title: Ultrasound Evaluation of the Combined Effects of Thoracolumbar Fascia Injury and Movement Restriction in a Porcine Model.
abstract: The persistence of back pain following acute back "sprains" is a serious public health problem with poorly understood pathophysiology. The recent finding that human subjects with chronic low back pain (LBP) have increased thickness and decreased mobility of the thoracolumbar fascia measured with ultrasound suggest that the fasciae of the back may be involved in LBP pathophysiology. This study used a porcine model to test the hypothesis that similar ultrasound findings can be produced experimentally in a porcine model by combining a local injury of fascia with movement restriction using a "hobble" device linking one foot to a chest harness for 8 weeks. Ultrasound measurements of thoracolumbar fascia thickness and shear plane mobility (shear strain) during passive hip flexion were made at the 8 week time point on the non-intervention side (injury and/or hobble). Injury alone caused both an increase in fascia thickness (p = .007) and a decrease in fascia shear strain on the non-injured side (p = .027). Movement restriction alone did not change fascia thickness but did decrease shear strain on the non-hobble side (p = .024). The combination of injury plus movement restriction had additive effects on reducing fascia mobility with a 52% reduction in shear strain compared with controls and a 28% reduction compared to movement restriction alone. These results suggest that a back injury involving fascia, even when healed, can affect the relative mobility of fascia layers away from the injured area, especially when movement is also restricted.
authors.affiliation: Department of Neurological Sciences, University of Vermont, Burlington, Vermont, United States of America.
authors.forename: James H
authors.initials: JH
authors.lastname: Bishop
authors.affiliation: Department of Neurological Sciences, University of Vermont, Burlington, Vermont, United States of America.
authors.forename: James R
authors.initials: JR
authors.lastname: Fox
authors.affiliation: Department of Neurological Sciences, University of Vermont, Burlington, Vermont, United States of America.
authors.forename: Rhonda
authors.initials: R
authors.lastname: Maple
authors.affiliation: Department of Neurological Sciences, University of Vermont, Burlington, Vermont, United States of America.
authors.forename: Caitlin
authors.initials: C
authors.lastname: Loretan
authors.affiliation: Department of Medical Biostatistics, University of Vermont, Burlington, Vermont, United States of America.
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Badger
authors.affiliation: Department of Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont, United States of America.
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Henry
authors.affiliation: Department of Neurological Sciences, University of Vermont, Burlington, Vermont, United States of America.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Vizzard
authors.affiliation: Department of Neurological Sciences, University of Vermont, Burlington, Vermont, United States of America.|Division of Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States of America.
authors.forename: Helene M
authors.initials: HM
authors.lastname: Langevin
mesh_terms: D000818:Animals; D015740:Calcitonin Gene-Related Peptide / Q000378:metabolism; D005205:Fascia / Q000000981:diagnostic imaging / Q000293:injuries; D005684:Gait; D017116:Low Back Pain / Q000000981:diagnostic imaging* / Q000378:metabolism; D008297:Male; D016059:Range of Motion, Articular; D013116:Spinal Cord / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D013373:Substance P / Q000378:metabolism; D034421:Sus scrofa; D014463:Ultrasonography
chemical_list: D013373:Substance P; D015740:Calcitonin Gene-Related Peptide
references.citation: J Anat. 2012 Dec;221(6):507-36
references.pmid: 22630613
references.citation: BMC Musculoskelet Disord. 2011;12:203
references.pmid: 21929806
references.citation: Eur Spine J. 2008 Jan;17(1):2-19
references.pmid: 17632738
references.citation: Trends Microbiol. 2012 Jan;20(1):50-7
references.pmid: 22153753
references.citation: Neuroscience. 2011 Oct 27;194:302-8
references.pmid: 21839150
references.citation: Phys Med Rehabil Clin N Am. 2010 Nov;21(4):711-24
references.pmid: 20977957
references.citation: Phys Sportsmed. 2001 Mar;29(3):31-42
references.pmid: 20086565
references.citation: Lab Anim Sci. 1986 Aug;36(4):408-12
references.pmid: 3534443
references.citation: J Anat. 1997 May;190 ( Pt 4):601-11
references.pmid: 9183682
references.citation: Wound Repair Regen. 2001 Mar-Apr;9(2):66-76
references.pmid: 11350644
references.citation: Cells Tissues Organs. 2011;194(6):521-30
references.pmid: 21411968
references.citation: Neurosci Biobehav Rev. 2007;31(5):728-51
references.pmid: 17445892
references.citation: Curr Probl Dermatol. 1978;7:39-52
references.pmid: 752456
references.citation: Ann Plast Surg. 1978 May;1(3):252-66
references.pmid: 727665
references.citation: BMC Musculoskelet Disord. 2009;10:151
references.pmid: 19958536
references.citation: Pain. 2008 Aug 15;138(1):119-29
references.pmid: 18164133
references.citation: Mol Immunol. 2015 Jul;66(1):14-21
references.pmid: 25466611
references.citation: Eur Spine J. 2011 Dec;20(12):2152-9
references.pmid: 21533851
references.citation: Vet Pathol. 2012 Mar;49(2):344-56
references.pmid: 21441112
references.citation: Surg Radiol Anat. 2011 Dec;33(10):855-62
references.pmid: 21203765
references.citation: Acta Orthop Scand. 1992 Apr;63(2):195-7
references.pmid: 1590057
references.citation: J Anat. 1998 Jul;193 ( Pt 1):105-19
references.pmid: 9758141
references.citation: Space Life Sci. 1972 Jun;3(3):226-34
references.pmid: 4556756
references.citation: Arch Dermatol Res. 1981;270(4):391-401
references.pmid: 7283467
references.citation: Spine (Phila Pa 1976). 1995 Apr 1;20(7):753-8
references.pmid: 7701385
references.citation: Pathophysiology. 2005 Dec;12(4):233-42
references.pmid: 16226434
references.citation: J Electromyogr Kinesiol. 2012 Apr;22(2):155-75
references.pmid: 22154465
references.citation: Am J Vet Res. 1966 May;27(118):765-72
references.pmid: 4164019