Ultrasonographic Assessment of Thoracolumbar Fascia in AxSpA and Controls With Trigger Point Evaluation
NCT ID: NCT06978374
Last Updated: 2025-05-18
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
132 participants
OBSERVATIONAL
2020-11-01
2025-03-30
Brief Summary
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The main questions it aims to answer are:
Is the thickness or shape of the thoracolumbar fascia different in patients with ax-SpA compared to healthy individuals? Is there a relationship between changes in the thoracolumbar fascia and the presence of painful muscle trigger points? Researchers will compare measurements in ax-SpA patients and healthy volunteers to see if differences in fascia structure are linked to pain, function, and disease activity.
Participants will:
Undergo a back ultrasound (non-invasive imaging) to assess the thickness and structure of the thoracolumbar fascia.
Be examined for muscle trigger points using gentle manual palpation. Complete questionnaires and assessments on physical function, quality of life, and disease activity.
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Detailed Description
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This research includes adults diagnosed with ax-SpA, as well as healthy volunteers of similar age and gender who do not have chronic back pain or spinal diseases.
The main questions it aims to answer are:
Do patients with ax-SpA have increased thickness or irregular structure in the thoracolumbar fascia compared to healthy individuals? Is there a connection between fascia changes and the presence of painful muscle trigger points? Are these findings related to the severity of disease symptoms, such as pain, stiffness, physical function, and quality of life? Does the use of anti-inflammatory or immune-modulating medications affect the presence of these muscle trigger points? Researchers will compare ultrasound and clinical findings between ax-SpA patients and healthy volunteers to determine whether structural differences in the fascia can be used as a non-invasive indicator of disease burden.
Participants will:
Undergo a high-resolution ultrasound scan of their lower back to assess the structure and thickness of the thoracolumbar fascia.
Receive a manual examination to check for muscle trigger points in the lower back.
Complete questionnaires related to pain, function, fatigue, and quality of life.
Share information about their medical history, including the use of medications such as non-steroidal anti-inflammatory drugs (NSAIDs), disease-modifying antirheumatic drugs (DMARDs), and TNF-alpha inhibitors.
Conditions
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Study Design
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CASE_CONTROL
CROSS_SECTIONAL
Study Groups
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AxSpA group
This study included individuals aged between 18 and 65 years who were classified as having axial spondyloarthritis (axSpA), including both radiographic and non-radiographic forms, according to the Assessment of SpondyloArthritis International Society (ASAS) classification criteria. Participants with additional health conditions that could affect thoracolumbar fascia (TLF) morphology or spinal biomechanics were excluded from the study. Exclusion criteria included: History of severe back or lower extremity trauma or surgery, Significant spinal deformity (e.g., scoliosis, kyphosis, spinal stenosis), History of spinal surgery, History of spinal fracture, Malignancy or spinal infection, Neurological deficit due to nerve root compression, Neurological or major psychiatric disorders, Bleeding disorders, Previous lumbar steroid injection or current systemic steroid use, Pregnancy, Disability status or ongoing legal process related to low back pain, Presence of acute systemic infection
Sonographic examination of thoracolumbar fascia, manual examination of MTrP
Patients were positioned in the prone position, with a cushion placed under the abdomen to flatten the lumbar lordosis.
A 14-18 MHz linear transducer was used for ultrasonographic (USG) evaluation, performed with a GE Logiq P5 ultrasound device (Serial No: GE-114118SU3).
The USG probe was placed longitudinally at the L2-L3 intervertebral level, 2 cm lateral to the vertical line connecting the spinous processes on both sides, in order to assess the thoracolumbar fascia (TLF).
Healthy group
Participants in the healthy control group were age-matched (18-65 years) and selected according to the same exclusion criteria applied to the patient group.
Sonographic examination of thoracolumbar fascia, manual examination of MTrP
Patients were positioned in the prone position, with a cushion placed under the abdomen to flatten the lumbar lordosis.
A 14-18 MHz linear transducer was used for ultrasonographic (USG) evaluation, performed with a GE Logiq P5 ultrasound device (Serial No: GE-114118SU3).
The USG probe was placed longitudinally at the L2-L3 intervertebral level, 2 cm lateral to the vertical line connecting the spinous processes on both sides, in order to assess the thoracolumbar fascia (TLF).
Interventions
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Sonographic examination of thoracolumbar fascia, manual examination of MTrP
Patients were positioned in the prone position, with a cushion placed under the abdomen to flatten the lumbar lordosis.
A 14-18 MHz linear transducer was used for ultrasonographic (USG) evaluation, performed with a GE Logiq P5 ultrasound device (Serial No: GE-114118SU3).
The USG probe was placed longitudinally at the L2-L3 intervertebral level, 2 cm lateral to the vertical line connecting the spinous processes on both sides, in order to assess the thoracolumbar fascia (TLF).
Eligibility Criteria
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Inclusion Criteria
* Diagnosis of axial spondyloarthritis (axSpA) according to the Assessment of -SpondyloArthritis International Society (ASAS) classification criteria, or being a healthy control with no known musculoskeletal or systemic inflammatory disease
* Ability to lie in the prone position for ultrasonographic examination
* Willingness to participate in the study
* Provision of written informed consent prior to inclusion
Exclusion Criteria
* Presence of major spinal deformities (e.g., scoliosis, kyphosis, spinal stenosis)
* History of spinal surgery or spinal fracture
* Known malignancy or spinal infection
* Neurological deficits due to nerve root compression
* Presence of a diagnosed neurological or major psychiatric disorder
* Known bleeding disorders
* History of lumbar steroid injection or current use of systemic corticosteroids
* Current pregnancy
* Legal or disability status related to low back pain
* Presence of an acute systemic infection
* Refusal or inability to provide written informed consent
18 Years
65 Years
ALL
Yes
Sponsors
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Ankara University
OTHER
Responsible Party
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Yuzlem Gyuner SIDZHIMLI MD
Principal Investigator
Principal Investigators
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Sebnem ATAMAN, Study Chair
Role: STUDY_CHAIR
Ankara University School of Medicine, Department of Rheumathology
Yuzlem Gyuner SIDZHIMLI, MD
Role: PRINCIPAL_INVESTIGATOR
Ankara University School of Medicine, Department of Physical Medicine and Rehabilitation
Seçilay GÜNEŞ, Ass Prof
Role: STUDY_DIRECTOR
Ankara University School of Medicine, Department of Physical Medicine and Rehabilitation
Locations
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Ankara University, Faculty of Medicine Hospital
Ankara, Mamak, Turkey (Türkiye)
Countries
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References
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De Coninck K, Hambly K, Dickinson JW, Passfield L. Measuring the morphological characteristics of thoracolumbar fascia in ultrasound images: an inter-rater reliability study. BMC Musculoskelet Disord. 2018 Jun 1;19(1):180. doi: 10.1186/s12891-018-2088-5.
Abe H, Hayashi S, Kim JH, Murakami G, Rodriguez-Vazquez JF, Jin ZW. Fetal development of the thoracolumbar fascia with special reference to the fascial connection with the transversus abdominis, latissimus dorsi, and serratus posterior inferior muscles. Surg Radiol Anat. 2021 Jun;43(6):917-928. doi: 10.1007/s00276-020-02668-4. Epub 2021 Jan 12.
Boccon Gibod L, Correas G, Godefroy D, Ducellier R, Teyssier P. [Radio-transparent renal calculi and epithelial tumours. Contribution of ultrasound and CT scan to the diagnosis (author's transl)]. Nouv Presse Med. 1981 Oct 31;10(39):3231-2. French.
Kondrup F, Gaudreault N, Venne G. The deep fascia and its role in chronic pain and pathological conditions: A review. Clin Anat. 2022 Jul;35(5):649-659. doi: 10.1002/ca.23882. Epub 2022 Apr 27.
Hodges PW, Danneels L. Changes in Structure and Function of the Back Muscles in Low Back Pain: Different Time Points, Observations, and Mechanisms. J Orthop Sports Phys Ther. 2019 Jun;49(6):464-476. doi: 10.2519/jospt.2019.8827.
Other Identifiers
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AUPMRYGSThesis
Identifier Type: -
Identifier Source: org_study_id
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