Janssens Lotte, McConnell Alison K, Pijnenburg Madelon, Claeys Kurt, Goossens Nina, Lysens Roeland, Troosters Thierry, Brumagne Simon
1KU Leuven Department of Rehabilitation Sciences, University of Leuven, Leuven, BELGIUM; 2Centre for Sports Medicine and Human Performance, Brunel University, Uxbridge, UNITED KINGDOM; 3KU Leuven Department of Rehabilitation Sciences, University of Leuven, Kulab, Bruges, BELGIUM; 4Department of Physical Medicine and Rehabilitation, University Hospitals Leuven, Leuven, BELGIUM; 5Respiratory Rehabilitation and Respiratory Division, University Hospitals Leuven, Leuven, BELGIUM.
Med Sci Sports Exerc. 2015 Jan;47(1):12-9. doi: 10.1249/MSS.0000000000000385.
We have shown that individuals with recurrent nonspecific low back pain (LBP) and healthy individuals breathing against an inspiratory load decrease their reliance on back proprioceptive signals in upright standing. Because individuals with LBP show greater susceptibility to diaphragm fatigue, it is reasonable to hypothesize that LBP, diaphragm dysfunction, and proprioceptive use may be interrelated. The purpose of this study was to investigate whether inspiratory muscle training (IMT) affects proprioceptive use during postural control in individuals with LBP.
Twenty-eight individuals with LBP were assigned randomly into a high-intensity IMT group (high IMT) and low-intensity IMT group (low IMT). The use of proprioception in upright standing was evaluated by measuring center of pressure displacement during local muscle vibration (ankle, back, and ankle-back). Secondary outcomes were inspiratory muscle strength, severity of LBP, and disability.
After high IMT, individuals showed smaller responses to ankle muscle vibration, larger responses to back muscle vibration, higher inspiratory muscle strength, and reduced LBP severity (P < 0.05). These changes were not seen after low IMT (P > 0.05). No changes in disability were observed in either group (P > 0.05).
After 8 wk of high IMT, individuals with LBP showed an increased reliance on back proprioceptive signals during postural control and improved inspiratory muscle strength and severity of LBP, not seen after low IMT. Hence, IMT may facilitate the proprioceptive involvement of the trunk in postural control in individuals with LBP and thus might be a useful rehabilitation tool for these patients.
我们已经表明，患有复发性非特异性腰痛（LBP）的个体以及在吸气负荷下呼吸的健康个体在直立站立时会减少对背部本体感觉信号的依赖。由于LBP个体对膈肌疲劳表现出更高的易感性，因此合理推测LBP、膈肌功能障碍和本体感觉的使用可能相互关联。本研究的目的是调查吸气肌训练（IMT）是否会影响LBP个体在姿势控制过程中本体感觉的使用。
28名LBP个体被随机分为高强度IMT组（高IMT组）和低强度IMT组（低IMT组）。通过测量局部肌肉振动（脚踝、背部和脚踝 - 背部）期间的压力中心位移来评估直立站立时本体感觉的使用情况。次要结果包括吸气肌力量、LBP严重程度和残疾情况。
高IMT后，个体对脚踝肌肉振动的反应较小，对背部肌肉振动的反应较大，吸气肌力量增强，LBP严重程度降低（P < 0.05）。低IMT后未观察到这些变化（P > 0.05）。两组的残疾情况均未发生变化（P > 0.05）。
经过8周的高IMT后，LBP个体在姿势控制过程中对背部本体感觉信号的依赖增加，吸气肌力量和LBP严重程度得到改善，低IMT后未出现这些情况。因此，IMT可能有助于LBP个体在姿势控制中躯干的本体感觉参与，从而可能是这些患者有用的康复工具。
