Bruno Paul
Assistant Professor and CCRF Research Chair in Neuromusculoskeletal Health, Faculty of Kinesiology and Health Studies, University of Regina.
J Can Chiropr Assoc. 2014 Jun;58(2):119-30.
It is well-established that the coordination of muscular activity in the lumbopelvic region is vital to the generation of mechanical spinal stability. Several models illustrating mechanisms by which dysfunctional neuromuscular control strategies may serve as a cause and/or effect of low back pain have been described in the literature. The term "core stability" is variously used by clinicians and researchers, and this variety has led to several rehabilitative approaches suggested to affect the neuromuscular control strategies of the lumbopelvic region (e.g. "stabilization exercise", "motor control exercise"). This narrative review will highlight: 1) the ongoing debate in the clinical and research communities regarding the terms "core stability" and "stabilization exercise", 2) the importance of sub-grouping in identifying those patients most likely to benefit from such therapeutic interventions, and 3) two protocols that can assist clinicians in this process.
腰椎骨盆区域肌肉活动的协调对于脊柱机械稳定性的产生至关重要,这一点已得到充分证实。文献中描述了几种模型,阐明了功能失调的神经肌肉控制策略可能作为腰痛的原因和/或结果的机制。临床医生和研究人员对“核心稳定性”一词的使用各不相同,这种多样性导致了几种旨在影响腰椎骨盆区域神经肌肉控制策略的康复方法(如“稳定化训练”“运动控制训练”)。本叙述性综述将强调:1)临床和研究界对“核心稳定性”和“稳定化训练”术语的持续争论;2)在确定最有可能从此类治疗干预中获益的患者时进行亚组划分的重要性;3)可在此过程中帮助临床医生的两种方案。