Masuda Takahiro, Miyamoto Kei, Shimizu Katsuji
Department of Orthopaedic Surgery, Gifu University, School of Medicine, Yanagido 1-1, Gifu City, Gifu 501-1194, Japan.
Clin Biomech (Bristol). 2006 Mar;21(3):245-53. doi: 10.1016/j.clinbiomech.2005.10.008. Epub 2005 Dec 20.
Although attention has been paid to the relationship between the changes in blood circulation in erector spinae muscles and back pain, little is known about their hemodynamics in several various comparable postures with and without loading. Studies on hemodynamics of erector spinae muscles using near-infrared spectroscopy have been performed on subjects and patients mainly in forward flexion positions.
Two near-infrared spectroscopes were used to measure oxygenated hemoglobin, deoxygenated hemoglobin, and total hemoglobin in bilateral erector spinae muscles at L2-3 in subjects in 9 postures, and holding no load, 10 kg or 20 kg in maximum flexed and lateral bending. Those three values in each posture and loading condition were expressed as a percentage of their corresponding values obtained in the standing upright position, and designated and statistically analyzed as %Oxy-Hb, %Deoxy-Hb and %Total-Hb, respectively.
%Total-Hb and %Oxy-Hb in maximum flexion were the most decreased. In maximum lateral bending, %Oxy-Hb only in the contralateral erector spinae muscles was decreased. When the load was 20 kg, the decreases in %Oxy-Hb were the largest in maximum flexion and lateral bendings.
Using two near-infrared spectroscopes allowed us to measure simultaneously the hemodynamics of bilateral muscles. They demonstrated different responses in each side. Asymmetrical posture and loading were accompanied by asymmetrical changes of the bilateral erector spinae muscles. Stretched muscle had less blood volume and oxygenation, both of which decreased with increasing load. These results showed that these postures and conditions might lead to fatigue of the ES muscles.
尽管竖脊肌血液循环变化与背痛之间的关系已受到关注,但在几种有无负荷的可比姿势下,其血流动力学情况却鲜为人知。使用近红外光谱法对竖脊肌血流动力学的研究主要是在受试者和患者处于前屈姿势时进行的。
使用两台近红外光谱仪,测量9种姿势下受试者L2-3水平双侧竖脊肌中的氧合血红蛋白、脱氧血红蛋白和总血红蛋白,且在最大前屈和侧屈时分别保持无负荷、10千克或20千克的负荷。将每种姿势和负荷条件下的这三个值表示为在直立位获得的相应值的百分比,分别命名为%氧合血红蛋白、%脱氧血红蛋白和%总血红蛋白,并进行统计分析。
最大前屈时的%总血红蛋白和%氧合血红蛋白下降最多。在最大侧屈时,仅对侧竖脊肌中的%氧合血红蛋白下降。当负荷为20千克时,最大前屈和侧屈时%氧合血红蛋白的下降幅度最大。
使用两台近红外光谱仪使我们能够同时测量双侧肌肉的血流动力学。它们在两侧表现出不同的反应。不对称的姿势和负荷伴随着双侧竖脊肌的不对称变化。伸展的肌肉血容量和氧合较少,两者均随负荷增加而下降。这些结果表明,这些姿势和条件可能导致竖脊肌疲劳。