Kerr J M, Vujnovich A L, Bradnam L
Physical Rehabilitation Research Centre, School of Physiotherapy, Auckland University of Technology, Private Bag 92006, Auckland, New Zealand.
Electromyogr Clin Neurophysiol. 2002 Dec;42(8):459-71.
The slump test assesses the contribution of neural tissue to the referred symptoms associated with spinal pain and musculo-skeletal injuries of the lower limb. The limitation to full range of movement in performing this test has, in the past, been attributed to a mechanical restriction in mobility of neural tissue. Recent literature suggests that the limitation may be caused by protective reflex muscle action. The purpose of this study was to establish whether the slump test was associated with an increase or a decrease in excitability of alpha-motoneurons and, therefore, an alteration in muscle activity at the end of the range of movement of the test. Forty-three normal subjects and eight subjects with abnormal neural tension participated in this study. Changes in alpha-motoneuron excitability in neck flexion, moderate slump, and maximum slump positions were assessed by observing changes in H-reflex recruitment curves. Linear regression analysis on the rising portion of the H-reflex recruitment curve enabled calculation of the dependent variable Hslp for statistical analysis. Normal subjects in the moderate and maximum slump positions demonstrated a significant decrease (p < 0.05) in the slope of the H-reflex recruitment curve. Subjects with abnormal neural tension showed a non-significant increase in slope when in these positions. Subject flexibility had a significant influence on motoneuron excitability in the moderate neural tension position with inflexible subjects demonstrating a significant inhibition of motoneurons. The difference between the flexible or moderately flexible subjects and inflexible subjects was not significant in the maximum neural tension position. These findings have important implications for the rationale for treatment selection and success of treatment outcomes in the clinical setting.
直腿弯腰试验评估神经组织对与脊柱疼痛和下肢肌肉骨骼损伤相关的牵涉痛症状的影响。过去，进行该试验时运动范围受限被归因于神经组织活动度的机械性限制。近期文献表明，这种限制可能是由保护性反射肌肉动作引起的。本研究的目的是确定直腿弯腰试验是否与α运动神经元兴奋性的增加或降低相关，进而确定在试验运动范围末端肌肉活动是否发生改变。43名正常受试者和8名神经张力异常的受试者参与了本研究。通过观察H反射募集曲线的变化，评估颈部屈曲、中度直腿弯腰和最大直腿弯腰位置时α运动神经元兴奋性的变化。对H反射募集曲线上升部分进行线性回归分析，计算出因变量Hslp用于统计分析。处于中度和最大直腿弯腰位置的正常受试者，其H反射募集曲线的斜率显著降低（p < 0.05）。神经张力异常的受试者在这些位置时，斜率有不显著的增加。受试者的柔韧性对中度神经张力位置时运动神经元的兴奋性有显著影响，柔韧性差的受试者运动神经元受到显著抑制。在最大神经张力位置，柔韧性好或中等柔韧性的受试者与柔韧性差的受试者之间的差异不显著。这些发现对临床环境中治疗选择的理论依据和治疗结果的成功具有重要意义。
