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影响复发性腰痛患者轴向躯干旋转时肩盆整合的因素。

Factors affecting shoulder-pelvic integration during axial trunk rotation in subjects with recurrent low back pain.

机构信息

Department of Physical Therapy, Korea University, #1 Jeongneung 3-dong, Sungbuk-gu, Seoul 136-703, Republic of Korea.

出版信息

Eur Spine J. 2012 Jul;21(7):1316-23. doi: 10.1007/s00586-012-2280-5. Epub 2012 Mar 29.


DOI:10.1007/s00586-012-2280-5
PMID:22456800
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3389122/
Abstract

INTRODUCTION: Shoulder-pelvic integration could play a central role in the control of dynamic posture and movement. However, kinematic coordination during axial trunk rotation has not been carefully investigated in subjects with recurrent low back pain (LBP). The purpose of this study was to compare the maximum rotational angles of the shoulders and pelvis in the transverse plane between subjects with and without recurrent LBP. MATERIALS AND METHODS: A total of 38 age-matched subjects (19 control subjects: 69.00 ± 5.75 years old and 19 subjects with LBP: 68.79 ± 5.40 years old) participated in the study. The axial trunk rotation test was conducted in the upright position with bilateral hips and knees fully extended and both feet shoulder width apart. RESULTS: The results of this study indicated that there was a difference in pelvic girdle rotation between groups (100.79 ± 26.46 in the control group, 82.12 ± 23.16 in the LBP group; t = 2.31, p = 0.02); however, there was no difference for the shoulder girdle (177.63 ± 36.98 in the control group, 156.42 ± 30.09 in the LBP group; t = 1.91, p = 0.06). There were interactions with age (F = 9.27, p = 0.004) and BMI (F = 7.50, p = 0.01) with the rotational angles of the shoulder and pelvis. CONCLUSION: These results indicated a different pattern of trunk rotation movement with the age and BMI serving as important factors to consider for recurrent LBP. The results of our study also indicated a different pattern of shoulder and pelvic coordination with age and gender. Clinicians need to consider the consequences of limited shoulder-pelvic rotational angles, especially limited rotational angle on the pelvis during trunk axial rotation. Further studies are required to determine the causes of the underlying problems for clinical decision-making and altered shoulder-pelvic rotation in subjects with recurrent LBP.

摘要

简介:肩部-骨盆整合可能在动态姿势和运动的控制中发挥核心作用。然而,在复发性腰痛(LBP)患者中,轴向躯干旋转过程中的运动协调尚未得到仔细研究。本研究的目的是比较复发性 LBP 患者和无 LBP 患者在横截面上肩部和骨盆的最大旋转角度。

材料和方法:共有 38 名年龄匹配的受试者(19 名对照组:69.00 ± 5.75 岁和 19 名 LBP 组:68.79 ± 5.40 岁)参加了这项研究。轴向躯干旋转测试在直立位置进行,双侧髋关节和膝关节完全伸展,双脚与肩同宽。

结果:本研究结果表明,组间骨盆旋转存在差异(对照组 100.79 ± 26.46°,LBP 组 82.12 ± 23.16°;t = 2.31,p = 0.02);然而,肩部旋转没有差异(对照组 177.63 ± 36.98°,LBP 组 156.42 ± 30.09°;t = 1.91,p = 0.06)。年龄(F = 9.27,p = 0.004)和 BMI(F = 7.50,p = 0.01)与肩和骨盆的旋转角度存在交互作用。

结论:这些结果表明,复发性 LBP 患者的躯干旋转运动模式存在差异,年龄和 BMI 是重要的考虑因素。我们的研究结果还表明,随着年龄和性别变化,肩部和骨盆的协调模式也存在差异。临床医生需要考虑肩部-骨盆旋转角度受限的后果,尤其是在轴向躯干旋转过程中骨盆的旋转角度受限的后果。需要进一步的研究来确定复发性 LBP 患者潜在问题的原因以及肩部-骨盆旋转异常的原因,以便为临床决策提供依据。

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[1]
Answer to the Letter to the Editor of M. Hamza, et al. concerning "Implications for fall efficacy strategies on center of pressure and center of gravity sway distances in adults with chronic low back pain" by P.S. Sung, et al. (Eur Spine J [2024]: doi: 10.1007/s00586-024-08523-z).

Eur Spine J. 2025-2

[2]
Hip biomechanics in patients with low back pain, what do we know? A systematic review.

BMC Musculoskelet Disord. 2024-5-28

[3]
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Spine Deform. 2022-7

[4]
The gait deviations of ankylosing spondylitis with hip involvement.

Clin Rheumatol. 2019-1-4

[5]
Is there evidence to use kinematic/kinetic measures clinically in low back pain patients? A systematic review.

Clin Biomech (Bristol). 2018-6

[6]
Reliability of the Kinematic Steadiness Index during one-leg standing in subjects with recurrent low back pain.

Eur Spine J. 2018-1

[7]
Analysis of relative kinematic index with normalized standing time between subjects with and without recurrent low back pain.

Eur Spine J. 2017-2

本文引用的文献

[1]
Influence of lumbar and hip mobility on the bending stresses acting on the lumbar spine.

Clin Biomech (Bristol). 1993-7

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