Hu Hai, Meijer Onno G, Hodges Paul W, Bruijn Sjoerd M, Strijers Rob L, Nanayakkara Prabath W B, van Royen Barend J, Wu Wenhua, Xia Chun, van Dieën Jaap H
Research Institute MOVE, Faculty of Human Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands.
Man Ther. 2012 Dec;17(6):531-7. doi: 10.1016/j.math.2012.05.010. Epub 2012 Jun 22.
The Active Straight Leg Raise (ASLR) is an important test in diagnosing pelvic girdle pain (PGP). It is difficult to understand what happens normally during the ASLR, let alone why it would be impaired in PGP. In the present study, healthy subjects performed the ASLR under normal conditions, with weight added above the ankle, and while wearing a pelvic belt. Activity of the abdominal muscles, rectus femoris (RF), and biceps femoris (BF) was recorded with surface electromyography (EMG), and transversus abdominis (TA) with fine wire EMG. RF was ipsilaterally active, BF contralaterally, and the abdominal muscles bilaterally. All muscle activity was higher with weight, and abdominal muscle activity was lower with the pelvic belt. In both these conditions, TA and obliquus abdominis internus (OI) were more asymmetrically active than obliquus externus. The abdominal muscles engage in multitasking, combining symmetric and asymmetric task components. Hip flexion causes an unwanted forward pull on the ipsilateral ilium, which is counteracted by contralateral BF activity. To transfer this contralateral force toward ipsilateral, the lateral abdominal muscles press the ilia against the sacrum ("force closure"). Thus, problems with the ASLR may derive from problems with force closure. Also abdominal wall activity counteracts forward rotation of the ilium. Moreover, contralateral BF activity causes transverse plane rotation of the pelvis, often visible as an upward movement of the contralateral anterior superior iliac spine. Such transverse plane rotation is countered by ipsilateral TA and OI. The present study facilitates the understanding of what normally happens during the ASLR.
主动直腿抬高试验（ASLR）是诊断骨盆带疼痛（PGP）的一项重要检查。很难理解在ASLR过程中正常情况下会发生什么，更不用说在PGP中它为何会受损了。在本研究中，健康受试者在正常条件下、在脚踝上方增加重量以及佩戴骨盆带的情况下进行ASLR。用表面肌电图（EMG）记录腹部肌肉、股直肌（RF）和股二头肌（BF）的活动，用细针肌电图记录腹横肌（TA）的活动。RF在同侧活跃，BF在对侧活跃，腹部肌肉双侧活跃。增加重量时所有肌肉活动都增强，佩戴骨盆带时腹部肌肉活动减弱。在这两种情况下，TA和腹内斜肌（OI）的活动比腹外斜肌更不对称。腹部肌肉执行多项任务，结合了对称和不对称的任务成分。髋关节屈曲会对同侧髂骨产生不必要的向前拉力，这会被对侧BF的活动抵消。为了将这种对侧力传递到同侧，外侧腹部肌肉将髂骨压向骶骨（“力闭合”）。因此，ASLR的问题可能源于力闭合的问题。此外，腹壁活动可抵消髂骨的向前旋转。而且，对侧BF的活动会导致骨盆在横平面内旋转，通常表现为对侧髂前上棘向上移动。这种横平面旋转会被同侧TA和OI抵消。本研究有助于理解ASLR过程中正常情况下会发生什么。
