INSTRUMENT ASSISSTED RELEASE OF QUADRATUS LUMBORUM ON PELVIC POSTURE AND ILIOPSOAS MUSCLE LENGTH IN NON-SPECIFIC LBP: A DOUBLE BLINDED PLACEBO CONTROLLED TRIAL

Iliopsoas and quadratus lumborum (QL) muscles, which are anatomically connected, frequently get stiff and adopt the anterior pelvic tilt posture in persistent non-specific low back pain (NSLBP). Since iliopsoas is a deep muscle it cannot be directly targeted for release. Instrument assisted release (IASTM) has gained popularity due to less efforts exerted by the therapist’s hands. However, the literature determining the effects of IASTM is still emerging. To determine the effect of IASTM release of QL on length of iliopsoas & pelvic posture in NSLBP. Thirty-two participants with NSLBP received conventional physiotherapy treatment including IFT & UST. In addition experimental group received IASTM (n=16), whereas control group (n=16) received sham IASTM for 10 days (5 sessions).The primary outcomes were length of iliopsoas using diagnostic ultrasonography & Thomas test angle, pelvic posture, assessed pre and post intervention. There was significant increase (p=0.0001) in the length of iliopsoas, decrease in the degree of Thomas test and angle of anterior pelvic tilt in experimental group when compared to control group.

髂腰肌（iliopsoas）与腰方肌（quadratus lumborum, QL）在解剖结构上相互连接，在持续性非特异性下腰痛（non-specific low back pain, NSLBP）患者中常出现僵硬症状，并易诱发骨盆前倾姿态。由于髂腰肌属于深层肌肉，无法直接进行针对性松解。工具辅助松解术（instrument assisted release, IASTM）因可降低治疗师手部施力负荷而逐渐普及，但目前探讨其治疗效果的相关研究仍较为匮乏。本研究旨在明确腰方肌工具辅助松解术对非特异性下腰痛患者髂腰肌长度及骨盆姿态的影响。本研究共纳入32名非特异性下腰痛患者，所有受试者均接受包括干扰电疗法（interferential therapy, IFT）与超声波疗法（ultrasound therapy, UST）在内的常规物理治疗。在此基础上，实验组（n=16）接受工具辅助松解术，对照组（n=16）接受假工具辅助松解术，干预周期为10天，共5次治疗。主要结局指标包括通过诊断性超声测量的髂腰肌长度、托马斯试验（Thomas test）角度，以及骨盆姿态，分别于干预前及干预后进行评估。结果显示，与对照组相比，实验组患者的髂腰肌长度显著增加（p=0.0001），托马斯试验角度及骨盆前倾角度均显著降低。