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不同节段性脊柱稳定训练方案对无症状受试者姿势稳定性的影响:随机对照试验

Effects of different segmental spinal stabilization exercise protocols on postural stability in asymptomatic subjects: randomized controlled trial.

作者信息

Kaya Derya Ozer, Ergun Nevin, Hayran Mutlu

机构信息

Ahi Evran University, School of Physiotherapy and Rehabilitation, Kirşehir, Turkey.

出版信息

J Back Musculoskelet Rehabil. 2012;25(2):109-16. doi: 10.3233/BMR-2012-0318.

Abstract

BACKGROUND AND OBJECTIVES

The aim was to assess and compare the postural stability effects of the "Progressive Dynamic Spine Stabilization Exercise Protocols" (PDSSEP) which were designed for different spinal segments.

MATERIAL AND METHOD

The asymptomatic, sedentary, and female volunteers (21.26 ± 1.30 years old) were allocated randomly into Cervical (n=22), Lumbar (n=21), Thoracic (n=20), Combined (n=20), and Control (n=21) Groups. All training groups participated into the related PDSSEP for six weeks, 3 days/week. The assessments were carried out at the baseline, after 6(th) week, and on the 12(th) week. "Tetrax Interactive Posturography and Balance System" (Tetrax System, Ramat Gan, Israel) was used to assess the overall postural stability (SI), weight distribution (WDI) and somatosensory reactions. "Kruskal Wallis Test" for the differences of the pre-6th weeks, pre-12(th) weeks within the groups, "Mann-Whitney U Test" for control and inter-group comparisons were used.

RESULTS

The differences were observed for eyes closed SI, and WDI in head right rotated position (p< 0.05) between the baseline and after completing the programs. Eyes closed SI in solid surface was shown statistically different in Thoracic group in comparison to controls (p< 0.02). SI on soft surface, SI head left rotated position and somatosensory reactions with head flexed position improved in Thoracic Group at the 12(th) week (p< 0.01). WDI significantly improved in Cervical Group (p< 0.01).

CONCLUSION

Thoracic spine can be considered as a hidden source for improving overall postural stability. It may be appropriate to focus on thoracic region in the kinetic chain for the treatment or training.

LEVEL OF EVIDENCE

A prospective randomized controlled trial, Level 1.

摘要

背景与目的

本研究旨在评估和比较针对不同脊柱节段设计的“渐进性动态脊柱稳定训练方案”(PDSSEP)对姿势稳定性的影响。

材料与方法

将无症状、久坐不动的女性志愿者(年龄21.26±1.30岁)随机分为颈椎组(n=22)、腰椎组(n=21)、胸椎组(n=20)、联合组(n=20)和对照组(n=21)。所有训练组均参加相关的PDSSEP训练,为期六周,每周三天。在基线、第6周和第12周进行评估。使用“Tetrax交互式姿势描记与平衡系统”(Tetrax系统,以色列拉马特甘)评估整体姿势稳定性(SI)、体重分布(WDI)和体感反应。组内第6周前、第12周前差异采用“Kruskal Wallis检验”,对照组与组间比较采用“Mann-Whitney U检验”。

结果

在完成训练方案前后,闭眼SI以及头部向右侧旋转位置的WDI存在差异(p<0.05)。与对照组相比,胸椎组在坚实表面的闭眼SI有统计学差异(p<0.02)。在第12周时,胸椎组在柔软表面的SI、头部向左旋转位置的SI以及头部屈曲位置的体感反应均有所改善(p<0.01)。颈椎组的WDI有显著改善(p<0.01)。

结论

胸椎可被视为改善整体姿势稳定性的潜在来源。在运动链中关注胸椎区域进行治疗或训练可能是合适的。

证据水平

前瞻性随机对照试验,1级。

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