体内骶髂关节的稳定:肌肉对骨盆力闭合作用的验证

Stabilization of the sacroiliac joint in vivo: verification of muscular contribution to force closure of the pelvis.

作者信息

van Wingerden J P, Vleeming A, Buyruk H M, Raissadat K

机构信息

Spine & Joint Centre, Westerlaan 10, 3016 CK, Rotterdam, The Netherlands.

出版信息

Eur Spine J. 2004 May;13(3):199-205. doi: 10.1007/s00586-003-0575-2. Epub 2004 Feb 24.

Abstract

A model of sacroiliac joint (SIJ) function postulates that SIJ shear is prevented by friction, dynamically influenced by muscle force and ligament tension. Thus, SIJ stability can be accommodated to specific loading situations. The purpose of this study was to examine, in vivo, whether muscles contribute to force closure of the SIJ. SIJ stiffness was measured using a verified method combining color Doppler imaging with induced oscillation of the ilium relative to the sacrum in six healthy women. SIJ stiffness was measured both in a relaxed situation and during isometric voluntary contractions (electromyographically recorded). The biceps femoris, gluteus maximus, erector spinae, and contralateral latissimus dorsi were included in this study. Results were statistically analyzed. The study showed that SIJ stiffness significantly increased when the individual muscles were activated. This held especially true for activation of the erector spinae, the biceps femoris and the gluteus maximus muscles. During some tests significant co-contraction of other muscles occurred. The finding that SIJ stiffness increased even with slight muscle activity supports the notion that effectiveness of load transfer from spine to legs is improved when muscle forces actively compress the SIJ, preventing shear. When joints are manually tested, the influence of muscle activation patterns must be considered, since both inter- and intra-tester reliability of the test can be affected by muscle activity. In this respect, the relation between emotional states, muscle activity and joint stiffness deserves further exploration.

摘要

骶髂关节(SIJ)功能模型假定,骶髂关节的剪切力可通过摩擦力来防止,而摩擦力受肌肉力量和韧带张力的动态影响。因此,骶髂关节的稳定性可适应特定的负荷情况。本研究的目的是在活体中检测肌肉是否有助于骶髂关节的力封闭。在六名健康女性中,采用一种经过验证的方法测量骶髂关节的刚度,该方法将彩色多普勒成像与相对于骶骨的髂骨诱导振荡相结合。在放松状态和等长自主收缩(通过肌电图记录)期间均测量骶髂关节的刚度。本研究纳入了股二头肌、臀大肌、竖脊肌和对侧背阔肌。对结果进行了统计分析。研究表明,当单个肌肉被激活时,骶髂关节的刚度显著增加。对于竖脊肌、股二头肌和臀大肌的激活尤其如此。在一些测试中,其他肌肉出现了明显的共同收缩。即使是轻微的肌肉活动,骶髂关节刚度也会增加这一发现支持了这样一种观点,即当肌肉力量主动压缩骶髂关节以防止剪切时,从脊柱到腿部的负荷传递效率会提高。当对关节进行手动测试时,必须考虑肌肉激活模式的影响,因为测试的测试者间和测试者内可靠性都可能受到肌肉活动的影响。在这方面,情绪状态、肌肉活动和关节刚度之间的关系值得进一步探索。

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