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There is limited research on the changes of biomechanical characteristics of the lumbar extensor myofascia in elderly patients with chronic low back pain. ,is study aimed to compare the biomechanical properties of the lumbar extensor myofascia in elderly patients with chronic low back pain and healthy people when resting and to analyze the relationship between the Japanese Orthopedic Association (JOA) score, visual analog scale (VAS) score, Cobb angle, disease course and the biomechanical characteristics of the lumbar extensor myofascia. This case-control study included 40 elderly patients with chronic low back pain and 40 healthy volunteers.

MyotonPRO was used to measure the biomechanical properties of the bilateral lumbar extensor myofascia (at L3/L4 level) in all participants, and the reliability of the MyotonPRO test was measured. Cobb angle was measured from lumbar computed tomography or magnetic resonance imaging data. JOA and VAS scores were used to evaluate lumbar function and pain.

We found that muscle tone, stiffness, and elasticity of the left and right lumbar extensor myofascia in patients with chronic low back pain were very reliable among different operators. The average lumbar extensor muscle tone and stiffness were significantly higher in patients with chronic low back pain than those in healthy controls. The average elasticity of the lumbar extensor myofascia of patients with chronic low back pain was significantly lower than that of the healthy controls.

The JOA score was negatively correlated, while the VAS score was positively correlated with the mean values of tone, stiffness, and elasticity of the bilateral lumbar extensor myofascia (logarithmic decrement). Disease course had no significant correlation with muscle tone, stiffness, and elasticity of the lumbar extensor myofascia. No significant correlation was found between Cobb angle and muscle tone, stiffness, and elasticity of the lumbar extensor myofascia in either group.

Reliability: In this study, we also performed a reliability analysis of the MyotonPRO test in patients with CLBP. The results showed that the MyotonPRO equipment had high reliability in testing the biomechanical properties of the lumbar extensor myofascia among different operators (ICC > 0.90). Reliability is very important when using instruments in clinical evaluation or research Figure 1. Based on results, we can conclude that the evaluation of muscle tone, stiffness, and elasticity using the MyotonPRO equipment is objective and reliable.

This study compared the biomechanical properties of the lumbar extensor myofascia in patients with CLBP and in healthy patients. We found that the tone and stiffness of the lumbar extensor myofascia on both sides in patients with CLBP were higher than those in healthy controls, while the elasticity was lower than that in healthy controls. We also found that the JOA score was negatively correlated with the tone and stiffness of the extensor myofascia bilaterally in patients with CLBP and positively correlated with elasticity.

The VAS score was positively correlated with the tone and stiffness of the lumbar extensor myofascia on both sides and negatively correlated with elasticity in patients with CLBP. Moreover, no significant correlation was found between the Cobb angle and disease course and muscle tone, stiffness, and elasticity of the lumbar extensor myofascia.

As this study only involved 40 patients and 40 healthy controls, research with larger sample sizes is needed in the future to form a complete database and further study the correlation between these factors and other influencing factors.