Dynamic Evaluation Of The Contractile Function Of Lumbodorsal Muscles In Low Back Pains During Locust Pose In Yoga By Real-time Ultrasound

Background Chronic Non-specific Low Back Pain CNSLBP is a disease that excludes specific pathophysiological mechanisms(such as inflammation,osteoporosis,rheumatoid arthritis,fracture,myelopathy,minor arthritis or tumor,etc.).CNSLBP is one of the most common clinical diseases.At present,the etiology and pathogenesis of this disease are not clear.Studies have shown that the incidence of CNSLBP is related to the changes of lumbar muscles,but there is no unified conclusion about the changes of the shape and structure of the patients’ lumbar and back muscles.At the same time,existing studies have shown that the lumbago muscle function of CNSLBP patients will change to varying degrees.X-ray,CT,and MRI have limited significance in the assessment of muscle function.Because ultrasound can realize real-time dynamic and continuous multi-section scanning,we try to apply it to the diagnosis and evaluation of CNSLBP by taking advantage of the advantages of ultrasound,and seek an auxiliary diagnosis and evaluation method for this disease.There is no specific treatment for CNSLBP.The guidelines recommend supervised exercise therapy as first-line treatment,but there is no recommended exercise regimen.As a kind of exercise,yoga has its unique advantages,and the therapeutic effect of yoga on CNSLBP has been proved.The yogic locust pose has also been widely accepted by clinicians and patients for the treatment of CNSLBP.Therefore,in this study,yoga locust posture was selected as the contraction state of the lumbar and back muscles,and prone relaxation position was selected as the relaxation state of the lumbar and back muscles,and real-time ultrasound was used to dynamically observe the acoustic characteristics and thickness changes of muscle contraction movement.Purpose In the state of lumbar back muscle relaxation(prone relaxation position)and contraction(yoga locust posture),dynamic observation of the acoustic and visual characteristics of the lumbar back muscle,measurement of the lumbar back muscle thickness,calculation of the lumbar back muscle contraction rate(contraction thickness/relaxation thickness C/R),comparison of normal people in the two states of low back muscle thickness difference;The difference of low back muscle thickness in patients with low back pain in two states was compared.The difference of low back muscle contraction rate(C/R)between patients with low back pain and normal controls was compared.Methods Fifty-two healthy volunteers from May 2019 to August 2019,age 1868 years old,21 males and 31 females,average age 40.35±11.042 years old,average body mass index(BMI)23.845±3.476;A total of 27 patients with chronic nonspecific low back pain from January 2021 to December 2021,aged 27-69 years,15 females and 12 males,mean age 38.77±12.12 years,mean body mass index(BMI)24.46±5.16)were enrolled.Dynamically observed the ultrasonographic features of lumbodorsal muscles(including the multifidus,longissimus,iliocostalis,and quadratus lumborum)and the changes of the muscle thickness from diastolic to shrink state by real-time ultrasound,the thickness of the two states were measured gradually.All measurements were carried out 3 times by the same physician then calculated the average and muscle contraction ratio(C/R).The difference of muscle thickness between contraction and relaxation of lumbago muscles in both normal group and LBP group and the difference of contraction rate(C/R)between normal group and LBP group were analyzed.Results Real-time ultrasound could clearly display the 2d ultrasonography and the contractile motion characteristics of lumbodorsal muscles from relaxation to contraction in each group.There were statistically significant differences in the thickness of lumbodorsal muscles in each group of healthy volunteers under the two different states.The longissimus of C/R was the largest,followed by longissimus and iliocostalis,and the quadratus lumborum was the smallest.Similarly,there were statistically significant differences in the thickness of lumbago muscle in the two different states in the LBP group.The contraction rate(C/R)of the four pairs of muscles between the LBP group and the normal group were compared.The differences of the C/R between the LBP group and the normal group was statistically significant except for the quadratus lumborum on both sides,in the other three pairs of muscles P<0.05.Conclusion Real-time ultrasound could dynamically observe the 2d ultrasonography and the contraction motion characteristics of the lumbodorsal muscles from relaxation to contraction.The contraction rate(C/R)of the lumbar muscles can be assessed according to the dynamic changes of the contractile function muscle in the prone relaxed position and the yoga locust position,and the C/R can indicate the contractile function of the muscles.Through the establishment of this model,the data of the contractile function of the lumbodorsal muscle in the normal population can be obtained.Based on this,the difference of the C/R between the LBP patients and the normal control group,the difference of the contractile function of the muscles before and after exercise in LBP patients can be further explored,as well as the influence of exercise on lumbar instability and patients after lumbar surgery can be assessed.