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Does Chronic Low Back Pain Influence Breathing Mechanics and Diaphragm Positioning? A Pilot Study

Background and objective: Chronic low back pain (CLBP) is a complex musculoskeletal condition and often the source of the pain is not clear. A correlation has been found to exist between incidences of low back pain (LBP) and those with respiratory diseases such as COPD. This could give reason to believe that the sequence of events could be reversed, and LBP could elicit changes in respiratory function. The purpose of this study is to investigate if CLBP has an influence on breathing mechanics and the positioning of the diaphragm in the trunk. Methods: Volunteers were recruited between the ages of 35-65 years old with and without CLBP. All subjects underwent an MRI for imaging of their diaphragm to find the position of the diaphragm at the end of exhalation and inhalation. The height of the diaphragm at the end of exhalation and inhalation was then measured. Respiratory values were measured that included forced expiratory volume in 1 second (FEV1), and respiratory amplitude at the thoracic and abdominal level both at rest and after a series of functional exercises. Respiratory amplitude was used to measure average displacement of the abdomen and mid-ribcage during normal breathing. FEV1 was measured using a handheld spirometer and respiratory amplitude was measured using band-like respiratory sensors that were wrapped around the participants. Results: A total of 36 participants were recruited for this study (n = 21M; n = 15F), with 18 controls (n = 11M; n = 7F) and 18 with CLBP (n = 10M; 8F). Eleven variables were assessed to compare the results from the control group and CLBP group and see if there were any differences. No statistically significant differences were found for all variables assessed. Conclusion: There was no significant evidence there was a difference in diaphragm positioning and breathing mechanics in those who have CLBP. For future testing, we would want to change categorization to CLBP groups based on pain severity or compare the differences between acute LBP and CLBP. We would also consider changing our method for measuring the diaphragm such as measuring the percent change in area of the diaphragm between inhalation and exhalation. We would also consider other parameters to test that could include more use of the information given in the PROMIS questionnaire or looking at the amount of lumbar lordosis as seen on the MRI and how those values compare to among the different groups.

Identiferoai:union.ndltd.org:BGMYU2/oai:scholarsarchive.byu.edu:etd-11028
Date26 June 2023
CreatorsWensel, Lindsey
PublisherBYU ScholarsArchive
Source SetsBrigham Young University
Detected LanguageEnglish
Typetext
Formatapplication/pdf
SourceTheses and Dissertations
Rightshttps://lib.byu.edu/about/copyright/

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