Cholewicki J, Juluru K, Radebold A, Panjabi M M, McGill S M
Biomechanics Laboratory, Department of Orthopaedics and Rehabilitation, Yale University School of Medicine, P.O. Box 208071, New Haven, CT 06520-8071, USA.
Eur Spine J. 1999;8(5):388-95. doi: 10.1007/s005860050192.
The increased intra-abdominal pressure (IAP) commonly observed when the spine is loaded during physical activities is hypothesized to increase lumbar spine stability. The mechanical stability of the lumbar spine is an important consideration in low back injury prevention and rehabilitation strategies. This study examined the effects of raised IAP and an abdominal belt on lumbar spine stability. Two hypotheses were tested: (1) An increase in IAP leads to increased lumbar spine stability, (2) Wearing an abdominal belt increases spine stability. Ten volunteers were placed in a semi-seated position in a jig that restricted hip motion leaving the upper torso free to move in any direction. The determination of lumbar spine stability was accomplished by measuring the instantaneous trunk stiffness in response to a sudden load release. The quick release method was applied in isometric trunk flexion, extension, and lateral bending. Activity of 12 major trunk muscles was monitored with electromyography and the IAP was measured with an intra-gastric pressure transducer. A two-factor repeated measures design was used (P < 0.05), in which the spine stability was evaluated under combinations of the following two factors: belt or no belt and three levels of IAP (0, 40, and 80% of maximum). The belt and raised IAP increased trunk stiffness in all directions, but the results in extension lacked statistical significance. In flexion, trunk stiffness increased by 21% and 42% due to 40% and 80% IAP levels respectively; in lateral bending, trunk stiffness increased by 16% and 30%. The belt added between 9% and 57% to the trunk stiffness depending on the IAP level and the direction of exertion. In all three directions, the EMG activity of all 12 trunk muscles increased significantly due to the elevated IAP. The belt had no effect on the activity of any of the muscles with the exception of the thoracic erector spinae in extension and the lumbar erector spinae in flexion, whose activities decreased. The results indicate that both wearing an abdominal belt and raised IAP can each independently, or in combination, increase lumbar spine stability. However, the benefits of the belt must be interpreted with caution in the context of the decreased activation of a few trunk extensor muscles.
人们推测,在体育活动中脊柱承受负荷时常见的腹腔内压力(IAP)升高会增强腰椎稳定性。腰椎的机械稳定性是预防和康复下背部损伤策略中的一个重要考量因素。本研究考察了IAP升高和腹带对腰椎稳定性的影响。检验了两个假设:(1)IAP升高会导致腰椎稳定性增强;(2)佩戴腹带会增加脊柱稳定性。十名志愿者被安置在一个限制髋部运动的夹具中呈半坐姿,上半身可自由向任何方向移动。通过测量对突然释放负荷的反应时的瞬时躯干刚度来确定腰椎稳定性。快速释放方法应用于等长躯干屈曲、伸展和侧屈。用肌电图监测12块主要躯干肌肉的活动,并用胃内压力传感器测量IAP。采用双因素重复测量设计(P<0.05),其中在以下两个因素的组合下评估脊柱稳定性:佩戴腹带与否以及IAP的三个水平(最大IAP的0%、40%和80%)。腹带和升高的IAP在所有方向上均增加了躯干刚度,但伸展方向的结果缺乏统计学意义。在屈曲时,由于IAP水平为40%和80%,躯干刚度分别增加了21%和42%;在侧屈时,躯干刚度增加了16%和30%。根据IAP水平和用力方向,腹带使躯干刚度增加了9%至57%。在所有三个方向上,由于IAP升高,所有12块躯干肌肉的肌电图活动均显著增加。腹带对任何肌肉的活动均无影响,但在伸展时胸段竖脊肌和在屈曲时腰段竖脊肌的活动除外,这两块肌肉的活动减少。结果表明,佩戴腹带和升高IAP均可单独或联合增加腰椎稳定性。然而,鉴于少数躯干伸肌肌肉的激活减少,对腹带的益处必须谨慎解读。