Thoracolumbar fascia ultrasound shear strain differs between low back pain and asymptomatic individuals: expanding the evidence
Bibliographic record
Abstract
Abstract Objectives To compare thoracolumbar fascia (TLF) shear strain between individuals with and without nonspecific low back pain (NSLBP), investigate its correlation with symptoms, and assess a standardized massage technique’s impact on TLF shear strain. Methods Participants were prospectively enrolled between February 2021 and June 2022. Pre- and post-intervention TLF ultrasound and pain/disability questionnaires were conducted. Cumulated (C|ShS| L ) and maximum (Max|ShS| L ) shear strain parameters were computed from radiofrequency data, and TLF thickness was measured on reconstructed B-mode images. Statistical analysis included linear mixed-effects regression. Results Thirty-two NSLBP participants (mean age, 57 ± 9 years [standard deviation]; 21 women) and 32 controls (51 ± 10 years; 22 women) ( p = 0.02) were enrolled. The mean shear strain was higher in NSLBP participants (C|ShS| L : 327.1% ± 106.0 vs 290.2% ± 99.8, p < 0.0001; Max|ShS| L : 8.1% ± 2.8 vs 7.0% ± 2.4, p < 0.0001) than controls, while mean TLF thickness (1.6 mm ± 1.0 vs 1.5 mm ± 0.9; p = 0.43) was comparable. Elastography parameters correlated with pain [C|ShS| L estimate [β], 0.01 [95% CI: 0.002, 0.02]; p = 0.02); Max|ShS| L [β] , 0.003 [95% CI: 0.001, 0.005]; p < 0.001)] and disability [C|ShS| L [β] 0.02 [95% CI: 0.005, 0.03]; p = 0.009); Max|ShS| L [β] 0.003 [95% CI: 0.001, 0.006]; p = 0.002)] scores. Neither C|ShS| L (β, 0.13 [−0.27, 0.53]; p = 0.53) nor Max|ShS| L (β, −0.02 [−0.10, 0.05]; p = 0.59) changed post-intervention. Conclusion Individuals with NSLBP demonstrated elevated TLF shear strain compared to controls, with similar TLF thickness. The shear strain correlated with pain and disability scores, yet a brief massage did not influence shear strain. Trial registration Clinicaltrials.gov, NCT04716101. Registered 14 January 2021, https://clinicaltrials.gov/study/NCT04716101 . Critical relevance statement Ultrasound shows elevated TLF shear strain in lower back pain sufferers compared to controls. This correlates with symptoms, suggesting a role as a pain generator. Further investigation into its anatomy, mechanical characteristics, and pathophysiology is crucial for better understanding. Key Points Structural and mechanical alterations of the TLF may contribute to low back pain. Elevated TLF lateral shear strain was found in patients with NSLBP. A brief standardized massage therapy technique did not influence elastography parameters. Graphical Abstract
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".