University of Virginia, Charlottesville, VA 22908-0159, USA.
J Athl Train. 2009 Sep-Oct;44(5):475-81. doi: 10.4085/1062-6050-44.5.475.
Isolated lumbar paraspinal muscle fatigue causes lower extremity and postural control deficits.
To describe the change in body position during gait after fatiguing lumbar extension exercises in persons with recurrent episodes of low back pain compared with healthy controls.
Case-control study.
Motion analysis laboratory.
Twenty-five recreationally active participants with a history of recurrent episodes of low back pain, matched by sex, height, and mass with 25 healthy controls.
INTERVENTION(S): We measured 3-dimensional lower extremity and trunk kinematics before and after fatiguing isometric lumbar paraspinal exercise.
MAIN OUTCOME MEASURE(S): Measurements were taken while participants jogged on a custom-built treadmill surrounded by a 10-camera motion analysis system.
Group-by-time interactions were observed for lumbar lordosis and trunk angles (P < .05). A reduced lumbar spine extension angle was noted, reflecting a loss of lordosis and an increase in trunk flexion angle, indicating increased forward trunk lean, in healthy controls after fatiguing lumbar extension exercise. In contrast, persons with a history of recurrent low back pain exhibited a slight increase in spine extension, indicating a slightly more lordotic position of the lumbar spine, and a decrease in trunk flexion angles after fatiguing exercise. Regardless of group, participants experienced, on average, greater peak hip extension after lumbar paraspinal fatigue.
Small differences in response may represent a necessary adaptation used by persons with recurrent low back pain to preserve gait function by stabilizing the spine and preventing inappropriate trunk and lumbar spine positioning.
孤立性腰旁肌疲劳会导致下肢和姿势控制能力下降。
与健康对照组相比,描述反复腰痛患者在进行疲劳性腰椎伸展运动后步态时的身体位置变化。
病例对照研究。
运动分析实验室。
25 名有反复发作腰痛病史的休闲活跃参与者,按性别、身高和体重与 25 名健康对照组相匹配。
我们在进行疲劳等长腰椎旁肌运动前后测量了 3 维下肢和躯干运动学。
参与者在定制跑步机上慢跑时,在 10 个摄像机运动分析系统周围进行测量。
观察到腰椎前凸和躯干角度的组间时间交互作用(P <.05)。健康对照组在疲劳性腰椎伸展运动后,腰椎伸展角度减小,反映出前凸减小和躯干前屈角度增加,表明前向躯干倾斜增加。相比之下,有反复发作腰痛病史的患者在疲劳后腰椎伸展角度略有增加,表明腰椎的前凸位置略有增加,而躯干前屈角度减小。无论组间如何,参与者在腰椎旁肌疲劳后平均经历更大的髋关节伸展峰值。
反应的微小差异可能代表反复腰痛患者为保持步态功能而进行的必要适应性改变,即稳定脊柱并防止不适当的躯干和腰椎定位。