Skip to main content

The use of ultrasound imaging to evaluate the thoracolumbar fascia in people with and without lower back pain

De Coninck, Kyra (2018) The use of ultrasound imaging to evaluate the thoracolumbar fascia in people with and without lower back pain. Doctor of Philosophy (PhD) thesis, University of Kent,. (KAR id:73748)

PDF (redacted version)
Language: English

Download (1MB) Preview
[thumbnail of redacted version]
This file may not be suitable for users of assistive technology.
Request an accessible format
Language: English

Restricted to Repository staff only

Contact us about this Publication
[thumbnail of 281The use of ultrasound imaging to evaluate the thoracolumbar fascia in people .pdf]


Chronic lower back pain remains a poorly understood multi-factorial condition, associated with reduced quality of life and function. Traditionally, research in lower back pain has focused on vertebrae, trunk muscles, motor control and biopsychosocial factors. Despite this substantial body of research, chronic lower back pain remains a prevalent global issue affecting health and well-being. Recently, the thoracolumbar fascia has been recognised to play a role in the pathophysiology of chronic lower back pain. Currently, there are no standardised methods for imaging and analysis of the thoracolumbar fascia. This thesis seeks to advance methods of analysis as well as furthering our understanding of role thoracolumbar fascia plays in chronic lower back pain.

The study presented in Chapter 5 used ultrasound to investigate the thickness and echogenicity of the thoracolumbar fascia in people with and without back pain. One hundred and forty-one participants took part in the study (74 with back pain, 67 without back pain). This study found that the echogenicity (brightness of pixels indicating presence of collagen) of the thoracolumbar fascia in people with lower back pain was 10% higher (p = 0.04), compared to people without lower back pain. Higher echogenicity suggests tissue fibrosis, as found in other pathological connective tissues.

The study presented in Chapter 7 was an inter-rater reliability study in which 30 medical practitioners rated the morphology of the thoracolumbar fascia of 30 ultrasound images of 30 individuals. The scans were rated on a Likert-type scale ranging from 5 being very disorganised, to 1 being very organised. Images were selected by a focus group and consisted of a representative range of thoracolumbar morphologies. This study found that medical practitioners can reliably rate scans, regardless of ultrasound experience (Cronbach's alpha - 0.98).

These findings contribute to the emerging field of research into the pathophysiology of the human fascial system.

Item Type: Thesis (Doctor of Philosophy (PhD))
Thesis advisor: Passfield, Louis
Thesis advisor: Dickinson, John
Uncontrolled keywords: ultrasound imaging; sonography; morphology; thoracolumbar fascia; thoracolumbar aponeurosis; specialised connectve tissues; lumbar fascia; lower back pain; low back pain
Divisions: Divisions > Division of Natural Sciences > School of Sport and Exercise Sciences
SWORD Depositor: System Moodle
Depositing User: System Moodle
Date Deposited: 03 May 2019 07:10 UTC
Last Modified: 16 Feb 2021 14:04 UTC
Resource URI: (The current URI for this page, for reference purposes)
  • Depositors only (login required):