Shadmehr Azadeh, Jafarian Zohreh, Talebian Saeed
Department of Physical Therapy, Faculty of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
J Back Musculoskelet Rehabil. 2012;25(1):27-32. doi: 10.3233/BMR-2012-0307.
Though the active straight leg raise (ASLR) test has been proposed as a reliable methodology for assessment of load transfer through the pelvis in patients with sacroiliac joint pain (SIJP), the tonicity and timing of muscle activation during the ASLR test have not been investigated. In clinical experiments, besides the ASLR test score, an increased duration of the test is also used for diagnosis of SIJP.
This study was a cross-sectional design of electro-myographic pattern of sacroiliac stabilizer muscles to establish a platform for comparison of patients with SIJP and healthy controls. To identify if the subjects with SIJP show changes in electromyographic pattern of sacroiliac stabilizer muscles as well as any duration difference in such tests for both groups.
Fifteen female patients with sacroiliac pain and the same number of healthy females at the same age were participated in this study. All the patients were diagnosed as positive ASLR as well as self reported maximum pain over the sacroiliac joint. Surface electromyographic activity was recorded from rectus abdominus, external oblique, internal oblique, adductor longus, biceps femoris, gluteus maximus and erector spinea during ASLR. Tonicity and onset of muscle activity in relation to the initiation of the ASLR and their duration were also compared.
The participants with SIJP exhibited a significantly increased latency at the onset of adductor longus following the initiation of the ASLR test (P=0.002) as compared to the healthy controls. A significant difference was also observed in tonicities of external oblique, biceps femoris, gluteus maximus and erector spinea as well as the duration of leg rising (P < 0.05) between the two groups.
These findings suggest that an alteration in the motor control strategy for lumbopelvic stabilization in patients with SIJP may influence load transfer through the pelvic.
尽管主动直腿抬高（ASLR）试验已被提议作为评估骶髂关节疼痛（SIJP）患者通过骨盆进行负荷转移的可靠方法，但ASLR试验期间肌肉激活的张力和时间尚未得到研究。在临床实验中，除了ASLR试验评分外，试验时间的延长也用于SIJP的诊断。
本研究采用横断面设计，观察骶髂稳定肌的肌电图模式，为比较SIJP患者和健康对照者建立一个平台。以确定SIJP患者是否表现出骶髂稳定肌肌电图模式的变化，以及两组在该试验中的持续时间差异。
15名患有骶髂关节疼痛的女性患者和15名年龄相同的健康女性参与了本研究。所有患者ASLR试验均为阳性，且自我报告骶髂关节处疼痛最为严重。在ASLR过程中，记录腹直肌、腹外斜肌、腹内斜肌、长收肌、股二头肌、臀大肌和竖脊肌的表面肌电活动。还比较了与ASLR开始相关的肌肉活动的张力、起始时间及其持续时间。
与健康对照组相比，SIJP患者在ASLR试验开始后长收肌起始的潜伏期显著延长（P = 0.002）。两组之间在腹外斜肌、股二头肌、臀大肌和竖脊肌的张力以及抬腿持续时间方面也观察到显著差异（P < 0.05）。
这些发现表明，SIJP患者腰骨盆稳定运动控制策略的改变可能会影响通过骨盆的负荷转移。
