Abstract
This study is aimed to use shear wave elastography (SWE) to study the relationship between shear modulus and different body postures of the thoracolumbar fascia (TLF) and acquire physiologically meaningful information from the stiffness-posture graph to better quantify passive flexion responses. Seven passive postures were defined to evaluate the shear modulus of right side TLF at the third and fourth lumbar vertebra levels (L3 and L4) in twenty healthy male subjects. The TLF stiffness was significantly different among different postures (p < 0.001), and the TLF stiffness at L3 was always less than that at L4 (p < 0.001). As the forward tilt increased from 0 to 60°, the TLF stiffness increased in sitting and standing postures by 54.01% and 192.84%. In the neutral postures, the TLF stiffness in standing and sitting postures was 66.98% and 165.48% higher than that in rest posture. The above results show that the elastic properties of TLF play an important role in maintaining body static posture and that the forward tilt and sitting postures are likely to induce low back pain (LBP). In conclusion, this study provides preliminary in vivo data for the relationship between body postures and TLF stiffness.
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Abbreviations
- TLF:
-
Thoracolumbar fascia
- SWE:
-
Shear wave elastography
- L2:
-
Second lumbar vertebra level
- L3:
-
Third lumbar vertebra level
- L4:
-
Fourth lumbar vertebra level
- LBP:
-
Low back pain
- ASIS:
-
Anterior superior iliac spines
- ANOVA:
-
Analysis of variance
- SD:
-
Standard deviation
References
Arshad R, Zander T, Dreischarf M, Schmidt H (2016) Influence of lumbar spine rhythms and intra-abdominal pressure on spinal loads and trunk muscle forces during upper body inclination. Med Eng Phys 38(4):333–338. https://doi.org/10.1016/j.medengphy.2016.01.013
Barker PJ, Briggs CA, Bogeski G (2004) Tensile transmission across the lumbar fasciae in unembalmed cadavers: effects of tension to various muscular attachments. Spine 29(2):129–138. https://doi.org/10.1097/01.BRS.0000107005.62513.32
Barker PJ, Guggenheimer KT, Grkovic I, Briggs CA, Jones DC, Thomas CD, Hodges PW (2006) Effects of tensioning the lumbar fasciae on segmental stiffness during flexion and extension: young investigator award winner. Spine 31(4):397–405. https://doi.org/10.1097/01.brs.0000195869.18844.56
Barker PJ, Hapuarachchi KS, Ross JA, Sambaiew E, Ranger TA, Briggs CA (2014) Anatomy and biomechanics of gluteus maximus and the thoracolumbar fascia at the sacroiliac joint. Clin Anat 27(2):234–240. https://doi.org/10.1002/ca.22233
Bruno AG, Burkhart K, Allaire B, Anderson DE, Bouxsein ML (2017) Spinal loading patterns from biomechanical modeling explain the high incidence of vertebral fractures in the thoracolumbar region. J Bone Miner Res Off J Am Soc Bone Miner Res 32(6):1282–1290. https://doi.org/10.1002/jbmr.3113
Chen B, Zhao H, Liao L, Zhang Z, Liu C (2020) Reliability of shear-wave elastography in assessing thoracolumbar fascia elasticity in healthy male. Sci Rep 10(1):19952. https://doi.org/10.1038/s41598-020-77123-w
Choi HW, Kim YE (2017) Effect of lumbar fasciae on the stability of the lower lumbar spine. Computer methods in biomechanics and biomedical engineering 20(13):1431–1437. https://doi.org/10.1080/10255842.2017.1370459
Creze M, Nordez A, Soubeyrand M, Rocher L, Maître X, Bellin MF (2018) Shear wave sonoelastography of skeletal muscle: basic principles, biomechanical concepts, clinical applications, and future perspectives. Skelet Radiol 47(4):457–471. https://doi.org/10.1007/s00256-017-2843-y
Fan C, Fede C, Gaudreault N, Porzionato A, Macchi V, DE Caro R, Stecco C (2018) Anatomical and functional relationships between external abdominal oblique muscle and posterior layer of thoracolumbar fascia. Clin Anat 31(7):1092–1098. https://doi.org/10.1002/ca.23248
Gatton ML, Pearcy MJ, Pettet GJ, Evans JH (2010) A three-dimensional mathematical model of the thoracolumbar fascia and an estimate of its biomechanical effect. J Biomech 43(14):2792–2797. https://doi.org/10.1016/j.jbiomech.2010.06.022
Hajihosseinali M, Arjmand N, Shirazi-Adl A (2015) Effect of body weight on spinal loads in various activities: a personalized biomechanical modeling approach. J Biomech 48(2):276–282. https://doi.org/10.1016/j.jbiomech.2014.11.033
Hestbaek L, Leboeuf-Yde C, Kyvik KO, Manniche C (2006) The course of low back pain from adolescence to adulthood: eight-year follow-up of 9600 twins. Spine 31(4):468–472. https://doi.org/10.1097/01.brs.0000199958.04073.d9
Ignasiak D, Rüeger A, Sperr R, Ferguson SJ (2018) Thoracolumbar spine loading associated with kinematics of the young and the elderly during activities of daily living. J Biomech 70:175–184. https://doi.org/10.1016/j.jbiomech.2017.11.033
Langevin HM, Fox JR, Koptiuch C, Badger GJ, Greenan-Naumann AC, Bouffard NA, Konofagou EE, Lee WN, Triano JJ, Henry SM (2011) Reduced thoracolumbar fascia shear strain in human chronic low back pain. BMC Musculoskelet Disord 12:203. https://doi.org/10.1186/1471-2474-12-203
Maher C, Underwood M, Buchbinder R (2017) Non-specific low back pain. Lancet 389(10070):736–747. https://doi.org/10.1016/S0140-6736(16)30970-9
Makhsous M, Lin F, Bankard J, Hendrix RW, Hepler M, Press J (2009) Biomechanical effects of sitting with adjustable ischial and lumbar support on occupational low back pain: evaluation of sitting load and back muscle activity. BMC Musculoskelet Disord 10:17. https://doi.org/10.1186/1471-2474-10-17
Mense S (2019) Innervation of the thoracolumbar fascia. European journal of translational myology 29(3):8297. https://doi.org/10.4081/ejtm.2019.8297
Moreau B, Vergari C, Gad H, Sandoz B, Skalli W, Laporte S (2016) Non-invasive assessment of human multifidus muscle stiffness using ultrasound shear wave elastography: a feasibility study. Proceedings of the institution of mechanical engineers. Part H, J Eng Med 230(8):809–814. https://doi.org/10.1177/0954411916656022
Park S, Hetzler T, Hammons D, Ward G (2018) Effects of biofeedback postural training on pre-existing low back pain in static-posture workers. J Back Musculoskelet Rehabil 31(5):849–857. https://doi.org/10.3233/BMR-171071
Sbriccoli P, Solomonow M, Zhou BH, Baratta RV, Lu Y, Zhu MP, Burger EL (2004) Static load magnitude is a risk factor in the development of cumulative low back disorder. Muscle Nerve 29(2):300–308. https://doi.org/10.1002/mus.10531
Shah Y, Arkesteijn M, Thomas D, Whyman J, Passfield L (2017) The acute effects of integrated myofascial techniques on lumbar paraspinal blood flow compared with kinesio-taping: a pilot study. J Bodyw Mov Ther 21(2):459–467. https://doi.org/10.1016/j.jbmt.2016.08.012
Straker LM, Coleman J, Skoss R, Maslen BA, Burgess-Limerick R, Pollock CM (2008) A comparison of posture and muscle activity during tablet computer, desktop computer and paper use by young children. Ergonomics 51(4):540–555. https://doi.org/10.1080/00140130701711000
Taguchi T, Hoheisel U, Mense S (2008) Dorsal horn neurons having input from low back structures in rats. Pain 138(1):119–129. https://doi.org/10.1016/j.pain.2007.11.015
Vleeming A, Schuenke MD, Danneels L, Willard FH (2014) The functional coupling of the deep abdominal and paraspinal muscles: the effects of simulated paraspinal muscle contraction on force transfer to the middle and posterior layer of the thoracolumbar fascia. J Anat 225(4):447–462. https://doi.org/10.1111/joa.12227
Willard FH, Vleeming A, Schuenke MD, Danneels L, Schleip R (2012) The thoracolumbar fascia: anatomy, function and clinical considerations. J Anat 221(6):507–536. https://doi.org/10.1111/j.1469-7580.2012.01511.x
Wilke J, Schleip R, Klingler W, Stecco C (2017) The lumbodorsal fascia as a potential source of low back pain: a narrative review. Biomed Res Int 2017:5349620–5349626. https://doi.org/10.1155/2017/5349620
Yahia LH, Pigeon P, DesRosiers EA (1993) Viscoelastic properties of the human lumbodorsal fascia. J Biomed Eng 15(5):425–429. https://doi.org/10.1016/0141-5425(93)90081-9
Zemp R, Fliesser M, Wippert PM, Taylor WR, Lorenzetti S (2016) Occupational sitting behaviour and its relationship with back pain - a pilot study. Appl Ergon 56:84–91. https://doi.org/10.1016/j.apergo.2016.03.007
Zhang ZJ, Ng G, Lee WC, Fu SN (2017) Increase in passive muscle tension of the quadriceps muscle heads in jumping athletes with patellar tendinopathy. Scand J Med Sci Sports 27(10):1099–1104. https://doi.org/10.1111/sms.12749
Zhou J, Liu C, Zhang ZJ (2019) Non-uniform stiffness within gastrocnemius-Achilles tendon complex observed after static stretching. J Sports Sci Med 18(3):454–461
Zhang J, Yu J, Liu C, Tang C, Zhang Z (2019) Modulation in elastic properties of upper trapezius with varying neck angle. App Bionics Biomech 2019:6048562–6048568. https://doi.org/10.1155/2019/6048562
Acknowledgements
The authors thank Prof. Chunlong Liu and Prof. Zhijie Zhang for technical support and review of this manuscript. SWE equipment for this article was provided by the Guangdong Province Traditional Chinese Medical Hospital. We are grateful to Ming Lin and Weixin Deng for medical screening of subjects and to the students of the Guangzhou University of Chinese Medicine for participated in the study as subject.
Funding
This study was supported by the “Elite Youth Education Program” of the Guangzhou University of Chinese Medicine (No. QNYC20170107).
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Baizhen Chen: Conceptualization, methodology, investigation, validation, visualization, data curation, writing-original draft, and formal analysis
Chunlong Liu: Writing-review, supervision, and resources
Ming Lin: Investigation and project administration
Weixin Deng: Investigation and project administration
Zhijie Zhang: Writing-review, supervision, and resources
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Chen, B., Liu, C., Lin, M. et al. Effects of body postures on the shear modulus of thoracolumbar fascia: a shear wave elastography study. Med Biol Eng Comput 59, 383–390 (2021). https://doi.org/10.1007/s11517-021-02320-2
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DOI: https://doi.org/10.1007/s11517-021-02320-2