Musculoskeletal Ultrasound Real-Time Dynamic Assessment Of Nonspecific Low Back Pain

Purpose:(1)To explore whether there are any difference in core muscle groups between patients with nonspecific low back pain and healthy people.(2)To explore the advantages of real-time and dynamic assessment of musculoskeletal ultrasound compared with static assessment.(3)To explore the effect of core stability training on patients with nonspecific low back pain,and at the same time the study explore which core exercise has a better therapeutic effect for patients.(4)To explore the evaluation value of musculoskeletal ultrasound for the core muscle group,and the feasibility of applying musculoskeletal ultrasound to more clinical diseases.Methods: Taking 66 patients diagnosed with chronic nonspecific low back pain(NLBP)in the Department of Rehabilitation Medicine,Department of Orthopedics and Traumatology of Traditional Chinese Medicine and Orthopedics Clinic of Zhongda Hospital of Southeast University from June 2019 to June 2020 as the research objects,the application and influencing factors of musculoskeletal ultrasound evaluation of core stabilization training for nonspecific low back pain were explored.Then,after signing the informed consent,all patients were numbered and randomly divided into sling group and cushion group.Each Group had 33 patients and received training for 20 minutes each time,3 times a week,and 8 weeks.Sling group adopted sling training,including sling movements in four positions of supine position,prone position,left-side position,and right-side position.Each movement was maintained for6-7 seconds,10 times,and repeated it twice.Between each group has two minutes’ rest.Cushion group adopted cushion training,including four positions of supine,prone,left,and right positions.Each movement was maintained for6-7 seconds,10 times,and repeated it twice.Between each group also has two minutes’ rest.In addition to NLBP patients,60 healthy subjects were recruited as the control group.People in control group do not do any exercise,and only performed basic data and musculoskeletal ultrasound-related data measurement.Before treatment and at the end of the 8-week treatment,the patients were measured for basic data and musculoskeletal ultrasound-related data.The evaluation indicators include the Visual Analogue Scale(VAS),Oswestry disability index(ODI)and the related data of Musculoskeletal ultrasound(transverse abdominis thickness in resting position,transverse abdominis thickness in contracted position,elastic modulus of transverse abdominis in resting position,elastic modulus of transverse abdominis in contracted position,multifidus thickness in resting position,multifidus muscle thickness in contracted position,multifissure in resting position Muscle elastic modulus,multifidus muscle elastic modulus in contracted position).Results: In total,there were 29 cushion group subjects,31 sling group subjects and 60 healthy subjects completed the experiment.(1)There are many differences in core muscle related data between patients with nonspecific low back pain and healthy people.Dynamic and static transverse abdominis thickness,dynamic and static elastic modulus of transverse abdominis in patients with NLBP,dynamic and static multifidus thickness,both dynamic and static multifidus muscle elastic modulus were not as good as the related data of healthy subjects.The differences among them were significant(P<0.05).(2)Both pad training and sling training can improve the VAS and ODI of NLBP patients with significant difference(P<0.05).(3)Sling training can improve the VAS and ODI of patients with NLBP better than on-pad training,significant difference(P<0.05).(4)Both on-mat training and sling training have an effect on the transverse abdominis and multifidus muscles.Both exercise methods can increase the thickness and elastic modulus of the transverse abdominis and multifidus muscles in patients with NLBP has significant differences with treatment(P<0.05).(5)The effect of sling training on transversus abdominis and multifidus muscle is greater than sling training,there was significant difference before and after the treatment(P<0.05).Conclusion:(1)There are significant differences in core muscles between NLBP patients and healthy people,not only the dynamic and static transverse abdominis thickness,dynamic and static elastic modulus,but also dynamic and static multifidus thickness,dynamic and static multifidus muscles elastic modulus are all not as good as that of healthy people.Therefore,it is feasible to conduct core training for NLBP patients,and musculoskeletal ultrasound also has a certain ability to distinguish between healthy people and patients.(2)Real-time dynamic evaluation of musculoskeletal ultrasound has better advantages than static evaluation.It can ensure that subjects use correct force during movement learning and exercise.It can also track and evaluate muscles in real-time,quantitatively,intuitively,and in real time.Dynamic changes before and after,to explore whether the muscles are exerting force correctly and the degree of muscle activation.(3)Sling training and mat training in core training have therapeutic effects on NLBP,which can improve the patient’s pain and waist mobility impairment,and have a benign effect on the core muscles.(4)The effect of sling training on NLBP is better than that of on-mat training,no matter from the aspects of pain and dysfunction improvement,core muscle data and so on.(5)Musculoskeletal ultrasound related data has significant effectiveness in evaluating the status of nonspecific low back pain and evaluating the efficacy of different treatment options,and has the advantages of convenience,non-invasiveness,non-radiation,low price,simple operation,real-time dynamic multi-plane inspection,etc.There is the feasibility of further popularization and use in more clinical diseases.