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静态负荷大小是累积性下背部疾病发展的一个风险因素。

Static load magnitude is a risk factor in the development of cumulative low back disorder.

作者信息

Sbriccoli Paola, Solomonow Moshe, Zhou Bing-He, Baratta Richard V, Lu Yun, Zhu Meng-Ping, Burger Evalina L

机构信息

Occupational Medicine Research Center, Bioengineering Laboratory, Suite 400, Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, 2025 Gravier Street, New Orleans, Louisiana 70112, USA.

出版信息

Muscle Nerve. 2004 Feb;29(2):300-8. doi: 10.1002/mus.10531.

Abstract

Occupations requiring frequent periods of static lumbar flexion are known epidemiologically to be risk factors for the development of cumulative low back disorder. The impact of the load magnitude sustained during a series of short static lumbar flexions followed by an equally long rest period on the development of a cumulative low back disorder was addressed in an in vivo feline model. Static loads of 20, 40, and 60 N were applied over 10 min of flexion followed by 10-min rest sessions that were repeated six times (for a total of 2 h) while monitoring lumbar viscoelastic creep (laxity) and reflex electromyographic (EMG) activity from the multifidus muscles. Creep and EMG were also monitored over 7 h of rest following the six flexion-rest sessions. It was found that the creep developed in the 10-min flexion periods did not recover completely during the following 10 min of rest, giving rise to a large cumulative creep at the end of the work-rest session. Muscle activity demonstrated spasms during the static flexion periods as well as initial and delayed hyperexcitability during the 7-h rest period. Loads of 20 and 40 N did not result in delayed hyperexcitability, whereas loads of 60 N resulted in delayed hyperexcitability. Statistical analysis demonstrated that increased load significantly intensified the magnitude of the hyperexcitabilities (P < 0.05). Thus, repeated periods of static lumbar flexion were found to result in a transient neuromuscular disorder with an intensity directly related to the load magnitude, which should be considered a compounding risk factor.

摘要

从流行病学角度来看,需要长时间保持静态腰椎前屈的职业是累积性下背部疾病发展的风险因素。在一个活体猫模型中,研究了一系列短暂静态腰椎前屈期间承受的负荷大小,以及随后同样长时间的休息期对累积性下背部疾病发展的影响。施加20、40和60 N的静态负荷,每次前屈10分钟,随后休息10分钟,重复六次(共2小时),同时监测腰椎粘弹性蠕变(松弛度)和多裂肌的反射肌电图(EMG)活动。在六次前屈-休息疗程后的7小时休息期间,也对蠕变和EMG进行了监测。结果发现,在10分钟前屈期产生的蠕变在随后10分钟的休息期内并未完全恢复,导致在工作-休息疗程结束时出现大量累积蠕变。肌肉活动在静态前屈期表现为痉挛,在7小时休息期表现为初始和延迟的过度兴奋性。20 N和40 N的负荷未导致延迟性过度兴奋性,而60 N的负荷导致了延迟性过度兴奋性。统计分析表明,负荷增加显著加剧了过度兴奋性的程度(P < 0.05)。因此,发现反复的静态腰椎前屈会导致短暂的神经肌肉紊乱,其强度与负荷大小直接相关,应被视为一个复合风险因素。

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