Thoracolumbar fascia deformation during deadlifting and trunk extension in individuals with and without back pain

Andreas Brandl; Jan Wilke; Christoph Egner; Rüdiger Reer; Tobias Schmidt; Robert Schleip

doi:10.3389/fmed.2023.1177146

Thoracolumbar fascia deformation during deadlifting and trunk extension in individuals with and without back pain

Front Med (Lausanne). 2023 Jun 5:10:1177146. doi: 10.3389/fmed.2023.1177146. eCollection 2023.

Authors

Andreas Brandl^{1

2

3}, Jan Wilke⁴, Christoph Egner², Rüdiger Reer¹, Tobias Schmidt^{3

5}, Robert Schleip^{2

6}

Affiliations

¹ Department of Sports Medicine, Institute for Human Movement Science, Faculty for Psychology and Human Movement Science, University of Hamburg, Hamburg, Germany.
² Department for Medical Professions, Diploma Hochschule, Bad Sooden-Allendorf, Germany.
³ Osteopathic Research Institute, Osteopathie Schule Deutschland, Hamburg, Germany.
⁴ Department of Movement Sciences, University of Klagenfurt, Klagenfurt, Austria.
⁵ Institute of Interdisciplinary Exercise Science and Sports Medicine, Medical School Hamburg (MSH), Hamburg, Germany.
⁶ Department of Sport and Health Sciences, Conservative and Rehabilitative Orthopedics, Technical University of Munich, Munich, Germany.

Abstract

Background: Alterations in posture, lumbopelvic kinematics, and movement patterns are commonly seen in patients with low back pain. Therefore, strengthening the posterior muscle chain has been shown to result in significant improvement in pain and disability status. Recent studies suggest that thoracolumbar fascia (TLF) has a major impact on the maintenance of spinal stability and paraspinal muscle activity, and thus is likely to have an equal impact on deadlift performance.

Objective: Aim of the study was to evaluate the role of thoracolumbar fascia deformation (TFLD) during spinal movement in track and field athletes (TF) as well as individuals with and without acute low back pain (aLBP).

Methods: A case-control study was performed with n = 16 aLBP patients (cases) and two control groups: untrained healthy individuals (UH, n = 16) and TF (n = 16). Participants performed a trunk extension task (TET) and a deadlift, being assessed for erector spinae muscle thickness (EST) and TLFD using high-resolution ultrasound imaging. Mean deadlift velocity (VEL) and deviation of barbell path (DEV) were measured by means of a three-axis gyroscope. Group differences for TLFD during the TET were examined using ANOVA. Partial Spearman rank correlations were calculated between TLFD and VEL adjusting for baseline covariates, EST, and DEV. TLFD during deadlifting was compared between groups using ANCOVA adjusting for EST, DEV, and VEL.

Results: TLFD during the TET differed significantly between groups. TF had the largest TLFD (-37.6%), followed by UH (-26.4%), while aLBP patients had almost no TLFD (-2.7%). There was a strong negative correlation between TLFD and deadlift VEL in all groups (r = -0.65 to -0.89) which was highest for TF (r = -0.89). TLFD during deadlift, corrected for VEL, also differed significantly between groups. TF exhibited the smallest TLFD (-11.9%), followed by aLBP patients (-21.4%), and UH (-31.9%).

Conclusion: TFLD maybe a suitable parameter to distinguish LBP patients and healthy individuals during lifting tasks. The cause-effect triangle between spinal movement, TFLD and movement velocity needs to be further clarified.

Clinical trial registration: https://drks.de/register/de/trial/DRKS00027074/, German Clinical Trials Register DRKS00027074.

Keywords: acute low back pain; correlation; deadlift velocity; thoracolumbar fascia deformation; track and field athletes; trunk extension.