Bel Ağrılı Hastalarda Solunum Tipinin Derin Spinal Stabilizatör Kas Kalınlıkları Üzerine Etkisinin İncelenmesi

Abstract

Yıldız OŞ. Investigation of the effect of breathing type on deep spinal stabilizer muscle thicknesses in patients with low back pain. Hacettepe University Graduate School of Health Sciences Neurology Physiotherapist Master Thesis, Ankara, 2023. The diaphragm, Transversus Abdominis (TrA) and pelvic floor muscles are the muscles involved in both lumbar stabilization and respiratory function. While maintaining stability with the tonic activity of these muscles, the transversus abdominis and diaphragm act in a coordinated manner in breathing. With low back pain, poor neuromuscular control of these stability muscles can potentially adversely affect breathing. The aim of this study was to examine the effect of breathing pattern on deep stabilizer muscle thicknesses in individuals with low back pain. 51 low back pain and 51 healthy individuals were included in the study. The respiratory pattern of the participants was evaluated by Manual Evaluation of Respiratory Movement method, and TrA and lumbar multifidus (MF) muscle thicknesses were evaluated by ultrasound. Pain levels of individuals with low back pain were evaluated with the Visual Analogue Scale (VAS), and disability levels were evaluated with the Oswestry Disability Index (ODI). While 62,7% of the group with low back pain had thoracic breathing and 37,3% of them were diaphragmatic breathing, 66,7% of the healthy group was doing diaphragmatic breathing and 33,3% was thoracic breathing. There was a significant difference in respiratory pattern between the groups (p=0.003). It was observed that the group with low back pain did more thoracic breathing, and the healthy group did more diaphragmatic breathing. TrA and lumbar MF muscle thickness changes were lower in individuals with low back pain breathing thoracically (p=0.003, p=0.002 p=0.006 p=0.013) In individuals with low back pain breathing diaphragmatically, right TrA thickness change (%) was lower (p=0.023). A significant difference was found between respiratory patterns and VAS values (cm) of individuals in the low back pain group (p=0.015). Individuals with thoracic respiration had higher VAS values. In the low back pain group, no significant difference was found between the thoracic and diaphragmatic breathing groups in terms of ODI scores and pain duration (p=0.391, p=0.328). As a result of the study, it was seen that the breathing pattern affected the muscle thickness of the deep stabilizer muscles. In the group with low back pain, the thickness of the TrA and lumbar MF muscles of the thoracic and diaphragmatic respiratory muscles decreased. Key words: Low back pain, respiration, pain intensity, diaphragm