Grimstone Sarah K, Hodges Paul W
Department of Physiotherapy, University of Queensland, Brisbane, QLD 4072, Australia.
Exp Brain Res. 2003 Jul;151(2):218-24. doi: 10.1007/s00221-003-1433-5. Epub 2003 May 21.
This study evaluated the degree to which the disturbance to posture from respiration is compensated for in healthy normals and whether this is different in people with recurrent low back pain (LBP), and to compare the changes when respiratory demand is increased. Angular displacement of the lumbar spine and hips, and motion of the centre of pressure (COP), were recorded with high resolution and respiratory phase was recorded from ribcage motion. With subjects standing in a relaxed posture, recordings were made during quiet breathing, while breathing with increased dead-space to induce hypercapnoea, and while subjects voluntarily increased their respiration to match ribcage expansion that was induced in the hypercapnoea condition. The relationship between respiration and the movement parameters was measured from the coherence between breathing and COP and angular motion at the frequency of respiration, and from averages triggered from the respiratory data. Small angular changes in the lumbopelvic and hip angles were evident at the frequency of respiration in both groups. However, in quiet standing, the LBP subjects had a greater displacement of their COP that was associated with respiration than the control subjects. The LBP group had a trend for less hip motion. There were no changes in the movement parameters when respiratory demand increased involuntarily via hypercapnoea, but when respiration increased voluntarily, the amplitude of motion and the displacement of the COP increased in both groups. The present data suggest that the postural compensation to respiration counteracts at least part of the disturbance to posture caused by respiration and that this compensation may be less effective in people with LBP.
本研究评估了健康正常人对呼吸引起的姿势干扰的代偿程度，以及这在复发性腰痛（LBP）患者中是否存在差异，并比较了呼吸需求增加时的变化。使用高分辨率记录腰椎和髋部的角位移以及压力中心（COP）的运动，并通过胸廓运动记录呼吸相位。让受试者以放松姿势站立，在安静呼吸、通过增加无效腔呼吸以诱发高碳酸血症以及受试者自愿增加呼吸以匹配高碳酸血症状态下诱发的胸廓扩张期间进行记录。通过呼吸与COP以及呼吸频率下的角运动之间的相干性，以及从呼吸数据触发的平均值来测量呼吸与运动参数之间的关系。两组在呼吸频率下腰椎骨盆和髋部角度均有明显的小角度变化。然而，在安静站立时，LBP受试者与呼吸相关的COP位移比对照组受试者更大。LBP组的髋部运动有减少的趋势。当通过高碳酸血症非自愿增加呼吸需求时，运动参数没有变化，但当呼吸自愿增加时，两组的运动幅度和COP位移均增加。目前的数据表明，对呼吸的姿势代偿抵消了至少部分由呼吸引起的姿势干扰，并且这种代偿在LBP患者中可能效果较差。
