Dynamic evaluation of the contractile function of lumbodorsal muscles during locust pose in yoga by real-time ultrasound

Abstract

Background and purpose: Chronic low back pain (CLBP), which has a close relationship with lumbar muscle degeneration, can be effectively treated by exercise therapy, and yoga has been widely accepted by clinicians and patients with CLBP. The purpose of this study was to observe the changes in the thickness of lumbodorsal muscles that occur during locust pose in yoga and how these changes occur. From the changes in muscle thickness that occur in the locust pose, the contractile function of lumbodorsal muscles can be evaluated.

Methods: Fifty-two healthy volunteers (from May 2019 to August 2019, age from 28 to 68 years, 23 males and 29 females (age: 40 ± 8 years; weight: 68.3 ± 5.2 kg; height: 170.2 ± 13.1 cm) were recruited, and lumbodorsal muscle, including the multifidus, longissimus, iliocostalis, and quadratus lumborum, ultrasonic examinations were carried out in the relaxed and contracted states. The changes in the thickness of the lumbodorsal muscles in the relaxed and contracted states were dynamically observed by real-time ultrasound when subjects were performing the locust yoga pose. Then, the thicknesses of the muscles during the two states were measured to calculate the ratio of contraction of each muscle and determine the statistical significance of the change in thickness of each muscle.

Results: The mean thickness of the left multifidus in the relaxed state was 1.32 ± 0.27 cm (95 % CI: 1.24 ~ 1.39), that in the contracted state was 1.60 ± 0.30 cm (95 % CI: 1.52 ~ 1.69) (obviously different between the relaxed and contracted states, P < 0.001), and those in the corresponding right side were 1.37 ± 0.31 cm (95 % CI: 1.29 ~ 2.46) and 1.68 ± 0.38 cm (95 % CI: 1.58 ~ 1.79) (P < 0.001), respectively. The mean thickness of the left quadratus lumborum in the relaxed state was 1.38 ± 0.32 cm (95 % CI: 1.29 ~ 1.47), that in the contracted state was 1.62 ± 0.40 cm (95 % CI: 1.50 ~ 1.73) (P = 0.001), and those in the corresponding right side were 1.30 ± 0.32 cm (95 % CI: 1.21 ~ 1.39) and 1.55 ± 0.41 cm (95 % CI: 1.44 ~ 1.67) (P = 0.001), respectively. The mean thickness of the left longissimus in the relaxed was 2.33 ± 0.51 cm (95 % CI: 2.19 ~ 2.47), that in the contracted state was 3.20 ± 0.61 cm (95 % CI: 3.03 ~ 3.37) (P < 0.001), and those in the corresponding right side were 2.34 ± 0.49 cm (95 % CI 2.20 ~ 2.48) and 3.26 ± 0.68 cm (95 % CI 3.07 ~ 3.45) (P < 0.001), respectively. The mean thickness of the left iliocostalis in the relaxed state was 1.88 ± 0.41 cm (95 % CI: 1.76 ~ 1.99), that in the contracted state was 2.34 ± 0.49 cm (95 % CI: 2.00 ~ 2.47) (P < 0.001), and those in the corresponding right side were 1.98 ± 0.40 cm (95 % CI: 1.87 ~ 2.09) and 2.44 ± 0.56 cm (95 % CI: 2.29 ~ 2.60) (P < 0.001), respectively. The mean contracted state/resting state (C/R) of the longissimus was 1.39 ± 0.14 on the left and 1.40 ± 0.16 on the right. The multifidus and iliocostalis had the second highest C/R. The mean C/R of the multifidus was 1.23 ± 0.12 on the left and 1.24 ± 0.15 on the right, and the mean C/R of the iliocostalis was 1.25 ± 0.12 on the left and 1.24 ± 0.14 on the right. The quadratus lumborum had the lowest C/R, and the mean C/R of the quadratus lumborum was 1.17 ± 0.10 on the left and 1.19 ± 0.11 on the right.

Conclusions: Ultrasound can be used to dynamically assess the contractile function of the lumbar muscle in the locust pose of yoga, the C/R ratio can be used to indicate the ability of a muscle to contract, and dynamic ultrasound can guide lumbar exercise and feedback the exercise results. The establishment of this model allowed data regarding the contraction state of the lumbar muscle to be obtained in a normal population, and based on this, future studies can further explore and evaluate the contraction state of the lumbar muscle after yoga exercise in CLBP patients, the effect exercise on lumbar instability and on a patient population after lumbar operation.

Keywords: Lumbodorsal muscles; locust yoga pose; low back pain; muscle thickness; ultrasonography.

Fig. 1

The head is lifted upward as much as possible, and both the upper limbs and lower limbs are stretched out from the bed surface. The lower abdomen is in contact with the bed surface to act as the fulcrum. The angle of the lower limbs and fulcrum and the angle of the upper body and fulcrum are close to 30°. The whole body is bent like an inverted arch.

Fig. 2

The thicknesses of the left (Fig. 2 A) and right (Fig. 2B) multifidus in the resting (blue line) and contracted conditions (red line). Comparison of the thicknesses in the resting (blue column) and contracted conditions (red column). Group 1 is right, and group 2 is left (Fig. 2 C). The sonogram of the multifidus: left shows the relaxed state, and right shows the contracted state (Fig. 2D)

Fig. 3

The thicknesses of the left (Fig. 3 A) and right (Fig. 3B) quadratus lumborum muscles in the resting (blue line) and contracted conditions (red line). Comparison of the thicknesses in the resting (blue column) and contracted conditions (red column). Group 1 is right, and group 2 is left (Fig. 3 C). The sonogram of the quadratus lumborum: left shows the relaxed state, and right shows the contracted state (Fig. 3D)

Fig. 4

The thicknesses of the left (Fig. 4 A) and right (Fig. 4B) longissimus muscles in the resting (blue line) and contracted conditions (red line). Comparison of the thicknesses in the resting (blue column) and contracted conditions (red column). Group 1 is right, and group 2 is left (Fig. 4 C). The sonogram of the longissimus: left shows the relaxed state, and right shows the contracted state (Fig. 4D)

Fig. 5

The thicknesses of the left (Fig. 5 A) and right (Fig. 5B) iliocostalis muscles in the resting (blue line) and contracted conditions (red line). Comparison of the thicknesses in the resting (blue column) and contracted conditions (red column). Group 1 is right, and group 2 is left (Fig. 5 C). The sonogram of the iliocostalis: left shows the relaxed state, and right shows the contracted state (Fig. 5D)