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Background and purpose:

High incidence rate of LBP was found amongst athletes. Sports-specific biomechanics, injury patterns and multiple risk factors, including spinal loading, age, gender or history of LBP, had been identified for the development of LBP in athletes. With LM being the key spinal stabilizer, imaging studies demonstrated the association between its morphological changes and LBP. Cross-sectional area (CSA), muscle thickness (MT) and echogenicity index (EI), differentiating fat from muscle, were correlated with several types of sports. However, the understanding of the listed morphological changes in LM amongst athletes with LBP, compared to those asymptomatic remains unknown. This systematic review and meta-analysis aimed to examine the morphological changes of LM and LBP in athletes, to better understand the specific morphological parameter (s) that are relevant for prospective evaluation and implementation research in management of LBP.

Methods:

This systematic review was conducted according to the PRISMA guideline and PICO question identified for the search. Newcastle Ottawa Scale (NOS) was used to assess the risk of bias of the articles.

Results:

Neither the LM CSA at both L4/5 (p= 0.443; ES= 0.322) and L5/S1 (p= 0.149; ES=-0.657); or MT recorded at resting (p= 0.311; ES= 0.919) and contraction status (p= 0.155; ES=-0.836) at L5/S1 showed any significant between-group differences in this analysis. In contrast, the EI at L5/S1 showed significantly higher fatty infiltration to muscle ratio in those athletes with LBP (p= 0.013; ES=-2.083).

Conclusion:

EI which quantified the fat component of LM, at L5/S1 level …