Dry immersion induced acute low back pain and its relationship with trunk myofascial viscoelastic changes
Authors: Anastasija Plehuna 1, 2, David Andrew Green 1, 3, 4, Liubov E. Amirova 2, Elena S. Tomilovskaya 2, Ilya V. Rukavishnikov 2, Inessa B. Kozlovskaya 2
- King’s College London, Centre of Human & Applied Physiological Sciences, London, United Kingdom
- Laboratory of Gravitational Physiology of the Sensorimotor System, Institute of Biomedical Problems, Russian Academy of Sciences, Moscow, Russia
- Space Medicine Team, HRE-OM, European Astronaut Centre, European Space Agency, Cologne, Germany
- KBRwyle Laboratories GmbH, Cologne, Germany
Journal: Frontiers in Physiology - October 2022, Volume 13, Article no. 1039924 (DOI: 10.3389/fphys.2022.1039924)
Field & Applications:
- Space medicine / Gravitational physiology
- Musculoskeletal disorder
- Low back pain
Microgravity induces spinal elongation and Low Back Pain (LBP) but the pathophysiology is unknown. Changes in paraspinal muscle viscoelastic properties may play a role. Dry Immersion (DI) is a ground-based microgravity analogue that induces changes in m. erector spinae superficial myofascial tissue tone within 2 h. This study sought to determine whether bilateral m. erector spinae tone, creep, and stiffness persist beyond 2 h; and if such changes correlate with DI-induced spinal elongation and/or LBP.
Ten healthy males lay in the DI bath at the Institute of Biomedical Problems (Moscow, Russia) for 6 h. Bilateral lumbar (L1, L4) and thoracic (T11, T9) trunk myofascial tone, stiffness and creep (MyotonPRO), and subjective LBP (0-10 NRS) were recorded before DI, after 1h, 6 h of DI, and 30min post. The non-standing spinal length was evaluated on the bath lifting platform using a bespoke stadiometer before and following DI.
DI significantly modulated m. erector spinae viscoelastic properties at L4, L1, T11, and T9 with no effect of laterality. Bilateral tissue tone was significantly reduced after 1 and 6 h DI at L4, L1, T11, and T9 to a similar extent. Stiffness was also reduced by DI at 1 h but partially recovered at 6 h for L4, L1, and T11. Creep was increased by DI at 1 h, with partial recovery at 6 h, although only T11 was significant. All properties returned to baseline 30 min following DI. Significant spinal elongation (1.17 ± 0.20 cm) with mild (at 1 h) to moderate (at 6 h) LBP was induced, mainly in the upper lumbar and lower thoracic regions. Spinal length increases positively correlated (Rho = 0.847, p = 0.024) with middle thoracic (T9) tone reduction, but with no other stiffness or creep changes. Spinal length positively correlated (Rho = 0.557, p = 0.039) with Max LBP; LBP failed to correlate with any m. erector spinae measured parameters.
The DI-induced bilateral m. erector spinae tone, creep, and stiffness changes persist beyond 2 h. Evidence of spinal elongation and LBP allows suggesting that the trunk myofascial tissue changes could play a role in LBP pathogenesis observed in real and simulated microgravity. Further study is warranted with longer duration DI, assessment of IVD geometry, and vertebral column stability.
Keywords: low back pain, muscle tone, MyotonPRO, dry immersion, space flight, myofascial tissue properties
This study demonstrates that DI-induced bilateral m. erector spinae tone, creep, and stiffness changes persist beyond 2 h – albeit tending to attenuate. Thus, whilst spinal elongation and LBP were induced, its relationship with the trunk myofascial tissue changes is complex and its role in LBP pathogenesis observed in real and simulated microgravity is yet to be determined. Further study is warranted with longer DI duration and additional assessment of IVD geometry and vertebral column stability. Correct quantitative assessment of trunk myofascial tissue changes will likely enhance the determination of astronauts’ predisposition to back pain or strong muscle atony in prolonged space flight. Experiments performed with DI may benefit the design and validation of specific countermeasures against the deterioration of back muscle biomechanical and viscoelastic properties induced by microgravity and hypokinesia.