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不同类型下腰痛患者腰骶关节节律性和屈伸反应的比较

Comparison of lumbopelvic rhythm and flexion-relaxation response between 2 different low back pain subtypes.

机构信息

Institute of Health Science, Yonsei University, Wonju, Gangwon-do, Republic of Korea.

出版信息

Spine (Phila Pa 1976). 2013 Jul 1;38(15):1260-7. doi: 10.1097/BRS.0b013e318291b502.

Abstract

STUDY DESIGN

A cross-sectional study to compare the kinematics and muscle activities during trunk flexion and return task in people with and without low back pain (LBP).

OBJECTIVE

To characterize the lumbopelvic rhythms during trunk flexion and return task in a group of healthy persons and 2 different subgroups of patients with LBP, identifying the flexion-relaxation (FR) responses in each group.

SUMMARY OF BACKGROUND DATA

The lumbopelvic rhythm is the coordinated movement of the lumbar spine and hip during trunk flexion and return and is a clinical sign of LBP. However, the reported patterns of lumbopelvic rhythm in patients with LBP are inconsistent, possibly because previous studies have examined a heterogeneous group of patients with LBP. To clarify the lumbopelvic rhythm patterns, it is necessary to study more homogeneous subgroups of patients with LBP.

METHODS

The study involved the following subjects: control group of healthy subjects (N = 16); lumbar flexion with rotation syndrome (LFRS) LBP subgroup (N = 17); and lumbar extension with rotation syndrome (LERS) LBP subgroup (N = 14). The kinematic parameters during the trunk flexion and return task were recorded using a 3-dimensional motion capture system, and the FR ratio of the erector spinae muscle was measured.

RESULTS

The flexion angle of the lumbar spine was larger in the LFRS subgroup than in the control group and the LERS LBP subgroup, and the hip flexion angle was larger in the LERS LBP subgroup than in the control group and LFRS subgroup. The FR response of the erector spinae muscle disappeared in the LFRS and LERS LBP subgroups.

CONCLUSION

These results show that the lumbopelvic rhythms are different among healthy subjects and patients assigned to 2 specific LBP subgroups. These results provide information on the FR response of the erector spinae muscle.

摘要

研究设计

一项横断面研究,旨在比较腰痛(LBP)患者和无腰痛患者在躯干屈伸和返回任务中的运动学和肌肉活动。

目的

描述一组健康个体和 2 个不同 LBP 亚组患者在躯干屈伸和返回任务中的腰骨盆节律,确定每组的屈伸松弛(FR)反应。

背景资料总结

腰骨盆节律是躯干屈伸和返回过程中腰椎和髋关节的协调运动,是 LBP 的临床征象。然而,先前研究中报告的 LBP 患者腰骨盆节律模式不一致,可能是因为之前的研究检查了异质的 LBP 患者群体。为了阐明腰骨盆节律模式,有必要对更同质的 LBP 患者亚组进行研究。

方法

研究对象包括:健康对照组(N=16);腰椎前屈伴旋转综合征(LFRS)LBP 亚组(N=17);腰椎后伸伴旋转综合征(LERS)LBP 亚组(N=14)。使用三维运动捕捉系统记录躯干屈伸任务过程中的运动学参数,并测量竖脊肌的 FR 比值。

结果

LFRS 亚组的腰椎前屈角度大于健康对照组和 LERS LBP 亚组,LERS LBP 亚组的髋关节前屈角度大于健康对照组和 LFRS 亚组。LFRS 和 LERS LBP 亚组的竖脊肌 FR 反应消失。

结论

这些结果表明,健康个体和被分配到 2 个特定 LBP 亚组的患者之间的腰骨盆节律不同。这些结果提供了竖脊肌 FR 反应的信息。

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