Tunnell John
Clinical Director, Excel Therapy Specialists, Broken Arrow, OK.
J Man Manip Ther. 2009;17(1):E19-24. doi: 10.1179/jmt.2009.17.1.19E.
A proposed mechanism for the persistence of low back pain due to clinical instability is a decrease in control of local spinal musculature, more specifically decreased recruitment of multifidus. Altered segmental mechanoreceptor input has been proposed as a contributing factor responsible for a decrease in local muscle recruitment. In this case report, immediate changes in the recruitment of the deep multifidus following manipulation were examined using needle EMG and isometric testing of trunk rotational force. Trunk rotational force appeared to improve while the multifidus demonstrated a decrease in activity as measured by needle EMG. No specific conclusions can be drawn from this report; however, the results do suggest that immediate multifidus function may be influenced with manipulation, resulting in improved muscular control of the trunk.
一种因临床不稳定导致下腰痛持续存在的推测机制是局部脊柱肌肉组织控制能力下降，更具体地说是多裂肌募集减少。节段性机械感受器输入改变被认为是导致局部肌肉募集减少的一个促成因素。在本病例报告中，使用针电极肌电图和躯干旋转力等长测试，研究了手法治疗后深部多裂肌募集的即时变化。躯干旋转力似乎有所改善，而针电极肌电图测量显示多裂肌活动减少。本报告无法得出具体结论；然而，结果确实表明手法治疗可能会影响多裂肌的即时功能，从而改善躯干的肌肉控制。
