1994) found that proprioceptive asymmetries were associated with injuries in male firefighters. In older adults, asymmetrical biomechanical properties of paravertebral muscles are also linked to chronic LBP severity (Wu et al, 2022). The present study provided empirical data to illustrate bilateral asymmetry in back muscle stiffness among emergency responders.…”

Section: Left-right Symmetry In Muscle Stiffnessmentioning

confidence: 67%

Functional versus conventional strength and conditioning programs for back injury prevention in emergency responders

Kong

Kan

JAMIL

et al. 2022

Front. Bioeng. Biotechnol.

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Back pain and back-related injuries are common complaints among emergency responders. The purpose of this study was to compare the effectiveness of two strength and conditioning programs in improving back muscle characteristics and disabilities in emergency responders (firefighters/paramedics). Participants (n = 24) were randomized into two groups to complete 16 weeks of supervised exercise intervention: 1) Functional training used unilateral movements that mimicked the asymmetrical nature of emergency operations, 2) Conventional training performed bilaterally loaded exercises. Outcome measures were maximum isometric back extension strength, passive muscle stiffness, lumbar extensor fatigability, and revised Oswestry Low Back Pain Questionnaire. A mixed model Analysis of Variance with repeated measures was performed to compare the difference over time and between groups. While the training effects were similar between groups, both programs improved isometric back extension strength (+21.3% functional, +20.3% conventional, p < 0.001, ηp2 = 0.625) and lumbar extensor muscle fatigability (+17.4% functional, +9.5% conventional, p = 0.009, ηp2 = 0.191). Bilateral symmetry in muscle stiffness was improved as indicated by reduction in symmetry index (-7.1% functional, -11.8% conventional, p = 0.027, ηp2 = 0.151). All self-reported pain and disability scores fell within the category of “minimum functional limitation” throughout the intervention and 6-month follow-up periods. For frontline firefighters and paramedics, both functional and conventional strength training are effective for improving back muscle characteristics.

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Section: Left-right Symmetry In Muscle Stiffnessmentioning

confidence: 67%

Functional versus conventional strength and conditioning programs for back injury prevention in emergency responders

Kong

Kan

JAMIL

et al. 2022

Front. Bioeng. Biotechnol.

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“…Pain and an inactive lifestyle may cause paraspinal muscle atrophy, which is significantly associated with pain. 33 In addition, previous studies have confirmed the increase in atrophy of the paraspinal muscles in clinical chronic low back pain patients. 34 In this study, the results demonstrated that the VAS of low back pain have a significant negative linear relationship with the paraspinal muscles in IS and DLS groups, which was consistent with previous studies.…”

Section: Discussionmentioning

confidence: 78%

Radiological Changes of Paraspinal Muscles: A Comparative Study of Patients with Isthmic Spondylolisthesis, Patients with Degenerative Lumbar Spondylolisthesis, and Healthy Subjects

Li¹,

Wang²,

Wang³

et al. 2022

JPR

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Objective To investigate the differences, correlations, and clinical significance of the paraspinal muscles among patients with isthmic spondylolisthesis (IS), degenerative lumbar spondylolisthesis (DLS), and age-matched healthy subjects. Methods This study involved 159 age-matched patients with L4 anterior spondylolisthesis. The patients were divided into the IS group (n = 81) and DLS group (n = 78). Eighty-four age-matched healthy adults were enrolled as the control group. The cross-sectional area (CSA) of paraspinal muscles (multifidus [MF], erector spinae [ES], and psoas [PS]) and the relative CSA of the paraspinal muscles (paraspinal muscle CSA/vertebral CSA) were measured in the IS group, DLS group, and control group. The degree of fat infiltration was simultaneously observed. Results There was no significant difference in age or sex among the three groups. The relative CSA of the MF and PS was higher in control group than in IS and DLS groups (p < 0.05). The relative CSA of ES was higher in IS and control groups than in DLS group (p < 0.05). The relative CSA of total paraspinal muscles decreased in the order of control group > IS group > DLS group (p < 0.05). Logistic regression analysis showed that the relative CSA of MF, and the degree of fat infiltration of ES were independent protective factors for IS (odds ratio < 1, p < 0.05). The relative CSA of MF was an independent protective factor for DLS (odds ratio < 1, p < 0.05), whereas BMI and the degree of fat infiltration of MF were independent risk factor for DLS (odds ratio > 1, p < 0.05). Conclusion Compared with the control group, patients with IS and DLS showed varying degrees of degeneration, and the degree of degeneration in patients with DLS was more severe at the same age. Lower fat infiltration and higher paraspinal muscle CSA are protective factors for IS and DLS, whereas the higher BMI is risk factor for DLS.

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“…It could be inferred that the possible mechanism was that PI-LL mismatch could aggravate the degeneration of the PVM, and the latter was an important source of pain ( 8 , 28 , 29 ), disability ( 28 ), and lumbar instability ( 30 , 31 ). Wu et al reported that the VAS score and ODI were significantly positively correlated with the tone and stiffness of the PVM on the painful side ( 32 ). Protopsaltis concluded that PI-LL correlated with the ODI and Short Form-36 physical component score scoliosis research society (SRS) correlated with all ( 33 ).…”

Section: Discussionmentioning

confidence: 99%

Characteristics of the paravertebral muscle in adult degenerative scoliosis with PI-LL match or mismatch and risk factors for PI-LL mismatch

Guo

Xie²,

Zhang³

et al. 2023

Front. Surg.

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ObjectivePelvic incidence (PI) minus the lumbar lordosis (LL) angle (PI-LL) correlates with function and disability. It is associated with paravertebral muscle (PVM) degeneration and is a valuable tool for surgical planning of adult degenerative scoliosis (ADS). This study aims to explore the characteristics of PVM in ADS with PI-LL match or mismatch and to identify the risk factors for PI-LL mismatch.MethodsA total of 67 patients with ADS were divided into PI-LL match and mismatch groups. The visual analog scale (VAS), symptom duration, and Oswestry disability index (ODI) were used to assess patients’ clinical symptoms and quality of life. The percentage of fat infiltration area (FIA%) of the multifidus muscle at the L1-S1 disc level was measured by using MRI with Image-J software. Sagittal vertical axis, LL, pelvic tilt (PT), PI, sacral slope, and the asymmetric and average degeneration degree of the multifidus were recorded. Logistic regression analysis was done to identify the risk factors for PI-LL mismatch.ResultsIn the PI-LL match and mismatch groups, the average FIA% of the multifidus on the convex side was less than that on the concave side (P < 0.05). There was no statistical difference of asymmetric degeneration degree of the multifidus between the two groups (P > 0.05). In the PI-LL mismatch group, the average degeneration degree of the multifidus, VAS, symptom duration, and ODI were significantly higher than that in the PI-LL match group, respectively (32.22 ± 6.98 vs. 26.28 ± 6.23 (%), 4.33 ± 1.60 vs. 3.52 ± 1.46, 10.81 ± 4.83 vs. 6.58 ± 4.23 (month), 21.06 ± 12.58 vs. 12.97 ± 6.49, P < 0.05). The average degeneration degree of the multifidus muscle was positively correlated with the VAS, symptom duration, and ODI, respectively (r = 0.515, 0.614, and 0.548, P < 0.05). Sagittal plane balance, LL, PT, and the average degeneration degree of the multifidus were the risk factors for PI-LL mismatch (OR: 15.447, 95% CI: 1.274–187.269; OR: 0.001, 95% CI: 0.000–0.099; OR: 107.540, 95% CI: 5.195–2,225.975; OR: 52.531, 95% CI: 1.797–1,535.551, P < 0.05).ConclusionThe PVM on the concave side was larger than that on the convex side in ADS irrespective of whether PI-LL matched or not. PI-LL mismatch could aggravate this abnormal change, which is an important cause of pain and disability in ADS. Sagittal plane imbalance, decreased LL, higher PT, and larger average degeneration degree of the multifidus were independent risk factors for PI-LL mismatch.

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Asymmetric Biomechanical Properties of the Paravertebral Muscle in Elderly Patients With Unilateral Chronic Low Back Pain: A Preliminary Study

Cited by 15 publications

References 57 publications

Functional versus conventional strength and conditioning programs for back injury prevention in emergency responders

Functional versus conventional strength and conditioning programs for back injury prevention in emergency responders

Radiological Changes of Paraspinal Muscles: A Comparative Study of Patients with Isthmic Spondylolisthesis, Patients with Degenerative Lumbar Spondylolisthesis, and Healthy Subjects

Characteristics of the paravertebral muscle in adult degenerative scoliosis with PI-LL match or mismatch and risk factors for PI-LL mismatch

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