Kiesel Kyle B, Butler Robert J, Duckworth Andrea, Halaby Tara, Lannan Kevin, Phifer Craig, DeLeal Christine, Underwood Frank B
Department of Physical Therapy, University of Evansville, Evansville, IN, USA.
Man Ther. 2012 Jun;17(3):236-40. doi: 10.1016/j.math.2012.01.008. Epub 2012 Feb 15.
Lumbar musculature plays an important role in stabilization during functional movements such as walking, bending and overhead activities. Current research has focused on the lumbar multifidus (LM) muscle to determine if altered activity of the LM may contribute to low back pain (LBP). Therefore, the purpose of this study was to determine whether experimentally induced LBP affects deep LM muscle activity during functionally oriented tasks, weight shifting and upper extremity lifting. Intramuscular electromyography (EMG) activity of the LM at L4 was measured in 17 healthy adults during a dominant side shoulder flexion and extension task and during a staggered-stance weight shift task. Data were collected at baseline, after pain was induced with hypertonic saline and after the pain had subsided. Comparisons of within-subjects effects were performed with the use of a two-way repeated-measure ANOVA. A significantly higher magnitude of activity was found in the induced pain condition as compared to the baseline condition for the shoulder extension phase of the upper extremity task (p = 0.04). During forward weight shifting, lower values in both the induced pain (p = 0.02) and the recovery conditions (p = 0.01) were measured. During backward weight shifting, lower values were measured during the recovery condition as compared to baseline (p = 0.03). Across trials and subjects the EMG amplitudes were increased during the extension phase of the upper extremity task and decreased during the weight shifting task. These results suggest that the LM does not respond to induced pain in the same manner during different phases of functionally oriented tasks.
腰椎肌肉组织在诸如行走、弯腰和上肢活动等功能性动作的稳定过程中发挥着重要作用。目前的研究聚焦于腰多裂肌(LM),以确定该肌肉活动的改变是否可能导致腰痛(LBP)。因此,本研究的目的是确定实验诱导的腰痛是否会影响功能性任务、体重转移和上肢举升过程中腰多裂肌深层肌肉的活动。在17名健康成年人进行优势侧肩屈伸任务和交错站立体重转移任务期间,测量了L4水平腰多裂肌的肌内肌电图(EMG)活动。在基线、用高渗盐水诱导疼痛后以及疼痛消退后收集数据。使用双向重复测量方差分析进行受试者内效应的比较。与上肢任务肩伸展阶段的基线状态相比,在诱导疼痛状态下发现活动幅度显著更高(p = 0.04)。在向前体重转移过程中,诱导疼痛状态(p = 0.02)和恢复状态(p = 0.01)下的值均较低。在向后体重转移过程中,与基线相比,恢复状态下的值较低(p = 0.03)。在所有试验和受试者中,上肢任务伸展阶段的EMG振幅增加,而体重转移任务期间的EMG振幅降低。这些结果表明,在功能性任务的不同阶段,腰多裂肌对诱导疼痛的反应方式不同。