Bernard J-C, Boudokhane S, Pujol A, Chaléat-Valayer E, Le Blay G, Deceuninck J
Service enfants-adolescents, département de médecine physique et réadaptation, Croix Rouge française, centre médico-chirurgical de réadaptation des Massues, 92, rue Edmond-Locard, 69322 Lyon cedex 05, France.
Service enfants-adolescents, département de médecine physique et réadaptation, Croix Rouge française, centre médico-chirurgical de réadaptation des Massues, 92, rue Edmond-Locard, 69322 Lyon cedex 05, France.
Ann Phys Rehabil Med. 2014 Feb;57(1):38-54. doi: 10.1016/j.rehab.2013.10.004. Epub 2013 Nov 7.
To assess with an isokinetic dynamometer the force and endurance of the spinal flexor and extensor muscles in pre-teens or teens aged 11 to 13 and 14 to 16 years with and without low back pain (LBP).
The control group and the LBP group were homogeneous in terms of age, weight, height and Body Mass Index (BMI). Assessment was carried out with the isokinetic dynamometer Cybex Norm®. The spinal flexors and extensors were explored concentrically at speeds of 60°, 90° and 120°/sec. The parameters chosen were: maximal moment of force (MMF), mean power (MP), total work (TW), F/E ratios (between the flexors and the extensors for the aforesaid parameters). In the LBP groups, clinical information (pain, extensibility of the spinal and sub-pelvic muscles, sports practice) and sagittal radiological data were all measured.
While no significant difference in isokinetic performance was found between asymptomatic and LBP children in the 11-to-13-year-old group, the isokinetic performances of the LBP children were influenced positively by BMI value, number of hours of physical activity and radiologic value of the lumbar lordosis. As regards these pre-teens, assessment with an isokinetic dynamometer does not highlight muscle characteristics that might explain LBP occurrence. As regards the 14-to-16-year-old group, muscle strength has been found to be correlated with age. LBP teens were showed to have weaker extensors and stronger flexors than the healthy teens. It is with regard to this age group that assessment with an isokinetic dynamometer clearly yields interesting results. Since we have yet to standardize our evaluation criteria (working speed, number of trials…), it is difficult to compare our results with those reported in the literature.
This is a preliminary study involving a relatively low number of patients. That said, given the fact that numerous parameters are connected with the age and height of the subjects, assessment with an isokinetic dynamometer can be constructively carried out from the age of 14. In order to further enhance understanding of this phenomenon, a longitudinal and comparative study of a larger group is needed.
使用等速测力计评估11至13岁以及14至16岁有和无下腰痛（LBP）的青少年脊柱屈伸肌的力量和耐力。
对照组和LBP组在年龄、体重、身高和体重指数（BMI）方面具有同质性。使用Cybex Norm®等速测力计进行评估。脊柱屈伸肌在60°、90°和120°/秒的速度下进行同心测试。选择的参数为：最大力矩（MMF）、平均功率（MP）、总功（TW）、F/E比值（上述参数中屈伸肌之间的比值）。在LBP组中，测量临床信息（疼痛、脊柱和骨盆下肌肉的伸展性、体育锻炼情况）和矢状面放射学数据。
在11至13岁组中，无症状儿童和LBP儿童在等速运动表现上未发现显著差异，LBP儿童的等速运动表现受到BMI值、体育活动小时数和腰椎前凸放射学值的积极影响。对于这些青少年，使用等速测力计评估并未突出可能解释LBP发生的肌肉特征。在14至16岁组中，发现肌肉力量与年龄相关。LBP青少年的伸肌比健康青少年弱，屈肌比健康青少年强。正是在这个年龄组中，使用等速测力计评估明显产生了有趣的结果。由于我们尚未标准化评估标准（工作速度、试验次数……），因此难以将我们的结果与文献中报道的结果进行比较。
这是一项涉及患者数量相对较少的初步研究。话虽如此，鉴于众多参数与受试者的年龄和身高相关，从14岁起就可以建设性地使用等速测力计进行评估。为了进一步加深对这一现象的理解，需要对更大的群体进行纵向和比较研究。
