Ultrasound Evaluation of the Combined Effects of Thoracolumbar Fascia Injury and Movement Restriction in a Porcine Model
Ultrasound Evaluation of the Combined Effects of Thoracolumbar Fascia Injury and Movement Restriction in a Porcine Model
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DOI：
10.1371/journal.pone.0147393
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发表时间：
2016-01-28
期刊：
影响因子：
3.7
通讯作者：
Langevin, Helene M.
中科院分区：
文献类型：
--
作者：
Bishop, James H.;Fox, James R.;Langevin, Helene M.
急性背部"扭伤"后持续的背痛是一个严重的公共卫生问题，其病理生理学知之甚少。最近的发现，人类受试者与慢性腰痛（LBP）的厚度增加和减少的活动性的胸腰椎筋膜测量超声表明，筋膜的背部可能参与LBP的病理生理。本研究使用猪模型来测试以下假设：通过将筋膜局部损伤与使用"蹒跚"装置将一只脚连接到胸带上8周的运动限制相结合，可以在猪模型中通过实验产生类似的超声结果。在非干预侧（损伤和/或跛行）的第8周时间点进行被动髋关节屈曲期间胸腰椎筋膜厚度和剪切平面移动性（剪切应变）的超声测量。单独损伤导致非损伤侧的筋膜厚度增加（p = 0.007）和筋膜剪切应变减少（p = 0.027）。单独的运动限制不会改变筋膜厚度，但会降低非跛行侧的剪切应变（p = 0.024）。与对照组相比，损伤加运动限制的组合对减少筋膜活动度具有叠加效应，剪切应变减少52%，与单独运动限制相比减少28%。这些结果表明，涉及筋膜的背部损伤，即使愈合，也会影响远离受伤区域的筋膜层的相对移动性，特别是当运动也受到限制时。
The persistence of back pain following acute back "sprains" is a serious public health problem with poorly understood pathophysiology. The recent finding that human subjects with chronic low back pain (LBP) have increased thickness and decreased mobility of the thoracolumbar fascia measured with ultrasound suggest that the fasciae of the back may be involved in LBP pathophysiology. This study used a porcine model to test the hypothesis that similar ultrasound findings can be produced experimentally in a porcine model by combining a local injury of fascia with movement restriction using a "hobble" device linking one foot to a chest harness for 8 weeks. Ultrasound measurements of thoracolumbar fascia thickness and shear plane mobility (shear strain) during passive hip flexion were made at the 8 week time point on the non-intervention side (injury and/or hobble). Injury alone caused both an increase in fascia thickness (p =.007) and a decrease in fascia shear strain on the non-injured side (p =.027). Movement restriction alone did not change fascia thickness but did decrease shear strain on the non-hobble side (p =.024). The combination of injury plus movement restriction had additive effects on reducing fascia mobility with a 52% reduction in shear strain compared with controls and a 28% reduction compared to movement restriction alone. These results suggest that a back injury involving fascia, even when healed, can affect the relative mobility of fascia layers away from the injured area, especially when movement is also restricted.