Shirado O, Kaneda K, Ito T
Department of Orthopaedic Surgery, Hokkaido University School of Medicine, Sapporo, Japan.
J Spinal Disord. 1992 Jun;5(2):175-82. doi: 10.1097/00002517-199206000-00005.
The physical evaluation and exercise program of trunk muscles in patients with chronic low-back pain (CLBP) is still controversial. Many studies have been performed in the isometric and/or concentric contraction mode. Few data, however, have been reported on trunk-muscle strength during eccentric contraction, which plays a significant role in functional activities. To evaluate whether trunk-muscle strength on eccentric contraction could be applicable to the assessment and exercise of the patients with CLBP, trunk strength was measured in 20 healthy men and 16 healthy women, as well as 15 male and 10 female patients with CLBP. Maximum voluntary concentric and eccentric strength was measured during attempted flexion and extension in a seated position. In the healthy subjects, the maximum torque of extensors was greater than that of the flexors during both concentric and eccentric contraction (p less than 0.05). In flexors and extensors, maximum torque exerted on the eccentric contraction was always greater than that on the concentric contraction (p less than 0.05). Although strength was likely to be weaker in the patients with CLBP than in the healthy subjects, there were no statistical differences between the two groups. In terms of the flexor/extensor ratio of maximum torque, there were also no statistical significances between the two groups in either contraction mode. In the flexors, correlation coefficient (r) between concentric and eccentric torque was 0.84 for the healthy subjects and 0.48 for the CLBP subjects (p less than 0.05). In the extensors, the coefficient was 0.90 for the healthy patients and 0.71 for the CLBP patients.(ABSTRACT TRUNCATED AT 250 WORDS)
慢性下腰痛(CLBP)患者躯干肌肉的体格评估和锻炼方案仍存在争议。许多研究是在等长收缩和/或向心收缩模式下进行的。然而,关于离心收缩过程中躯干肌肉力量的报道较少,而离心收缩在功能活动中起着重要作用。为了评估离心收缩时的躯干肌肉力量是否适用于CLBP患者的评估和锻炼,对20名健康男性、16名健康女性以及15名男性和10名女性CLBP患者进行了躯干力量测量。在坐位下尝试屈伸时测量最大自主向心和离心力量。在健康受试者中,等长收缩和离心收缩时伸肌的最大扭矩均大于屈肌(p<0.05)。在屈肌和伸肌中,离心收缩时施加的最大扭矩总是大于向心收缩时的最大扭矩(p<0.05)。虽然CLBP患者的力量可能比健康受试者弱,但两组之间没有统计学差异。就最大扭矩的屈肌/伸肌比值而言,两种收缩模式下两组之间也没有统计学意义。在屈肌中,健康受试者向心扭矩和离心扭矩之间的相关系数(r)为0.84,CLBP受试者为0.48(p<0.05)。在伸肌中,健康患者的系数为0.90,CLBP患者为0.71。(摘要截短至250字)