{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T14:05:01Z","timestamp":1791381901948,"version":"4.3.3"},"reference-count":38,"publisher":"Human Kinetics","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,1]]},"abstract":"\n \n Clinical Scenario<\/jats:bold>\n :\n <\/jats:italic>\n Low back pain is a common musculoskeletal condition, with nonspecific low back pain (NS-LBP) accounting for the majority of cases. NS-LBP lacks a definitive pathological cause, complicating diagnosis and management. Emerging research has identified diaphragm dysfunction, including alterations in thickness and excursion, as a potential factor contributing to NS-LBP. Ultrasound is a noninvasive tool used to measure these diaphragm characteristics and explore their association with NS-LBP.\n \n Clinical Question<\/jats:bold>\n :\n <\/jats:italic>\n In patients with NS-LBP, is there a difference in diaphragm thickness and excursion (as measured by ultrasound) compared with healthy controls?\n \n Summary of Key Findings<\/jats:bold>\n :\n <\/jats:italic>\n A systematic search yielded 4 high-quality case-control studies assessing diaphragm function in patients with NS-LBP. All 4 studies demonstrated significantly reduced diaphragm thickness in patients with NS-LBP compared with healthy controls. Findings on diaphragm excursion were inconsistent, with 1 study reporting significant differences while 3 showed no differences between groups. Reduced diaphragm thickness and slower changes in thickness were consistently associated with impaired spinal stabilization.\n \n Clinical Bottom Line<\/jats:bold>\n :\n <\/jats:italic>\n The evidence indicates a consistent difference in diaphragm thickness between individuals with NS-LBP and healthy controls, suggesting a potential role of diaphragm dysfunction in the pathophysiology of NS-LBP. However, inconsistent findings on diaphragm excursion warrant further investigation.\n \n Strength of Recommendation<\/jats:bold>\n :\n <\/jats:italic>\n Based on the Strength of Recommendation Taxonomy, the clinical bottom line is based on grade A evidence for diaphragm thickness while diaphragm excursion is grade B.\n <\/jats:p>","DOI":"10.1123\/jsr.2024-0466","type":"journal-article","created":{"date-parts":[[2025,10,7]],"date-time":"2025-10-07T18:48:42Z","timestamp":1759862922000},"page":"171-176","source":"Crossref","is-referenced-by-count":1,"title":["Diaphragm Thickness and Excursion in Nonspecific Low Back Pain: A Critically Appraised Topic"],"prefix":"10.1123","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-1956-4375","authenticated-orcid":true,"given":"Brittany","family":"Braun","sequence":"first","affiliation":[{"name":"Moravian University, Bethlehem, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9528-4689","authenticated-orcid":true,"given":"Eleni","family":"Petrou","sequence":"additional","affiliation":[{"name":"Moravian University, Bethlehem, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4964-9647","authenticated-orcid":true,"given":"Jennifer","family":"Ostrowski","sequence":"additional","affiliation":[{"name":"Moravian University, Bethlehem, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"100","reference":[{"key":"r1","series-title":"Pain Res Manag","article-title":"Ultrasonography comparison of diaphragm morphological structure and function in young and middle-aged subjects with and without non-specific chronic low back pain: a case-control study","volume":"2022","author":"Xiao W","year":"2022","unstructured":"Xiao W, Zheng F, Dong K, Wang Z, Zu Y, Wang C. 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