Dolan P, Adams M A
Comparative Orthopaedic Research Unit, University of Bristol, UK.
Clin Biomech (Bristol). 1993 Jul;8(4):185-92. doi: 10.1016/0268-0033(93)90013-8.
Bending and lifting activities are associated with injury to the lumbar discs and ligaments, and cadaveric experiments suggest that this damage is most attributable to a high bending moment (bending stress) acting on the osteoligamentous spine. We examined the hypothesis that people with poor sagittal mobility in the lumbar spine and hips apply higher bending stresses to their spines during everyday lifting activities. Forty-nine subjects performed a series of simple forward bending and lifting exercises while their lumbar flexion was measured continuously using a skin-surface technique (3-space isotrak). Peak flexion angles were compared with the bending properties of cadaveric osteoligamentous spines in order to calculate the peak bending moment (bending stress) acting on the lumbar spine during each exercise. All subjects flattened or reversed their lumbar lordosis when lifting, and most came close to or exceeded their static in vivo limit of lumbar flexion in many of the activities. The bending moment acting on the lumbosacral junction rose to about 30 Nm, which is about 50% of that required to cause injury in a single lift. Bending moments were significantly lower in subjects who had good sagittal mobility in the lumbar spine. Good hip mobility was similarly associated with a reduction in bending moment, but this reached significance only in subjects who reported a history of low back pain.
弯腰和提举活动与腰椎间盘及韧带损伤相关，尸体实验表明这种损伤主要归因于作用于骨韧带脊柱的高弯矩（弯曲应力）。我们检验了这样一个假设：腰椎和髋部矢状面活动度较差的人在日常提举活动中会对其脊柱施加更高的弯曲应力。49名受试者进行了一系列简单的前屈和提举练习，同时使用一种皮肤表面技术（3空间isotrak）连续测量其腰椎前屈情况。将峰值前屈角度与尸体骨韧带脊柱的弯曲特性进行比较，以便计算每次练习期间作用于腰椎的峰值弯矩（弯曲应力）。所有受试者在提举时都会使腰椎前凸变平或反向，并且在许多活动中，大多数人接近或超过了其在体内的静态腰椎前屈极限。作用于腰骶关节的弯矩升至约30牛米，这约为单次提举造成损伤所需弯矩的50%。腰椎矢状面活动度良好的受试者的弯矩明显更低。髋部活动度良好同样与弯矩降低相关，但这仅在有腰痛病史的受试者中具有统计学意义。
