Sena Cinarli & Betul Akyol

The thoracolumbar fascia is a complex connective tissue structure providing anatomical continuity between the lumbar spine, abdominal wall, diaphragm, and respiratory musculature, contributing to respiratory mechanics through thoracoabdominal mobility and force transmission. However, functional evidence supporting its role in pulmonary function remains limited. Stroke, characterized by impaired respiratory mechanics and altered trunk biomechanics, provides a relevant model to explore these relationships. The aim of this study is to investigate the morphofunctional role of the thoracolumbar fascia in respiratory mechanics by examining the acute effects of its modulation on pulmonary function in stroke patients, using respiratory exercise as a comparative functional model. Thirty male stroke patients (mean age: 59.01 ± 3.08 years) were randomly assigned to control (CON), respiratory exercise (RE), or thoracolumbar fascia release (TLF) groups. All participants received standard rehabilitation. The RE group performed additional breathing exercises, and the TLF group received myofascial release targeting the thoracolumbar fascia (15 min). Pulmonary function was assessed via spirometry before and immediately after intervention. Both RE and TLF groups showed significant improvements in pulmonary parameters (p < 0.05), while no changes were observed in CON. Improvements ranged from 2.82–18.79 % in RE and 3.36–14.83 % in TLF. Significant time effects were found for FEV1/FVC, FEV1, FVC, and PEF (p < 0.01), with significant group × time interactions for FEV1, FVC, and PEF (p < 0.01). Thoracolumbar fascia release induced measurable improvements in pulmonary function comparable to respiratory exercise, supporting its morphofunctional relevance in respiratory mechanics. These findings suggest that fascial structures may actively contribute to thoracoabdominal dynamics. Further studies are required to clarify underlying mechanisms and long-term effects.

KEY WORDS: Thoracolumbar fascia; Morphofunction; Respiratory mechanics; Stroke; Connective tissue.

CINARLI, S. & AKYOL, B. Morphofunctional role of the thoracolumbar fascia in respiratory mechanics: Evidence from a randomized controlled study in stroke. Int. J. Morphol, 44(4):1359-1366, 2026.