University of Utah, College of Health, Salt Lake City, UT, USA.
Arch Phys Med Rehabil. 2010 Jan;91(1):78-85. doi: 10.1016/j.apmr.2009.08.146.
UNLABELLED: Hebert JJ, Koppenhaver SL, Magel JS, Fritz JM. The relationship of transversus abdominis and lumbar multifidus activation and prognostic factors for clinical success with a stabilization exercise program: a cross-sectional study. OBJECTIVE: To examine the relationship between prognostic factors for clinical success with a stabilization exercise program and lumbar multifidus (LM) and transversus abdominis (TrA) muscle activation assessed using rehabilitative ultrasound imaging (RUSI). DESIGN: Cross-sectional study. SETTING: Outpatient physical therapy clinic. PARTICIPANTS: Volunteers with current low back pain (N=40). INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: We examined the relationship between prognostic factors associated with clinical success with a stabilization exercise program (positive prone instability test, age <40y, aberrant movements, straight leg raise >91 degrees , presence of lumbar hypermobility) and degree of TrA and LM muscle activation assessed by RUSI. RESULTS: Significant univariate relationships were identified between LM muscle activation and the number of prognostic factors present (Pearson correlation coefficient [r] =-.558, P=.001), as well as the individual factors of a positive prone instability test (point biserial correlation coefficient [r(pbis)]=.376, P=.018) and segmental hypermobility (r(pbis)=.358, P=.025). The multivariate analyses indicated that after controlling for other variables, the addition of the variable "number of prognostic factors present" resulted in a significant increase in R(2) (P=.006). No significant univariate or multivariate relationships were observed between the prognostic factors and TrA muscle activation. CONCLUSIONS: Decreased LM muscle activation, but not TrA muscle activation, is associated with the presence of factors predictive of clinical success with a stabilization exercise program. Our findings provide researchers and clinicians with evidence regarding the construct validity of the prognostic factors examined in this study, as well as the potential clinical importance of the LM muscle as a target for stabilization exercises.
未加标签：赫伯特 JJ、科彭哈弗尔 SL、马吉尔 JS、弗里茨 JM。腰椎稳定运动计划的临床成功的预测因素与横腹内肌和多裂肌的激活之间的关系：一项横断面研究。
目的：使用康复超声成像（RUSI）评估腰椎稳定运动计划的临床成功的预测因素与腰椎多裂肌（LM）和横腹内肌（TrA）肌肉激活之间的关系。
设计：横断面研究。
地点：门诊物理治疗诊所。
参与者：有当前腰痛的志愿者（N=40）。
干预措施：不适用。
主要观察指标：我们研究了与腰椎稳定运动计划的临床成功相关的预测因素（阳性俯卧不稳定试验、年龄<40 岁、异常运动、直腿抬高>91 度、存在腰椎过度活动）与 RUSI 评估的 TrA 和 LM 肌肉激活程度之间的关系。
结果：发现 LM 肌肉激活与存在的预测因素数量之间存在显著的单变量关系（皮尔逊相关系数[r]=-.558，P=.001），以及阳性俯卧不稳定试验（点双列相关系数[r(pbis)]=.376，P=.018）和节段性过度活动（r(pbis)=.358，P=.025）的个体因素。多元分析表明，在控制其他变量后，“存在的预测因素数量”变量的增加导致 R²显著增加（P=.006）。在预测因素和 TrA 肌肉激活之间没有观察到显著的单变量或多变量关系。
结论：与腰椎稳定运动计划临床成功相关的因素是 LM 肌肉激活减少，而不是 TrA 肌肉激活减少。我们的发现为研究人员和临床医生提供了关于本研究中检查的预测因素的结构有效性的证据，以及 LM 肌肉作为稳定运动目标的潜在临床重要性。
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