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急性下背痛患者行走时骨盆和腰椎的运动

Movements of the pelvis and lumbar spine during walking in people with acute low back pain.

作者信息

Taylor Nicholas, Goldie Patricia, Evans Owen

机构信息

Musculoskeletal Research Centre, School of Physiotherapy, Faculty of Health Sciences, La Trobe University, Victoria, Australia.

出版信息

Physiother Res Int. 2004;9(2):74-84. doi: 10.1002/pri.304.

Abstract

BACKGROUND AND PURPOSE

Little is known about how acute low back pain affects pelvic and lumbar movements during walking. The aim of the present study was to determine if measurement of the amplitude of the angular movements of the pelvis and lumbar spine during walking is useful in the evaluation of people with acute low back pain.

METHOD

The study used a repeated-measures and correlational design; 11 individuals with low back pain (tested in the acute phase and six weeks later when symptoms had resolved) and matched control subjects were tested during treadmill walking. A video-analysis system was used to measure the amplitudes of movements of the pelvis and lumbar spine during walking. Pain level was measured with a visual analogue scale (VAS).

RESULTS

During walking, movements of the pelvis (axial rotation) and lumbar spine (lateral flexion) were reduced in people with acute back pain compared with the resolved condition, but were not different from a group without a history of back pain. The amplitudes of the frontal plane movements of the pelvis and lumbar spine were negatively correlated with the intensity of pain (r(s) = -0.74).

CONCLUSIONS

Measurement of pelvic and lumbar movements during walking is unlikely to have useful clinical applications for individuals, or when discriminating between impaired and unimpaired people, but may be applied to groups for hypothesis testing in evaluating change in back pain over time. An hypothesized model to explain the observed movements has been proposed.

摘要

背景与目的

关于急性下背痛如何影响行走过程中骨盆和腰椎的运动,目前所知甚少。本研究的目的是确定在行走过程中测量骨盆和腰椎角运动的幅度是否有助于评估急性下背痛患者。

方法

本研究采用重复测量和相关性设计;11名下背痛患者(在急性期及症状缓解六周后进行测试)及匹配的对照组受试者在跑步机上行走时接受测试。使用视频分析系统测量行走过程中骨盆和腰椎的运动幅度。采用视觉模拟量表(VAS)测量疼痛程度。

结果

与症状缓解后的情况相比,急性下背痛患者在行走时骨盆(轴向旋转)和腰椎(侧屈)的运动减少,但与无下背痛病史的组无差异。骨盆和腰椎在额状面运动的幅度与疼痛强度呈负相关(r(s)=-0.74)。

结论

对于个体而言,或在区分受损和未受损人群时,行走过程中骨盆和腰椎运动的测量不太可能有实际临床应用价值,但可应用于群体,以进行关于下背痛随时间变化的假设检验。本文提出了一个假设模型来解释观察到的运动情况。

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