Stanton Tasha, Kawchuk Greg
University of Alberta, Edmonton, Alberta, Canada.
Spine (Phila Pa 1976). 2008 Mar 15;33(6):694-701. doi: 10.1097/BRS.0b013e318166e034.
Intrasubject controls with randomized intervention order.
To quantify the immediate change in posteroanterior (PA) spinal stiffness produced by different combinations of trunk muscle contraction.
The abdominal hollow and the abdominal brace are 2 different combinations of trunk muscle contractions that are commonly prescribed to increase spinal stability. Unfortunately, the immediate effect of these different contractions on spinal stiffness (one indicator of spinal stability) has not yet been quantified directly.
Twenty-eight asymptomatic subjects were taught abdominal hollow and brace contractions then performed them in a randomized order framed by periods of rest. Surface electromyography and B-mode ultrasound confirmed that all contractions were performed appropriately. During each test condition (hollow, brace, and rest), a noninvasive indentation technique was used to quantify PA spinal stiffness. A repeated measures analysis of variance was used to assess the significance of changes in the PA spinal stiffness between test conditions.
Both the abdominal hollow and abdominal brace contractions increased PA spinal stiffness significantly when compared with the rest condition (P < 0.001). When the abdominal hollow and brace contractions were compared with each other, the abdominal brace contraction produced significantly greater PA spinal stiffness (P < 0.05).
In asymptomatic subjects, the abdominal brace contraction provided an immediate PA stiffening effect that was significantly greater in magnitude when compared with conditions of rest and abdominal hollowing. These findings may allow clinicians to better match commonly prescribed contraction-based interventions with specific patient needs. Future work is required to assess the long-term effect of repeated abdominal brace and hollow contractions on PA spinal stiffness and low back pain.
采用随机干预顺序的自身对照研究。
量化躯干肌肉不同收缩组合所产生的前后位(PA)脊柱刚度的即时变化。
收腹和腹带是两种常用于增加脊柱稳定性的不同躯干肌肉收缩组合。遗憾的是,这些不同收缩对脊柱刚度(脊柱稳定性的一个指标)的即时影响尚未得到直接量化。
对28名无症状受试者教授收腹和腹带收缩动作,然后让他们以随机顺序进行,中间穿插休息时段。表面肌电图和B超确认所有收缩动作均正确完成。在每种测试条件(收腹、腹带和休息)下,采用无创压痕技术量化PA脊柱刚度。采用重复测量方差分析评估不同测试条件下PA脊柱刚度变化的显著性。
与休息状态相比,收腹和腹带收缩均显著增加了PA脊柱刚度(P < 0.001)。将收腹和腹带收缩相互比较时,腹带收缩产生的PA脊柱刚度显著更大(P < 0.05)。
在无症状受试者中,腹带收缩产生了即时的PA脊柱刚度增强效应,与休息和收腹状态相比,其幅度显著更大。这些发现可能有助于临床医生更好地将常用的基于收缩的干预措施与特定患者需求相匹配。未来需要开展工作来评估重复进行腹带和收腹收缩对PA脊柱刚度和腰痛的长期影响。