Ershad Neda, Kahrizi Sedighe, Abadi Mohamad Firooz, Zadeh Soghrat Faghih
Department of Physical Therapy, Tarbiat Modares University, Tehran, Iran.
J Back Musculoskelet Rehabil. 2009;22(3):165-72. doi: 10.3233/BMR-2009-0230.
Low back pain after load-carrying is the most important disorder in musculoskeletal system and a cause of dysfunction and economic problems. Holding materials can disturb spinal stability; nevertheless, there are few researches about the pattern of trunk muscle recruitment in patients with chronic low back pain (CLBP) during load holding.
Ten female patients with CLBP and ten matched healthy subjects participated in this study. Normalized electromyography activation of trunk muscles during holding loads was analyzed.
The low back pain group demonstrated significantly higher activation levels of the External oblique abdominis muscle during loading 12 kg in flexed trunk position and lower activation levels of the Internal oblique abdominis muscle during loading 6 and 12 kg in neutral trunk position than the control group. With the highest external load and trunk flexion, the electrical activity of back muscles increased significantly in both groups. With increasing load, the activation of Rectus abdominis muscle in patients with CLBP and the activation of Rectus abdominis and Internal oblique muscles were increased significantly in healthy subjects.
Higher activation of global and lower activation of local abdominal muscles in patients with CLBP may represent that pain changes neuromuscular control systems. The increased activity of extensor muscles during trunk flexion is probably needed for stability and controlling of flexion.
负重后下背痛是肌肉骨骼系统中最重要的病症,也是功能障碍和经济问题的一个原因。手持物品会干扰脊柱稳定性;然而,关于慢性下背痛(CLBP)患者在手持重物过程中躯干肌肉募集模式的研究却很少。
10名CLBP女性患者和10名匹配的健康受试者参与了本研究。分析了在手持重物过程中躯干肌肉的标准化肌电图激活情况。
与对照组相比,下背痛组在躯干屈曲位手持12 kg重物时腹外斜肌的激活水平显著更高,在躯干中立位手持6 kg和12 kg重物时腹内斜肌的激活水平更低。在最大外部负荷和躯干屈曲时,两组的背部肌肉电活动均显著增加。随着负荷增加,CLBP患者腹直肌的激活以及健康受试者腹直肌和腹内斜肌的激活均显著增加。
CLBP患者整体腹部肌肉激活较高而局部腹部肌肉激活较低,这可能表明疼痛改变了神经肌肉控制系统。在躯干屈曲过程中伸肌活动增加可能是为了保持稳定性和控制屈曲。