Dept. of Rehabilitation and Movement Science, University of Vermont, Burlington, VT 05405, USA.
Clin Neurophysiol. 2010 Mar;121(3):431-40. doi: 10.1016/j.clinph.2009.11.076. Epub 2010 Jan 13.
To determine whether low back pain (LBP) associates with altered postural stabilization and concomitant changes in cerebrocortical motor physiology.
Ten participants with LBP and 10 participants without LBP performed self-initiated, voluntary arm raises. Electromyographic onset latencies of the bilateral internal oblique and erector spinae muscles were analyzed relative to that of the deltoid muscle as measures of anticipatory postural adjustments (APAs). Amplitudes of alpha event-related desynchronization (ERD) and of Bereitschaftspotentials (BP) were calculated from scalp electroencephalography as measures of cerebrocortical motor physiology.
The APA was first evident in the trunk muscles contralateral to the arm raise for both groups. Significant alpha ERD was evident bilaterally at the central and parietal electrodes for participants with LBP but only at the electrodes contralateral and midline to the arm raise for those without LBP. The BP amplitudes negatively correlated with APA onset latencies for participants with (but not for those without) LBP.
Cerebrocortical activity becomes altered prior to arm movements requiring APAs for individuals with chronic LBP.
These results support a theoretical model that altered central motor neurophysiology associates with LBP, thereby implying that rehabilitation strategies should address these neuromotor impairments.
确定慢性下背痛（LBP）是否与姿势稳定改变及伴随的大脑皮质运动生理学变化有关。
10 名 LBP 患者和 10 名无 LBP 患者进行自主发起的、自愿的手臂抬起运动。双侧内斜肌和竖脊肌的肌电图起始潜伏期相对于三角肌进行分析，作为预期姿势调整（APAs）的测量指标。头皮脑电图中计算阿尔法事件相关去同步（ERD）和准备电位（BP）的幅度，作为大脑皮质运动生理学的测量指标。
对于两组患者，对侧躯干肌肉的 APA 首先出现。LBP 患者双侧中央和顶叶电极有明显的 alpha ERD，但无 LBP 患者仅在与手臂抬起相对应的电极和中线出现。BP 幅度与 LBP 患者（但不是无 LBP 患者）的 APA 起始潜伏期呈负相关。
慢性 LBP 患者在需要进行 APA 的手臂运动前，大脑皮质活动发生改变。
这些结果支持了一种理论模型，即中枢运动神经生理学的改变与 LBP 有关，这意味着康复策略应针对这些神经运动障碍进行治疗。
