Quantifying the stiffness of lumbar erector spinae during different positions among participants with chronic low back pain
Authors: Yapeng Li 1, Jiafeng Yu 2, Jun Zhang 3, Zhijie Zhang 1, Xueqiang Wang 4
- Rehabilitation Therapy Center, Luoyang Orthopedic Hospital of Henan Province, Orthopedic Hospital of Henan Province, Luoyang, China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Department of Rehabilitation, Institute of Rehabilitation and Health Care, Hunan Traditional Chinese Medical College, Hunan, China
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
Journal: PLOS ONE - June 2022, 17(6):e0270286 (DOI: 10.1371/journal.pone.0270286)
Field & Applications:
- Musculoskeletal disorder
- Low back pain
- Muscle symmetry
- MyotonPRO has excellent reliability and portability, and the evaluation is not limited by personnel and venues.
Objective: The purposes of this study were to (1) detect the intra- and inter-reliabilities of the lumbar erector spinae stiffness by MyotonPRO among participants with chronic lower back pain (CLBP); (2) compare the muscle stiffness between pain and non-pain sides during different positions; (3) explore the correlation between intensity of pain and muscle stiffness.
Design: Twenty participants with CLBP were recruited and the stiffness measurements were carried out by two experienced physiotherapists (operators Ⅰ and Ⅱ). Each participant was evaluated by the operatorⅠ in different postures (static prone and sitting). After a 5-day interval, the same participant was reassessed by the operatorⅠ in the static prone posture. For the inter-rater reliability test, each participant was quantified by both operators once, with 30 minutes between the measurements on the same day. The intensity of pain was evaluated using a 0–10 visual analog scale (VAS).
Results: The intra- and inter-rater reliabilities were excellent (ICC = 0.88–0.99). The MDC values ranged from 25.03 to 86.26 N/m. Examples of Bland-Altman plots showed good agreement. The erector spinae stiffness on the painful sides was higher with a marked increase in the sitting position (P < .05) when compared with the non-painful side. However, there was no significant difference in the prone position (P > .05). The intensity of pain among adults with CLBP was not associated with muscle stiffness of the lumbar erector spinae muscle.
Conclusions: Our findings indicated that the MyotonPRO is a feasible device in quantifying the stiffness of the lumbar erector spinae muscle in patients with CLBP. Meanwhile, the erector spinae stiffness on the painful sides was higher in the sitting when compared with the non-painful side.
Keywords: myalgia, stiffness, muscle analysis, pain, lower back pain, biomechanics, electromyography, muscle tissue
In the current study, we indicated that the MyotonPRO device has excellent intra- and inter-rater reliabilities in quantifying the stiffness of the lumbar erector spinae muscles in patients with CLBP. Meanwhile, the erector spinae stiffness on the painful sides was higher with a marked increase in sitting when compared with the non-painful side. Hence, the MyotonPRO can be used in clinical assessment and research in patients with CLBP, although there was no significant correlation between the lumbar erector spinae muscle stiffness and pain intensity.