Van Daele Ulrike, Huyvaert Stefanie, Hagman Friso, Duquet William, Van Gheluwe Bart, Vaes Peter
Institute of Physical Therapy and Occupational Therapy, Department of Health Care, University College of Antwerp, Belgium.
BMC Musculoskelet Disord. 2007 May 22;8:44. doi: 10.1186/1471-2474-8-44.
Postural control tests like standing and sitting stabilometry are widely used to evaluate neuromuscular control related to trunk balance in low back pain patients. Chronic low back pain patients have lesser postural control compared to healthy subjects. Few studies have assessed the reproducibility of the centre of pressure deviations and to our knowledge no studies have investigated the reproducibility of three-dimensional kinematics of postural control tests in a low back pain population. Therefore the aim of this study was to assess the test-retest reproducibility of a seated postural control test in low back pain patients.
Postural control in low back pain patients was registered by a three dimensional motion analysis system combined with a force plate. Sixteen chronic low back pain patients having complaints for at least six months, were included based on specific clinical criteria. Every subject performed 4 postural control tests. Every test was repeated 4 times and lasted 40 seconds. The force plate registered the deviations of the centre of pressure. A Vicon-612-datastation, equipped with 7 infra-red M1 camera's, was used to track 13 markers attached to the torso and pelvis in order to estimate their angular displacement in the 3 cardinal planes.
All Intraclass Correlation Coefficients (ICC) calculated for the force plate variables did not exceed 0.73 (ranging between 0.11 and 0.73). As for the torso, ICC's of the mean flexion-extension and rotation angles ranged from 0.65 to 0.93 and of the mean lateral flexion angle from 0.50 to 0.67. For the pelvis the ICC of the mean flexion-extension angle varied between 0.66 and 0.83, the mean lateral flexion angle between 0.16 and 0.81 and the mean rotation angle between 0.40 and 0.62. Consecutive data suggest that the low test-retest reproducibility is probably due to a learning effect.
The test-retest reproducibility of these postural control tests in an unstable sitting position can globally be considered as rather moderate. In order to improve the test-retest reproducibility, a learning period may be advisable at the beginning of the test.
诸如站立和坐位稳定分析等姿势控制测试被广泛用于评估腰痛患者与躯干平衡相关的神经肌肉控制。与健康受试者相比，慢性腰痛患者的姿势控制能力较差。很少有研究评估压力中心偏差的可重复性，据我们所知，尚无研究调查腰痛人群中姿势控制测试三维运动学的可重复性。因此，本研究的目的是评估腰痛患者坐位姿势控制测试的重测可重复性。
通过三维运动分析系统结合测力板记录腰痛患者的姿势控制情况。根据特定临床标准纳入16例有至少6个月疼痛主诉的慢性腰痛患者。每位受试者进行4次姿势控制测试。每次测试重复4次，持续40秒。测力板记录压力中心的偏差。使用配备7台红外M1摄像机的Vicon - 612数据采集站跟踪附着在躯干和骨盆上的13个标记，以估计它们在三个基本平面上的角位移。
为测力板变量计算的所有组内相关系数（ICC）均未超过0.73（范围在0.11至0.73之间）。对于躯干，屈伸和旋转平均角度的ICC范围为0.65至0.93，侧屈平均角度的ICC范围为0.50至0.67。对于骨盆，屈伸平均角度的ICC在0.66至0.83之间变化，侧屈平均角度在0.16至0.81之间，旋转平均角度在0.40至0.62之间。连续数据表明，较低的重测可重复性可能是由于学习效应。
这些不稳定坐位姿势控制测试的重测可重复性总体上可认为是中等的。为了提高重测可重复性，在测试开始时可能建议设置一个学习期。
