Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hunghom, Kowloon, Hong Kong SAR,
Exp Brain Res. 2013 Nov;231(3):305-13. doi: 10.1007/s00221-013-3692-0. Epub 2013 Sep 14.
Repeated measures design. This study examined recovery of postural equilibrium (centre of pressure (COP) excursion, time to recover balance, and the number of postural adjustments) following unexpected support surface perturbation in healthy participants with and without a rigid lumbar corset to reduce lumbar motion. Lumbar spine movement is thought to aid postural stability, especially when a "hip" (lumbopelvic) strategy is required, such as in response to large and fast perturbations. Delayed onset of lumbar spine movement in association with prolonged postural recovery in chronic low back pain implies reduced spinal motion could underpin balance deficits in this group. However, other explanations such as poor proprioception cannot be excluded, and the relationship between lumbar movement and postural stability remains unclear. We hypothesized restricted lumbar spine movement would impair control of postural recovery following support surface perturbation. Participants regained postural stability following unexpected support surface perturbations in different directions (forward and backward), with different amplitudes (small, medium, and large), with and without restriction of spine motion by a hard lumbar corset. Although the latency of the postural adjustment was unaffected by the corset, the quality of postural recovery was compromised (increased COP range, time taken for postural recovery, and number of postural adjustments) during recovery, especially in response to large perturbation. Restriction of lumbar spine movement adversely affects postural recovery. The results suggest movement of the lumbar spine, although small in amplitude, is critical for efficient recovery of standing balance.
重复测量设计。本研究旨在观察在健康参与者中,使用和不使用刚性腰椎束带减少腰椎运动,以恢复意外支撑面扰动后的姿势平衡(压力中心(COP)偏移、恢复平衡所需的时间和姿势调整的次数)。腰椎运动被认为有助于姿势稳定性,特别是在需要“髋部”(腰骶)策略时,例如对大而快的扰动的反应。慢性下腰痛患者中,腰椎运动延迟与姿势恢复延长相关,这意味着脊柱运动减少可能是该组平衡缺陷的基础。然而,不能排除其他解释,如本体感觉差,并且腰椎运动与姿势稳定性之间的关系仍不清楚。我们假设限制腰椎运动将损害对支撑面扰动后姿势恢复的控制。参与者在不同方向(向前和向后)、不同幅度(小、中、大)下意外地受到支撑面扰动后恢复姿势稳定,同时通过硬腰椎束带限制脊柱运动。尽管束带对姿势调整的潜伏期没有影响,但在恢复期间(尤其是对大扰动的反应),姿势恢复的质量受到影响(COP 范围增加、恢复平衡所需的时间和姿势调整的次数增加)。限制腰椎运动对姿势恢复产生不利影响。结果表明,腰椎运动虽然幅度较小,但对站立平衡的有效恢复至关重要。