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Short-term increase in discs’ apparent diffusion is associated with pain and mobility improvements after spinal mobilization for low back pain
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Short-term increase in discs’ apparent diffusion is associated with pain and mobility improvements after spinal mobilization for low back pain
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Journal Article
Short-term increase in discs’ apparent diffusion is associated with pain and mobility improvements after spinal mobilization for low back pain
2018
Overview
Pain perception, trunk mobility and apparent diffusion coefficient (
ADC
) within all lumbar intervertebral discs (IVDs) were collected before and shortly after posterior-to-anterior (PA) mobilizations in 16 adults with acute low back pain. Using a pragmatic approach, a trained orthopaedic manual physical therapist applied PA mobilizations to the participants’ spine, in accordance with his examination findings.
ADC
all
was computed from diffusion maps as the mean of anterior (
ADC
ant
), middle (
ADC
mid
), and posterior (
ADC
post
) portions of the IVD. After mobilization, pain ratings and trunk mobility were significantly improved and a significant increase in
ADC
all
values was observed. The greatest
ADC
all
changes were observed at the L
3
-L
4
and L
4
-L
5
levels and were mainly explained by changes in
ADC
ant
and
ADC
post
, respectively. No significant changes in
ADC
were observed at L
5
-S
1
level. The reduction in pain and largest changes in
ADC
observed at the periphery of the hyperintense IVD region suggest that increased peripheral random motion of water molecules is implicated in the IVD nociceptive response modulation. Additionally,
ADC
changes were observed at remote IVD anatomical levels that did not coincide with the PA spinal mobilization application level.
Publisher
Nature Publishing Group UK,Nature Publishing Group
