{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T18:43:41Z","timestamp":1772995421737,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Fascial stretching is gaining interest as a potential intervention for pain management. However, evidence regarding the effect of latissimus dorsi\u2013thoracolumbar fascia (LD\u2010TLF) complex stretching in patients with chronic low back pain (CLBP) remains limited. Therefore, this study aimed to investigate the effects of LD\u2010TLF complex stretching on pain\u2010related factors and disability in patients with CLBP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Thirty patients with CLBP were randomly assigned to a study group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915; 7 men, 8 women) and a control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915; 7 men, 8 women). The study group received 4\u2009weeks of LD\u2010TLF complex stretching in combination with conventional physiotherapy, while the control group received conventional physiotherapy only. Outcomes were assessed before and after the interventions, including primary measures of pain pressure thresholds (PPT) at thoracolumbar fascia levels (L1, L3 and 12th costa), and secondary measures included the Pain Sensitivity Questionnaire (PSQ), the effects of pain on daily activities measured by the Brief Pain Inventory (BPI), and disability assessed by the Oswestry Disability Questionnaire (ODQ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Pre\u2010 and post\u2010treatment PPTs, at the L1, L3 vertebrae and 12th costa levels, demonstrated significant differences between the study group and control groups. Post\u2010treatment thresholds were significantly higher compared to pre\u2010treatment thresholds (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, \u03b7p\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.67;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, \u03b7p\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.61;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001, \u03b7p\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090.74). Additionally, significant improvements were found in PSC, BPI and ODQ scores in the study group compared to the control group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The results of this study suggest that stretching the LD\u2010TLF complex may be a beneficial addition to the conventional physiotherapy approach for patients with CLBP. Specifically, LD\u2010TLF complex stretching, when used in combination with conventional physiotherapy, appears to provide improved pain thresholds, decreased pain sensitivity and pain during activity, as well as reduced disability compared to conventional physiotherapy alone in patients with CLBP.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance Statement<\/jats:title>\n                    <jats:p>Chronic low back pain (CLBP) is a multifactorial condition, with the thoracolumbar fascia increasingly recognized as a potential contributing factor. This study suggests that stretching the latissimus dorsi\u2010thoracolumbar fascia complex in combination with conventional physiotherapy, enhances pain thresholds, reduces pain sensitivity, and decreases disability in individuals with CLBP. Incorporating fascia\u2010specific interventions into CLBP treatment programs could offer significant benefits for both patients and clinicians.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.70143","type":"journal-article","created":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T06:50:31Z","timestamp":1759387831000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Role of Latissimus Dorsi\u2013Thoracolumbar Fascia Complex Stretching on Pain and Pain\u2010Related Parameters in Patients With Chronic Low Back Pain: A Randomised Clinical Trial"],"prefix":"10.1002","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3062-1655","authenticated-orcid":false,"given":"Naime","family":"Ulug","sequence":"first","affiliation":[{"name":"Orthotics and Prosthetics Department, Faculty of Health Sciences Ankara University  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2226-6056","authenticated-orcid":false,"given":"Seyde Busra","family":"Kodak","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation K\u0131r\u015fehir Ahi Evran University  K\u0131r\u015fehir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7164-5162","authenticated-orcid":false,"given":"Muhammed \u0130hsan","family":"Kodak","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation K\u0131r\u015fehir Ahi Evran University  K\u0131r\u015fehir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2636-4818","authenticated-orcid":false,"given":"Sema Nur","family":"Aslan","sequence":"additional","affiliation":[{"name":"Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences At\u0131l\u0131m University  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,10,1]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00276-020-02668-4"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbmt.2014.06.001"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2015.01.062"},{"key":"e_1_2_10_5_1","first-page":"200","article-title":"Ethnic Differences Identified by Pain Sensitivity Questionnaire Correlate With Clinical Pain Responses","volume":"43","author":"Bell B. 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