Hoffman Shannon L, Johnson Molly B, Zou Dequan, Van Dillen Linda R
Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO, USA.
Man Ther. 2012 Apr;17(2):157-63. doi: 10.1016/j.math.2011.12.007. Epub 2012 Jan 17.
Patterns of lumbar posture and motion are associated with low back pain (LBP). Research suggests LBP subgroups demonstrate different patterns during common tasks. This study assessed differences in end-range lumbar flexion during two tasks between two LBP subgroups classified according to the Movement System Impairment model. Additionally, the impact of gender differences on subgroup differences was assessed. Kinematic data were collected. Subjects in the Rotation (Rot) and Rotation with Extension (RotExt) LBP subgroups were asked to sit slumped and bend forward from standing. Lumbar end-range flexion was calculated. Subjects reported symptom behaviour during each test. Compared to the RotExt subgroup, the Rot subgroup demonstrated greater end-range lumbar flexion during slumped sitting and a trend towards greater end-range lumbar flexion with forward bending. Compared to females, males demonstrated greater end-range lumbar flexion during slumped sitting and forward bending. A greater proportion of people in the Rot subgroup reported symptoms with each test compared to the RotExt subgroup. Males and females were equally likely to report symptoms with each test. Gender differences were not responsible for LBP subgroup differences. Subgrouping people with LBP provides insight into differences in lumbar motion within the LBP population. Results suggesting potential consistent differences across flexion-related tasks support the presence of stereotypical movement patterns that are related to LBP.
腰椎姿势和运动模式与腰痛(LBP)相关。研究表明,腰痛亚组在常见任务中表现出不同的模式。本研究评估了根据运动系统损伤模型分类的两个腰痛亚组在两项任务中终末范围腰椎前屈的差异。此外,还评估了性别差异对亚组差异的影响。收集了运动学数据。旋转(Rot)和旋转伴伸展(RotExt)腰痛亚组的受试者被要求弯腰驼背坐着并从站立位向前弯曲。计算腰椎终末范围前屈。受试者报告每次测试期间的症状表现。与RotExt亚组相比,Rot亚组在弯腰驼背坐着时表现出更大的终末范围腰椎前屈,并且在向前弯曲时终末范围腰椎前屈有增大的趋势。与女性相比,男性在弯腰驼背坐着和向前弯曲时表现出更大的终末范围腰椎前屈。与RotExt亚组相比,Rot亚组中更大比例的人在每次测试时报告有症状。男性和女性在每次测试时报告有症状的可能性相同。性别差异并非导致腰痛亚组差异的原因。对腰痛患者进行亚组分类有助于深入了解腰痛人群中腰椎运动的差异。结果表明在与前屈相关的任务中存在潜在的一致差异,这支持了与腰痛相关的刻板运动模式的存在。