Kim Min-Hee, Yoo Won-Gyu
Institute of Health Science, Yonsei University, Wonju, Korea.
Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Gimhae, Korea.
Work. 2015 Jun 5;51(2):223-8. doi: 10.3233/WOR-141856.
Differences in LBP symptoms are particularly important with regard to the controversy over repositioning error because there can be considerable variation in the pattern of LBP symptoms in a heterogeneous LBP group. For this reason, several researchers have suggested that a study of subdivided LBP types is needed. Indeed, some recent studies have attempted to differentiate LBP subgroups.
This study used a comparative cross-sectional design to compare the lumbar flexion angle and repositioning error between people with and without LBP during a lumbar flexion-extension task.
The subjects were divided into three groups: a control group of 13 asymptomatic subjects, 13 LBP subjects with L4-5 pain associated with lumbar flexion, and 13 LBP subjects with L4-5 pain associated with lumbar extension. The subjects performed a lumbar flexion-extension task. Joint kinematics on the lumbar flexion angle and lumbar spine repositioning error were measured using a 3-D motion capture system.
The lumbar flexion angle of the LBP group with flexion pain was significantly greater than that of the asymptomatic group and the LBP group with extension pain. The difference in lumbar repositioning error was significantly greater in the LBP group with lumbar flexion pain than in the asymptomatic group.
This study suggests that lumbar hyper-mobility occurred and proprioception of the lumbar segment was decreased in people with LBP associated with lumbar flexion compared with people with LBP associated with lumbar extension. We also suggest that a lumbar repositioning error measurement using the lumbar flexion-extension test may be a more effective evaluation method in people with LBP associated with lumbar flexion than in those with LBP associated with lumbar extension.
鉴于在重新定位误差方面存在的争议，腰痛（LBP）症状的差异尤为重要，因为在异质性腰痛群体中，腰痛症状模式可能存在相当大的差异。因此，一些研究人员建议有必要对细分的腰痛类型进行研究。事实上，最近一些研究试图区分腰痛亚组。
本研究采用比较性横断面设计，比较在腰椎屈伸任务中，有和没有腰痛的人群之间的腰椎前屈角度和重新定位误差。
受试者分为三组：13名无症状受试者组成的对照组，13名伴有L4-5节段与腰椎前屈相关疼痛的腰痛受试者，以及13名伴有L4-5节段与腰椎后伸相关疼痛的腰痛受试者。受试者进行腰椎屈伸任务。使用三维运动捕捉系统测量腰椎前屈角度和腰椎重新定位误差的关节运动学数据。
伴有前屈疼痛的腰痛组的腰椎前屈角度显著大于无症状组和伴有后伸疼痛的腰痛组。伴有腰椎前屈疼痛的腰痛组的腰椎重新定位误差差异显著大于无症状组。
本研究表明，与伴有腰椎后伸相关疼痛的腰痛患者相比，伴有腰椎前屈相关疼痛的腰痛患者出现腰椎活动过度且腰椎节段本体感觉下降。我们还建议，对于伴有腰椎前屈相关疼痛的腰痛患者，使用腰椎屈伸试验测量腰椎重新定位误差可能是一种比伴有腰椎后伸相关疼痛的患者更有效的评估方法。
