Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Spine (Phila Pa 1976). 2010 Dec 15;35(26):E1612-8. doi: 10.1097/BRS.0b013e3181d12642.
A cross-sectional study comparing normal subjects and patients with lumbar disc herniation (LDH) with sciatica.
To simultaneously measure the isokinetic muscle strength of the trunk, knees, and ankles in both groups.
Coordination between the trunk and lower extremity muscles is important for normal physical activity. Reduced trunk and knee muscle strength have been reported in patients with lower level LDH; however, ankle performance in these patients is still unknown.
We recruited 43 normal subjects as controls and 33 patients with lower level LDH with sciatica. The isokinetic strength of the trunk, knees, and ankles was measured at 2 velocities in random order: 60°/s and 120°/s, and 60°/s and 180°/s for trunk and ankle strength and for knee strength, respectively.
The isokinetic trunk strength was significantly lower in the LDH group irrespective of test modes or velocity. Despite unilateral sciatica or test modes and velocity, the unilateral knee strength was significantly lower in the LDH group than that in the control group. Knee extension torque was also found to be significantly lower in the limbs with sciatica than in those without sciatica at the testing velocity of 180°/s (80.25 ± 24.88 vs. 95.42 ± 26.29 Nm, P < 0.05). Irrespective of unilateral sciatica or test velocity, ankle plantar flexion torque revealed to be significantly lower in the LDH group than the control group; however, dorsiflexion torque was not different. Significant correlations were demonstrated among the total muscle strength of the trunk, knees, and ankles in both groups.
Besides the lower trunk strength, concurrent lower unilateral knee and ankle plantar flexion but not dorsiflexion strength was demonstrated in the LDH subjects with unilateral sciatica, regardless of its location. As compared to the limbs without sciatica, an additional 14% reduction of knee extension torque at 180°/s was found in the limbs with sciatica in the LDH patients.
一项比较正常受试者和腰椎间盘突出症（LDH）伴坐骨神经痛患者的横断面研究。
同时测量两组患者的躯干、膝关节和踝关节的等速肌力。
躯干和下肢肌肉之间的协调性对于正常的身体活动很重要。已有报道称，低位 LDH 患者的躯干和膝关节肌肉力量下降；然而，这些患者的踝关节表现仍不清楚。
我们招募了 43 名正常受试者作为对照组和 33 名患有低位 LDH 伴坐骨神经痛的患者。等速力量分别在随机的两种速度下测量：60°/s 和 120°/s，以及 60°/s 和 180°/s，用于测量躯干和踝关节力量以及膝关节力量。
LDH 组的躯干等速力量无论测试模式或速度如何均显著较低。尽管存在单侧坐骨神经痛或测试模式和速度，LDH 组的单侧膝关节力量仍明显低于对照组。在 180°/s 的测试速度下，患有坐骨神经痛的肢体的膝关节伸展扭矩也明显低于无坐骨神经痛的肢体（80.25 ± 24.88 与 95.42 ± 26.29 Nm，P < 0.05）。无论是否存在单侧坐骨神经痛或测试速度，LDH 组的踝关节跖屈扭矩均明显低于对照组；然而，背屈扭矩没有差异。两组的躯干、膝关节和踝关节总肌力之间均显示出显著相关性。
除了较低的躯干力量外，单侧坐骨神经痛的 LDH 患者还表现出单侧膝关节和踝关节跖屈（但不是背屈）力量下降，无论其位置如何。与无坐骨神经痛的肢体相比，LDH 患者的坐骨神经痛肢体的膝关节伸展扭矩在 180°/s 时下降了 14%。
