2023, Vol. 27 ›› Issue (9): 1417-1421

Respiratory training improves morphological changes of the multifidus muscle in patients with chronic nonspecific lower back pain assessed by musculoskeletal ultrasound

Li Chao1, Zhang Peipei2, Xu Mengting3, Li Linlin1, Ding Jiangtao3, Liu Xihua1, Bi Hongyan1   

Abstract: BACKGROUND: Studies have confirmed that lumbar spine stabilization training can improve muscle morphology of the multifidus muscle in patients with chronic low back pain. There is no clinical study on whether respiratory training affects the multifidus muscle morphology in patients with chronic lower back pain.  
OBJECTIVE: To investigate the effect of respiratory training on the changes of muscle thickness and cross-sectional area of lumbar stable muscle (multifidus muscle) in patients with chronic nonspecific lower back pain.
METHODS: Totally 96 patients with chronic nonspecific lower back pain who met the inclusion criteria were randomly divided into trial group (n=32), respiratory training control group (n=32) and core training control group (n=32). The respiratory training and core training control groups received respiratory training and core stabilization training, respectively. The trial group received respiratory training combined with core stabilization training. The treatment was performed once a day, 20 minutes every time, 5 days per week, for 10 consecutive weeks. Before and after treatment, musculoskeletal ultrasound was used to observe and record the thickness and cross-sectional area of the lumbar stabilizing muscle (multifidus muscle) in the three groups. The morphology of the multifidus muscle was evaluated before and after treatment in the three groups.
RESULTS AND CONCLUSION: (1) After treatment, there was no significant difference in bilateral L5 multifidus muscle thickness sum between the respiratory training control group and the core training control group, but the multifidus muscle thickness sum was significantly thicker in the trial group than that in the other two groups. After treatment, there were significant differences in cross-sectional area sum of bilateral L5 multifidus muscle among groups (trial group >
respiratory training control group > core training control group) (P < 0.001). (2) Musculoskeletal ultrasound results of the morphological changes of the multifidus muscle in the three groups before and after treatment confirmed that respiratory training could improve the thickness and cross-sectional area of the lumbar multifidus muscle. Musculoskeletal ultrasound technology, as a new curative effect observation tool, can be used as an effective means for the evaluation and adjuvant therapy in patients with chronic nonspecific lower back pain.
Key words: chronic nonspecific lower back pain, respiratory training, lumbar stabilization muscle, musculoskeletal ultrasound, multifidus muscle