Hodges P W
Prince of Wales Medical Research Institute & University of New South Wales, Sydney, Australia.
J Sci Med Sport. 2000 Sep;3(3):243-53. doi: 10.1016/s1440-2440(00)80033-x.
The purpose of this review is to consider the role of the motor system in spinal pain. It is well accepted that spinal stability is dependent on the contribution of the muscular system. However, the ability of this system to satisfy the requirements of stability is dependent on its controller--the central nervous system (CNS). The CNS must predict the outcome of movements to plan appropriate strategies of muscle activity to meet the demands of internal and external forces, and initiate appropriate responses to unexpected disturbances. In addition, this complex control of stability must occur in conjunction with control of the trunk muscles for other functions, such as respiration. For the CNS to cope with athletic performance the coordination of these parameters must be streamlined. Yet evidence suggests that when spinal pain is present the strategies used by the CNS to control trunk muscles may be altered. The mechanism for these changes is poorly understood but may be due to changes at many levels of the CNS. For rehabilitation of the athlete with spinal pain it is critical that the motor control of stability is optimised. Furthermore, this must be coordinated with the multiple other functions of trunk muscles, including respiration.
本综述的目的是探讨运动系统在脊柱疼痛中的作用。人们普遍认为脊柱稳定性取决于肌肉系统的贡献。然而，该系统满足稳定性要求的能力取决于其控制器——中枢神经系统（CNS）。中枢神经系统必须预测运动结果，以规划适当的肌肉活动策略，以满足内部和外部力量的需求，并对意外干扰做出适当反应。此外，这种复杂的稳定性控制必须与躯干肌肉的其他功能控制（如呼吸）同时进行。为了使中枢神经系统应对运动表现，这些参数的协调必须简化。然而，有证据表明，当出现脊柱疼痛时，中枢神经系统控制躯干肌肉的策略可能会改变。这些变化的机制尚不清楚，但可能是由于中枢神经系统多个层面的变化所致。对于患有脊柱疼痛的运动员的康复而言，优化稳定性的运动控制至关重要。此外，这必须与躯干肌肉的多种其他功能（包括呼吸）相协调。
