Davarian Sanaz, Maroufi Nader, Ebrahimi Ismaeil, Farahmand Farzam, Parnianpour Mohammad
Faculty of Rehabilitation, Tehran University of Medical Sciences, Iran.
J Back Musculoskelet Rehabil. 2012;25(2):123-9. doi: 10.3233/BMR-2012-0320.
Previous research has shown inconsistent findings regarding muscle endurance in chronic low back pain (CLBP). Questions also remain about muscle endurance in patients with clinical instability. The aim of this study was to investigate trunk muscles strength and endurance in CLBP patients with and without clinical instability.
32 CLBP patients (15 with and 17 without clinical instability) and 39 matched healthy subjects participated in this study. The standing extension test was performed to assess the strength and endurance of the lumbar extensors while recording their electromyographic activity. The patients' disability was evaluated using the Oswestry and Roland-Morris Disability Questionnaires.
Patients with clinical instability showed lower maximal voluntary exertion (MVE) and higher time to fatigue (TTF) compared to healthy subjects (P=0.000 and P=0.008, respectively) and patients without instability (P=0.002 and P=0.02, respectively). There was no difference in these variables between patients without instability and healthy controls. A negative relationship between MVE and TTF and a positive correlation between disability and pain intensity were seen.
Strength training of trunk extensor muscles can be considered as part of the treatment protocol for CLBP patients with clinical instability. Although patients without instability suffered from pain or disability, they showed more similarity to healthy subjects in terms of trunk muscles strength and endurance.
先前的研究在慢性下腰痛（CLBP）患者的肌肉耐力方面得出了不一致的结果。对于临床不稳定患者的肌肉耐力问题也仍然存在疑问。本研究的目的是调查有和没有临床不稳定的CLBP患者的躯干肌肉力量和耐力。
32名CLBP患者（15名有临床不稳定，17名无临床不稳定）和39名匹配的健康受试者参与了本研究。进行站立伸展测试以评估腰伸肌的力量和耐力，同时记录其肌电图活动。使用Oswestry和Roland-Morris残疾问卷评估患者的残疾情况。
与健康受试者相比，有临床不稳定的患者表现出较低的最大自主用力（MVE）和较长的疲劳时间（TTF）（分别为P = 0.000和P = 0.008），与无临床不稳定的患者相比也有差异（分别为P = 0.002和P = 0.02）。无临床不稳定的患者与健康对照在这些变量上没有差异。观察到MVE与TTF之间呈负相关，残疾与疼痛强度之间呈正相关。
对于有临床不稳定的CLBP患者，躯干伸肌的力量训练可被视为治疗方案的一部分。虽然无临床不稳定的患者也有疼痛或残疾，但他们在躯干肌肉力量和耐力方面与健康受试者更相似。
