Sihvonen T, Partanen J, Hänninen O, Soimakallio S
Department of Clinical Neurophysiology, University Central Hospital of Kuopio, Finland.
Arch Phys Med Rehabil. 1991 Dec;72(13):1080-7.
The functioning of low back muscles of back pain patients during flexion and reextension has not been properly investigated. In this study, we analyzed rectified, averaged electric activity (RMS EMG) and corresponding raw intramuscular (IM) EMG from lumbar paraspinal muscles to quantify the activity level during simple bending cycles in 87 back pain patients compared to 25 able-bodied controls.
All functional phases seen in raw IM EMG were also shown in surface RMS EMG. Surface RMS EMG pattern seems to yield more information from activity level than IM EMG pattern. The RMS EMG patterns of back pain patients differed from those of controls as follows: (1) There was clearly noticeable activity during standing in back pain patients. (2) There was only a partial decrease of EMG activity after flexion in back pain patients with current pain. (3) The ratio of mean reached at maximal activity level during extension and flexion was less in patients (1.8, SD = 0.5, p less than .001) than able-bodied controls (3.2, SD = 0.8). (4) Segmental differences were observed in IM EMG activities in patients having hypermobility in bending x-ray. (5) Large peak potentials occurred during movements in patients having segmental hypermobility. THE RESULTS indicate that averaged surface recording is a valuable tool in the investigation of dynamic spine functions in back pain patients.
背痛患者在脊柱前屈和后伸过程中，其下背部肌肉的功能尚未得到充分研究。在本研究中，我们分析了87名背痛患者与25名健康对照者在简单弯曲周期中腰旁肌的整流平均电活动（均方根肌电图，RMS EMG）及相应的原始肌内（IM）肌电图，以量化其活动水平。
原始IM肌电图中观察到的所有功能阶段在表面RMS肌电图中也有显示。表面RMS肌电图模式似乎比IM肌电图模式能从活动水平中获取更多信息。背痛患者的RMS肌电图模式与对照组的不同之处如下：（1）背痛患者站立时存在明显可察的活动。（2）当前有疼痛的背痛患者在脊柱前屈后，肌电图活动仅部分降低。（3）患者在伸展和屈曲过程中达到最大活动水平时的平均比值（1.8，标准差=0.5，p<0.001）低于健康对照者（3.2，标准差=0.8）。（4）在X线显示脊柱弯曲过度活动的患者中，观察到IM肌电图活动存在节段性差异。（5）节段性活动过度的患者在运动过程中出现大的峰值电位。结果表明，平均表面记录是研究背痛患者动态脊柱功能的一种有价值的工具。
