The Relationship Between Transversus Abdominis Muscle Architecture and Upper Extremity Function in Patients With Chronic Low Back Pain

Condition(s) studied

Study summary

Core stability is the ability to control the position and movement of the trunk for optimal production, transfer, and control of forces in the upper and lower extremities during functional activities.

Studies have shown that TrA activation is delayed in individuals with low back pain. The relationship between core stability and the lower extremity has been frequently studied in the literature, and according to Kibler's 'Kinetic Chain' theory, loss of proximal stability is known to lead to dysfunction in distal segments; however, the relationship between the upper extremity and core stability is still unclear. The aim of our study is to investigate the upper extremity reach capacity and scapular stability of individuals with low back pain in relation to TrA involvement and to compare them with healthy individuals without low back pain.

Eligibility

Primary outcome measure(s)

• Severity of back pain — It will only be evaluated once.
  Resting, activity, and nocturnal pains will be marked on a visual analog scale.
• Ultrasound — It will only be evaluated once.
  Measurements taken from the TrA muscle will first involve measuring the length of the cross-section in the resting position, then taking another measurement during the maneuver, and recording the differences between these measurements.
• Funcitonal Reach Test — It will only be evaluated once.
  During the measurement, the patient lies on their side against the wall (leaving a small enough distance between themselves and the wall to avoid contact). Their feet are shoulder-width apart and fixed. The patient raises the arm closest to the wall to 90 degrees of shoulder flexion (straight forward). Make a fist. While the patient's arm is at 90 degrees, the point where the head of the 3rd metacarpal (middle finger joint) aligns with the measuring tape on the wall is recorded. The patient is then asked to reach forward as far as they can without lifting their feet off the ground or taking a step. At the furthest point the patient can reach without losing their balance, the alignment of the 3rd metacarpal head is again recorded. The distance between these points is taken as the final measurement. During the measurement, it is crucial that the heels do not lift off the ground, that no steps are taken, that no support is placed against the wall, and that the arm does not drop.
• Kibler's Lateral Scapular Slide Test — It will only be evaluated once.
  Measurements were taken using a measuring tape to gauge the distance between the spinous processes of the spine and the inferior angulus of the scapula, and repeated in three different positions: arms free at the sides, hands on the hips (approximately 45 degrees abduction), and arms outstretched to the sides (90 degrees abduction and maximum internal rotation). Under normal conditions, the distance between these positions does not vary significantly or changes symmetrically. If the difference between the two sides is more than 1.5 cm or if there is excessive variation between positions, the diagnosis will be considered "Scapular Dyskinesia Present (+)".

Trial sites (1)

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