Department of Physical Therapy, College of Health Science, Korea University, Seoul, South Korea.
Spine (Phila Pa 1976). 2010 Jul 15;35(16):E753-60. doi: 10.1097/BRS.0b013e3181d53b9c.
An experimental design comparing kinematic changes in the lumbar spine axis in subjects with and without low back pain (LBP) while standing on one leg with and without visual feedback.
The purpose of this study was to evaluate the lumbar stability index, which includes relative holding time (RHT) and relative standstill time (RST), in subjects with and without LBP.
Even though a number of studies have evaluated postural adjustments based on kinematic changes in subjects with LBP, lumbar spine stability has not been examined for abnormal postural responses with visual feedback.
All participants were asked to maintain the stork test position (standing on one leg with the contra lateral hip flexed 90 degrees) for 25 seconds. The outcome measures included RHT and RST for the axes of the core spine and lumbar spine. Independent t tests were used to compare the differences between groups. Two-way repeated measure analysis of variance was used to compare the differences for both axes. The age variable was used as a covariate to control confounding effects for the data analyses.
The RHT was longer for the lumbar spine axis in subjects without LBP than those with LBP, especially without visual feedback. There was also significant interaction in RST between subjects with and without LBP (F = 7.18, P = 0.01). For the core axis of the trunk, significant differences existed based on the main effect of side (F = 9.07, P = 0.004), trunk rotation (F = 24.30, P = 0.001), and both of these interactions (F = 8.93, P = 0.004). However, there was a lack of significant interaction with age for the lumbar and core spine axes (F = 0.06, P = 0.81).
Although the control group included slightly younger volunteers compared with the LBP group, the stability index of the core spine significantly decreased in RHT and RST, especially when visual feedback was blocked for subjects with LBP. The interaction between visual feedback and trunk rotation indicated that core spine stability is critical in coordinating balance control. A trunk muscle imbalance may contribute to unbalanced postural activity, which could prompt a decreased, uncoordinated bracing effect in subjects with LBP. As a result, core spine training could be used in the prevention of postural instability in such subjects.
一项实验设计，比较有和无腰痛（LBP）的受试者在单腿站立时，有和无视觉反馈时腰椎轴的运动学变化。
本研究旨在评估腰椎稳定指数，包括相对保持时间（RHT）和相对静止时间（RST），在有和无 LBP 的受试者中。
尽管许多研究已经评估了基于 LBP 受试者运动学变化的姿势调整，但尚未检查腰椎稳定性对于视觉反馈的异常姿势反应。
所有参与者均被要求保持鹳式测试姿势（单腿站立，对侧髋关节弯曲 90 度）25 秒。结果测量包括核心脊柱和腰椎轴的 RHT 和 RST。独立样本 t 检验用于比较组间差异。采用双因素重复测量方差分析比较两个轴的差异。年龄变量被用作数据分析的协变量，以控制混杂效应。
无 LBP 的受试者的腰椎轴的 RHT 比有 LBP 的受试者长，尤其是在没有视觉反馈的情况下。LBP 患者和无 LBP 患者的 RST 之间也存在显著的交互作用（F = 7.18，P = 0.01）。对于躯干核心轴，基于侧方（F = 9.07，P = 0.004）、躯干旋转（F = 24.30，P = 0.001）的主要效应以及这两个交互作用（F = 8.93，P = 0.004）存在显著差异。然而，对于腰椎和核心脊柱轴，年龄的显著交互作用并不存在（F = 0.06，P = 0.81）。
尽管对照组的志愿者比 LBP 组稍年轻，但在 RHT 和 RST 中，核心脊柱的稳定指数显著降低，尤其是在 LBP 患者的视觉反馈被阻断时。视觉反馈和躯干旋转之间的相互作用表明，核心脊柱稳定性对于协调平衡控制至关重要。躯干肌肉失衡可能导致姿势活动不平衡，从而导致 LBP 患者的支撑效果降低且不协调。因此，核心脊柱训练可用于预防此类患者的姿势不稳定。
