Lamoth Claudine J C, Meijer Onno G, Wuisman Paul I J M, van Dieën Jaap H, Levin Mindy F, Beek Peter J
Institute de Réadaptation de Montréal, Université de Montréal, Canada.
Spine (Phila Pa 1976). 2002 Feb 15;27(4):E92-9. doi: 10.1097/00007632-200202150-00016.
Transverse pelvis and thorax rotations were studied during walking in 39 patients with nonspecific low back pain and 19 healthy participants.
To gain insight into the consequences of low back pain for gait and to identify clinically useful measures for characterizing the quality of walking in patients with low back pain.
Gait studies in patients with low back pain have reported a decrease in walking velocity. In normal gait, in-phase pelvis-thorax coordination (synchronicity) evolves toward antiphase coordination (counterrotation) as walking velocity increases. This study examined the effect of walking velocity on pelvis and thorax rotations in patients with low back pain.
Amplitudes of pelvis and thorax rotations were calculated, and spectral analyses were performed. Pelvis-thorax coordination was characterized in terms of relative Fourier phase, and coupling strength was assessed by means of cross-spectral analysis.
In comparison with healthy participants, relative Fourier phase was significantly smaller in low back pain patients for walking velocities of 3.8 km/h and higher, whereas coupling strength was significantly higher for velocities from 1.4 to 3.0 km/h. No significant group differences were found in amplitude or spectral content of individual pelvis and thorax rotations.
In comparison with healthy participants, the gait of patients with low back pain was characterized by a more rigid, less flexible pelvis-thorax coordination in the absence of significant differences in the kinematics of the component rotations. This result suggests that coordination measures are more adequate in assessing quality of walking in patients with low back pain than are kinematic measures pertaining to the individual segment rotations, and that conservative therapy should use methods aimed at improving intersegmental coordination.
对39例非特异性下腰痛患者和19名健康参与者在行走过程中的骨盆和胸廓横向旋转进行了研究。
深入了解下腰痛对步态的影响，并确定用于表征下腰痛患者行走质量的临床有用指标。
关于下腰痛患者的步态研究报告称其步行速度有所下降。在正常步态中，随着步行速度增加，同相骨盆 - 胸廓协调（同步性）会逐渐转变为反相协调（反向旋转）。本研究考察了步行速度对下腰痛患者骨盆和胸廓旋转的影响。
计算骨盆和胸廓旋转的幅度，并进行频谱分析。骨盆 - 胸廓协调通过相对傅里叶相位来表征，耦合强度通过互谱分析进行评估。
与健康参与者相比，下腰痛患者在步行速度为3.8千米/小时及以上时，相对傅里叶相位显著更小，而在速度为1.4至3.0千米/小时时，耦合强度显著更高。在单个骨盆和胸廓旋转的幅度或频谱内容方面未发现显著的组间差异。
与健康参与者相比，下腰痛患者的步态特征是在各组成部分旋转的运动学无显著差异的情况下骨盆 - 胸廓协调更僵硬、灵活性更低。这一结果表明，与单个节段旋转的运动学测量方法相比，协调测量方法在评估下腰痛患者的行走质量方面更为合适，并且保守治疗应采用旨在改善节段间协调的方法。
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