Virginia Research Day 2025

Medical Student Research Clinical

Jaeda Mattis, OMS-3; David Risov, DO; Nicole Fremarek, DO, MBA; Edward Magalhaes, PhD, LPC; Vincent Wang, PhD; Georgina Flynn-Smith, MBEE; Mathew Chung, DO; Gunnar Brolinson, DO; Al Kozar, DO, FAOASM, R-MSK Corresponding author: jmattis@vt.vcom.edu 29 Correlation Between Psychosocial Survey Scores and Thoracolumbar Fascia Glide Impairment in Chronic Low Back Pain

Edward Via College of Osteopathic Medicine - Virginia Campus

assessment, all candidates completed standardized psychosocial questionnaires at baseline, including the GAD-7, PHQ-9, and SHQ. Dynamic ultrasound video of the glide of the posterior TLF layer was captured during passive trunk flexion at L3-4 and active ipsilateral & contralateral hip extension at T12-L1. Total scores on each psychosocial survey and their averages were calculated and compared between CLBP and NLBP subjects, making note of TLF glide impairment and no glide impairment. RESULTS: Preliminary data shows that average GAD-7 scores are at least 2 times greater in the CLBP group than NLBP group (n = 4.52 vs n = 2.17). All subjects who scored at least a 5 (indicating at least mild anxiety symptoms) on the GAD-7 measured positive for glide impairment of the TLF. PHQ-9 average scores were 1.7 times greater in the CLBP group (n=2.7 vs n = 1.52), and all subjects who scored a 5 or higher (indicating at least mild depression symptoms) on the PHQ-9 measured positive for TLF glide impairment. SHQ data yielded no significant difference between the two groups.

INTRODUCTION: It is well documented that there is a relationship between chronic low back pain (CLBP) and symptoms of depression and anxiety. The role of Thoracolumbar Fascia (TLF) in chronic back pain, and the clinical relevance of fascia overall, is being newly understood. Of the existing studies that have measured glide of the TLF, none have documented psychosocial survey data. Understanding the correlation between TLF glide and psychiatric symptoms may provide a new treatment approach when addressing the psychological burden of CLBP. It may also provide us with a new understanding of the etiology of low back pain and its associated psychiatric symptoms. It is our hypothesis that subjects with CLBP with TLF glide impairment will have an increased incidence of depression and anxiety symptoms compared to those without glide impairment. METHODS: 36 recruited subjects between 18 and 50 years of age with no low back pain (NLBP) (n=17) and chronic low back pain (CLBP) (n=19), from a convenience sample, were evaluated for both static and dynamic assessment of the TLF. As part of their

DISCUSSION: In summary, data thus far shows all of the CLBP subjects who score in mild-severe ranges for psychiatric symptoms utilizing the PHQ-9 and GAD-7 total scores have TLF glide impairment. Additionally, there is a significant difference in average GAD-7 scores and PHQ-9 scores between the CLBP and NLBP groups, indicating higher levels of anxiety and depression symptoms in those with CLBP. Social functioning questionnaires yielded no significant difference between the two groups. As further data is collected, we expect to see TLF glide impairment demonstrating a strong correlation with higher scores on the PHQ-9 and GAD-7. Limitations of this study include the GAD-7 being specifically for generalized anxiety disorder and not other anxiety disorders, and its failure to assess symptom severity. Future research is needed to determine associations between fascial glide and psychiatric symptoms. Approved by the Edward Via College of Osteopathic Medicine Institutional Review Board, Blacksburg, VA. 10/24/2023. 2023-154.

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