Hides Julie A, Belavý Daniel L, Cassar Lana, Williams Michelle, Wilson Stephen J, Richardson Carolyn A
Division of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, 4072, Australia.
Eur Spine J. 2009 Mar;18(3):410-8. doi: 10.1007/s00586-008-0827-2. Epub 2008 Nov 18.
An important aspect of neuromuscular control at the lumbo-pelvic region is stabilization. Subjects with low back pain (LBP) have been shown to exhibit impairments in motor control of key muscles which contribute to stabilization of the lumbo-pelvic region. However, a test of automatic recruitment that relates to function has been lacking. A previous study used ultrasound imaging to show that healthy subjects automatically recruited the transversus abdominis (TrA) and internal oblique (IO) muscles in response to a simulated weight-bearing task. This task has not been investigated in subjects with LBP. The aim of this study was to compare the automatic recruitment of the abdominal muscles among subjects with and without LBP in response to the simulated weight-bearing task. Twenty subjects with and without LBP were tested. Real-time ultrasound imaging was used to assess changes in thickness of the TrA and internal oblique IO muscles as well as lateral movement ("slide") of the anterior fascial insertion of the TrA muscle. Results showed that subjects with LBP showed significantly less shortening of the TrA muscle (P < 0.0001) and greater increases in thickness of the IO muscle (P = 0.002) with the simulated weight-bearing task. There was no significant difference between groups for changes in TrA muscle thickness (P = 0.055). This study provides evidence of changes in motor control of the abdominal muscles in subjects with LBP. This test may provide a functionally relevant and non-invasive method to investigate the automatic recruitment of the abdominal muscles in people with and without LBP.
腰骨盆区域神经肌肉控制的一个重要方面是稳定作用。研究表明，患有下背痛（LBP）的受试者在关键肌肉的运动控制方面存在损伤，而这些肌肉对腰骨盆区域的稳定起着重要作用。然而，一直缺乏与功能相关的自动募集测试。先前的一项研究使用超声成像显示，健康受试者在面对模拟负重任务时会自动募集腹横肌（TrA）和腹内斜肌（IO）。但该任务尚未在患有LBP的受试者中进行研究。本研究的目的是比较有和没有LBP的受试者在面对模拟负重任务时腹部肌肉的自动募集情况。对20名有和没有LBP的受试者进行了测试。使用实时超声成像来评估TrA和腹内斜肌IO的厚度变化以及TrA肌前筋膜附着点的横向移动（“滑动”）。结果显示，在模拟负重任务中，患有LBP的受试者TrA肌的缩短明显较少（P < 0.0001），而IO肌的厚度增加更大（P = 0.002）。两组之间TrA肌厚度的变化没有显著差异（P = 0.055）。本研究提供了患有LBP的受试者腹部肌肉运动控制变化的证据。该测试可能为研究有和没有LBP的人群腹部肌肉的自动募集提供一种与功能相关的非侵入性方法。
