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Ali MG, Mohammed AA, Ragab WM, Zakaria HM, Alwhaibi RM, Ibrahim ZM, Mamoon RS. Do Lumbar Paravertebral Muscle Properties Show Changes in Mothers with Moderate-Severity Low Back Pain Following a Cesarean Birth? A Case–Control Study. J Clin Med 2025; 14:719. [DOI: -doi:10.3390/jcm14030719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2025] Open
Abstract
Background/Objectives: Cesarean birth (CB) is linked to nonspecific low back pain (NSLBP). Different properties of the muscular tissue, including contractile, biomechanical, and viscous properties, may reflect its physiological or pathological condition. This study aimed to measure these properties of lumbar paravertebral muscles (LPVMs) and their relationship with post-CB mothers with moderate-severity NSLBP and match their measurements to those of the controls. Methods: Sixty women were included in this case–control research. They were divided into two equal groups: Group (A) representing cases, consisted of 30 females who experienced CB and complained of moderate-severity NSLBP, and Group (B) representing controls, consisted of 30 healthy females who had never experienced pregnancy with no or mild-severity NSLBP. Results: The statistical analysis between the two groups yielded significant differences in the right and left LPVMs’ tone (p = 0.002 and 0.015), relaxation time (p = 0.002 and 0.022), and creep (p = 0.013 and 0.008), respectively. On the other side, there were non-significant differences in the right and left LPVMs’ stiffness (p = 0.055 and 0.367) and elasticity (p = 0.115 and 0.231), respectively. The regression analysis’s final model indicated a strong overall performance (Nagelkerke: 1.00). Conclusions: The LPVMs of post-CB mothers with moderate-severity NSLBP showed remarkable changes in both contractile and viscous properties: muscle tone notably decreased, while viscosity increased. However, biomechanical properties like stiffness and elasticity showed negligible changes. This fitted regression analysis illustrated the holistic strong effect of LPVMs’ properties as risk factors contributing to post-CB NSLBP, emphasizing their consideration in diagnosis and intervention strategies for such cases.
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Affiliation(s)
- Mohamed G. Ali
- Department of Physical Therapy for Women’s Health, Faculty for Physical Therapy, South Valley University, Qena 83523, Egypt
| | - Abeer A. Mohammed
- Department of Physical Therapy for Neurology, Faculty for Physical Therapy, Cairo University, Giza 12613, Egypt
| | - Walaa M. Ragab
- Department of Physical Therapy for Neurology, Faculty for Physical Therapy, Cairo University, Giza 12613, Egypt
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, Taibah University, Medina 42353, Saudi Arabia
| | - Hoda M. Zakaria
- Department of Physical Therapy for Neurology, Faculty for Physical Therapy, Cairo University, Giza 12613, Egypt
| | - Reem M. Alwhaibi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Zizi M. Ibrahim
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia
| | - Rehab S. Mamoon
- Department of Physical Therapy for Women’s Health, Faculty for Physical Therapy, South Valley University, Qena 83523, Egypt
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García-Luque L, Alcaraz-Clariana S, Rodrigues-de-Souza DP, Carmona-Pérez C, Garrido-Castro JL, Alburquerque-Sendín F. Influence of pain, sequential movement or short-term rest performance on the evaluation results of neck muscle mechanical properties: a case-control study. Physiother Theory Pract 2025:1-10. [PMID: 39846441 DOI: 10.1080/09593985.2025.2451200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2024] [Revised: 12/19/2024] [Accepted: 01/05/2025] [Indexed: 01/24/2025]
Abstract
INTRODUCTION Individuals with neck pain (NP) often experience altered muscle mechanical properties (MMPs), such as increased tone and stiffness. Myotonometry has become a reliable, noninvasive tool for measuring MMPs. However, the effect of movement and rest on MMPs in acute neck pain (ANP) individuals remains insufficiently explored. OBJECTIVE This study aimed to evaluate how sequential movement and short-term rest influence the MMPs of neck muscles in subjects with ANP. METHODS A case-control study was conducted with 37 subjects with APN and 37 matched healthy controls. Muscle mechanical properties were assessed by myotonometry at baseline, post-movement (after a motion assessment sequence), and post-rest. The outcome measures of MMPs were frequency or tone, stiffness, decrement, which is the inverse of elasticity, relaxation, and creep. RESULTS Subjects with ANP showed higher muscle tone, stiffness and decrement, and lower relaxation than controls, all with p < .05. In the ANP group, decrement was the only property that showed a significant change after movement and rest, both with p < .05. Reduced means values (m) with its standard deviation (SD) were observed post-movement (m = 1.35 Ø, SD = 0.03) and post-rest (m = 1.33 Ø, SD = 0.03) compared to baseline values (m = 1.43 Ø, SD = 0.04). The other MMPs remained stable across evaluation times (p > .05). CONCLUSION The evaluation of MMPs should be conducted prior to any mobility protocol to ensure that the results reflect the basal tissue characteristics in individuals with ANP, highlighting decrement as a sensitive marker of these changes.
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Affiliation(s)
- Lourdes García-Luque
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, Córdoba, Spain
| | - Sandra Alcaraz-Clariana
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, Córdoba, Spain
| | - Daiana Priscila Rodrigues-de-Souza
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, Córdoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain
| | - Cristina Carmona-Pérez
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, Córdoba, Spain
| | - Juan Luis Garrido-Castro
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain
- Department of Computer Science and Numerical Analysis, Rabanales Campus, University of Córdoba, Córdoba, Spain
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, Córdoba, Spain
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba, Spain
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Ali MG, Mohammed AA, Ragab WM, Zakaria HM, Alwhaibi RM, Ibrahim ZM, Mamoon RS. Do Lumbar Paravertebral Muscle Properties Show Changes in Mothers with Moderate-Severity Low Back Pain Following a Cesarean Birth? A Case-Control Study. J Clin Med 2025; 14:719. [PMID: 39941389 PMCID: PMC11818502 DOI: 10.3390/jcm14030719] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2024] [Revised: 12/19/2024] [Accepted: 01/15/2025] [Indexed: 02/16/2025] Open
Abstract
Background/Objectives: Cesarean birth (CB) is linked to nonspecific low back pain (NSLBP). Different properties of the muscular tissue, including contractile, biomechanical, and viscous properties, may reflect its physiological or pathological condition. This study aimed to measure these properties of lumbar paravertebral muscles (LPVMs) and their relationship with post-CB mothers with moderate-severity NSLBP and match their measurements to those of the controls. Methods: Sixty women were included in this case-control research. They were divided into two equal groups: Group (A) representing cases, consisted of 30 females who experienced CB and complained of moderate-severity NSLBP, and Group (B) representing controls, consisted of 30 healthy females who had never experienced pregnancy with no or mild-severity NSLBP. Results: The statistical analysis between the two groups yielded significant differences in the right and left LPVMs' tone (p = 0.002 and 0.015), relaxation time (p = 0.002 and 0.022), and creep (p = 0.013 and 0.008), respectively. On the other side, there were non-significant differences in the right and left LPVMs' stiffness (p = 0.055 and 0.367) and elasticity (p = 0.115 and 0.231), respectively. The regression analysis's final model indicated a strong overall performance (Nagelkerke: 1.00). Conclusions: The LPVMs of post-CB mothers with moderate-severity NSLBP showed remarkable changes in both contractile and viscous properties: muscle tone notably decreased, while viscosity increased. However, biomechanical properties like stiffness and elasticity showed negligible changes. This fitted regression analysis illustrated the holistic strong effect of LPVMs' properties as risk factors contributing to post-CB NSLBP, emphasizing their consideration in diagnosis and intervention strategies for such cases.
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Affiliation(s)
- Mohamed G. Ali
- Department of Physical Therapy for Women’s Health, Faculty for Physical Therapy, South Valley University, Qena 83523, Egypt;
| | - Abeer A. Mohammed
- Department of Physical Therapy for Neurology, Faculty for Physical Therapy, Cairo University, Giza 12613, Egypt; (A.A.M.); (W.M.R.); (H.M.Z.)
| | - Walaa M. Ragab
- Department of Physical Therapy for Neurology, Faculty for Physical Therapy, Cairo University, Giza 12613, Egypt; (A.A.M.); (W.M.R.); (H.M.Z.)
- Department of Physical Therapy, Faculty of Medical Rehabilitation Sciences, Taibah University, Medina 42353, Saudi Arabia
| | - Hoda M. Zakaria
- Department of Physical Therapy for Neurology, Faculty for Physical Therapy, Cairo University, Giza 12613, Egypt; (A.A.M.); (W.M.R.); (H.M.Z.)
| | - Reem M. Alwhaibi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (R.M.A.); (Z.M.I.)
| | - Zizi M. Ibrahim
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah Bint Abdulrahman University, Riyadh 11671, Saudi Arabia; (R.M.A.); (Z.M.I.)
| | - Rehab S. Mamoon
- Department of Physical Therapy for Women’s Health, Faculty for Physical Therapy, South Valley University, Qena 83523, Egypt;
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Lin CF, Jankaew A, Tsai MC, Liao JC. Immediate effects of thoracic mobilization versus soft tissue release on trunk motion, pain, and lumbar muscle activity in patients with chronic low back pain. J Bodyw Mov Ther 2024; 40:1664-1671. [PMID: 39593506 DOI: 10.1016/j.jbmt.2024.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 09/03/2024] [Accepted: 09/25/2024] [Indexed: 11/28/2024]
Abstract
INTRODUCTION Thoracic mobilization and tissue release are common manual techniques in clinical practice. However, the relative effects of these two treatments on chronic low back pain (CLBP) have not yet been explored. Thus, this study aimed to investigate and compare the immediate effects of thoracic mobilization with those of soft tissue release on trunk movement, pain sensation, and muscle activity in patients with CLBP. METHODS 28 participants were randomly assigned to two intervention groups. The mobilization group received mobilization treatment at the hypomobile joints of the trunk segment, while the soft tissue release group received thoracolumbar fascia release and massage in the lumbar region. The trunk range of motion (ROM), tissue hardness, pressure pain threshold (PPT), and erector spinae activity during light-weight lifting tasks were measured before and immediately after both interventions. FINDINGS All measured outcomes in both groups improved after intervention (p < 0.05). The mobilization technique significantly improved side bending and rotation, PPT, and tissue hardness compared to soft tissue release. However, lumbar muscle activation reduced to a greater extent in the soft-tissue release group. CONCLUSION Both techniques improved trunk ROM and PPT and reduced tissue hardness and muscle activation. Therefore, both these techniques are recommended for patients with CLBP. TRIAL REGISTRATION ISRCTN75190733.
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Affiliation(s)
- Cheng-Feng Lin
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Physical Therapy Center, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Amornthep Jankaew
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Min-Chi Tsai
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jen-Chieh Liao
- Department of Neurosurgery, Chi Mei Hospital, Chia-Li, Tainan, Taiwan; Department of Biomedical Engineering, College of Engineering, National Cheng Kung University, Tainan, Taiwan.
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Bohlen L, Schwarze J, Richter J, Gietl B, Lazarov C, Kopyakova A, Brandl A, Schmidt T. Effect of osteopathic techniques on human resting muscle tone in healthy subjects using myotonometry: a factorial randomized trial. Sci Rep 2022; 12:16953. [PMID: 36217012 PMCID: PMC9551048 DOI: 10.1038/s41598-022-20452-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 09/13/2022] [Indexed: 12/29/2022] Open
Abstract
Musculoskeletal disorders (MSDs) are highly prevalent, burdensome, and putatively associated with an altered human resting muscle tone (HRMT). Osteopathic manipulative treatment (OMT) is commonly and effectively applied to treat MSDs and reputedly influences the HRMT. Arguably, OMT may modulate alterations in HRMT underlying MSDs. However, there is sparse evidence even for the effect of OMT on HRMT in healthy subjects. A 3 × 3 factorial randomised trial was performed to investigate the effect of myofascial release (MRT), muscle energy (MET), and soft tissue techniques (STT) on the HRMT of the corrugator supercilii (CS), superficial masseter (SM), and upper trapezius muscles (UT) in healthy subjects in Hamburg, Germany. Participants were randomised into three groups (1:1:1 allocation ratio) receiving treatment, according to different muscle-technique pairings, over the course of three sessions with one-week washout periods. We assessed the effect of osteopathic techniques on muscle tone (F), biomechanical (S, D), and viscoelastic properties (R, C) from baseline to follow-up (primary objective) and tested if specific muscle-technique pairs modulate the effect pre- to post-intervention (secondary objective) using the MyotonPRO (at rest). Ancillary, we investigate if these putative effects may differ between the sexes. Data were analysed using descriptive (mean, standard deviation, and quantiles) and inductive statistics (Bayesian ANOVA). 59 healthy participants were randomised into three groups and two subjects dropped out from one group (n = 20; n = 20; n = 19-2). The CS produced frequent measurement errors and was excluded from analysis. OMT significantly changed F (-0.163 [0.060]; p = 0.008), S (-3.060 [1.563]; p = 0.048), R (0.594 [0.141]; p < 0.001), and C (0.038 [0.017]; p = 0.028) but not D (0.011 [0.017]; p = 0.527). The effect was not significantly modulated by muscle-technique pairings (p > 0.05). Subgroup analysis revealed a significant sex-specific difference for F from baseline to follow-up. No adverse events were reported. OMT modified the HRMT in healthy subjects which may inform future research on MSDs. In detail, MRT, MET, and STT reduced the muscle tone (F), decreased biomechanical (S not D), and increased viscoelastic properties (R and C) of the SM and UT (CS was not measurable). However, the effect on HRMT was not modulated by muscle-technique interaction and showed sex-specific differences only for F.Trial registration German Clinical Trial Register (DRKS00020393).
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Affiliation(s)
- Lucas Bohlen
- Osteopathic Research Institute, Osteopathie Schule Deutschland, Hamburg, Germany.
| | - Jonah Schwarze
- Osteopathic Research Institute, Osteopathie Schule Deutschland, Hamburg, Germany
| | - Jannik Richter
- Osteopathie Schule Deutschland, Hamburg, Germany
- Dresden International University, Dresden, Germany
| | - Bernadette Gietl
- Osteopathie Schule Deutschland, Hamburg, Germany
- Dresden International University, Dresden, Germany
| | - Christian Lazarov
- Osteopathie Schule Deutschland, Hamburg, Germany
- Dresden International University, Dresden, Germany
| | - Anna Kopyakova
- Erasmus School of Economics, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Andreas Brandl
- Osteopathic Research Institute, Osteopathie Schule Deutschland, Hamburg, Germany
| | - Tobias Schmidt
- Osteopathic Research Institute, Osteopathie Schule Deutschland, Hamburg, Germany
- Institute of Interdisciplinary Exercise Science and Sports Medicine, MSH Medical School Hamburg, Hamburg, Germany
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Alcaraz-Clariana S, García-Luque L, Garrido-Castro JL, Carmona-Pérez C, Rodrigues-de-Souza DP, Fernández-de-las-Peñas C, Alburquerque-Sendín F. Influence of Spinal Movements Associated with Physical Evaluation on Muscle Mechanical Properties of the Lumbar Paraspinal in Subjects with Acute Low Back Pain. Diagnostics (Basel) 2022; 12:302. [PMID: 35204392 PMCID: PMC8870934 DOI: 10.3390/diagnostics12020302] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/11/2022] [Accepted: 01/24/2022] [Indexed: 12/29/2022] Open
Abstract
This research aimed to identify changes in muscle mechanical properties (MMPs) when a standardized sequence of movements is performed and to determine the influence of acute low back pain (LBP) and age on the MMPs. Socio-demographic, clinical variables and MMPs were collected in 33 patients with LBP and 33 healthy controls. A 2 × 2 × 2 (group × age × time) analysis of variance (ANOVA) mixed model was used to determine the effect of the study factors on the different MMPs. There were no significant triple interactions. After the movements, tone and stiffness increased 0.37 Hz and 22.75 N/m, respectively, in subjects <35 years, independent of their clinical status. Relaxation showed differences by age in healthy subjects and creep in LBP subjects. Furthermore, elasticity was higher in <35 years (p < 0.001) without the influence of any other factor. In conclusion, sequenced movements can modify tone and stiffness as a function of age, while age-associated changes in viscoelastic characteristics depends on pain but not on movements. The MMPs should be assessed, not only at the beginning of the physical examination at rest, but also along the patient's follow-up, depending on their pain and age, in a clinical setting.
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Affiliation(s)
- Sandra Alcaraz-Clariana
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (D.P.R.-d.-S.); (F.A.-S.)
| | - Lourdes García-Luque
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (D.P.R.-d.-S.); (F.A.-S.)
| | - Juan Luis Garrido-Castro
- Department of Computer Science and Numerical Analysis, Rabanales Campus, University of Córdoba, 14071 Córdoba, Spain;
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
| | - Cristina Carmona-Pérez
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (D.P.R.-d.-S.); (F.A.-S.)
| | - Daiana Priscila Rodrigues-de-Souza
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (D.P.R.-d.-S.); (F.A.-S.)
| | - César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia: Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
| | - Francisco Alburquerque-Sendín
- Department of Nursing, Pharmacology and Physical Therapy, Faculty of Medicine and Nursing, University of Córdoba, 14004 Córdoba, Spain; (S.A.-C.); (L.G.-L.); (C.C.-P.); (D.P.R.-d.-S.); (F.A.-S.)
- Maimonides Biomedical Research Institute of Cordoba (IMIBIC), 14004 Córdoba, Spain
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