Radwan Ahmed, Bigney Kyle A, Buonomo Haily N, Jarmak Michael W, Moats Shannon M, Ross Jaimie K, Tatarevic Enida, Tomko Mary Anne
Physical Therapy Program, Utica College, Utica, NY, USA.
J Back Musculoskelet Rehabil. 2015;28(1):61-66. doi: 10.3233/BMR-140490.
To evaluate the extent of intra-subject difference in hamstring flexibility and its possible relationship to the severity of Low Back Pain (LBP). A secondary purpose was to evaluate the extent of intra-rater reliability using both electrogoniometer and conventional goniometer for measuring hamstring tightness.
Potential correlations between muscle impairments and LBP may lead to more effective treatments and prevention strategies.
Seventy two participants with mechanical LBP were recruited for this study. The sample included; 41 females, 31 males with a mean age of 33.69 ± (11.04) years, height of 170 ± (9) cm, and weight of 79.5 ± (1.6) kg. Hamstring length was detected indirectly using the Active Knee Extension method in the 90/90 position from supine. The amount of extension was measured using both electro-goniometer (EG)and a standard goniometer (SG).
Right lower extremities of these patients were significantly more flexible than left ones at α=0.025 (t72=3.14,p=0.002). Similarly, dominant lower extremities of these patients were significantly more flexible than the non dominant ones at α=0.025 (t72=2.56,p=0.013). Additionally, Oswestry scores of the patients were significantly and positively correlated with the amount of hamstring tightness of the right lower extremities (r=0.244,p=0.039), left lower extremities (r=0.225,p=0.048) and the average of both sides (r=0.24,p=0.039). However, the Oswestry scores were negatively, but insignificantly correlated to the absolute difference between right and left extremities at (r=-0.156,p=0.091). Finally, the extent of intrasubject reliability in measuring hamstring tightness using EG and SG was found to be high (ICC=0.93).
There is a possible relation between mild mechanical LBP and hamstrings tightness. It was found that the more the tightness, the higher the severity of LBP that patient experienced. Also, these patients had one of their lower extremities significantly tighter than the other. Such tightness was successfully detected utilizing both EG and SG. These findings and their possible pathomechanical consequences should be considered while constructing effective rehabilitation protocols for patients with mechanical LBP.
评估绳肌柔韧性的个体内差异程度及其与下腰痛（LBP）严重程度的可能关系。次要目的是评估使用电子测角仪和传统测角仪测量绳肌紧张度时评估者内信度的程度。
肌肉损伤与LBP之间的潜在相关性可能会带来更有效的治疗和预防策略。
招募了72名患有机械性LBP的参与者进行本研究。样本包括；41名女性，31名男性，平均年龄33.69±（11.04）岁，身高170±（9）厘米，体重79.5±（1.6）千克。在仰卧位的90/90位置使用主动膝关节伸展法间接检测绳肌长度。使用电子测角仪（EG）和标准测角仪（SG）测量伸展量。
在α=0.025时，这些患者的右下肢比左下肢明显更灵活（t72=3.14，p=0.002）。同样，在α=0.025时，这些患者的优势下肢比非优势下肢明显更灵活（t72=2.56，p=0.013）。此外，患者的Oswestry评分与右下肢（r=0.244，p=0.039）、左下肢（r=0.225，p=0.048）以及双侧平均值的绳肌紧张度显著正相关（r=0.24，p=0.039）。然而，Oswestry评分与左右下肢之间的绝对差异呈负相关，但不显著（r=-0.156，p=0.091）。最后，发现使用EG和SG测量绳肌紧张度时个体内信度程度较高（ICC=0.93）。
轻度机械性LBP与绳肌紧张度之间可能存在关联。发现紧张度越高，患者经历的LBP严重程度越高。此外，这些患者的一条下肢明显比另一条更紧。使用EG和SG均成功检测到了这种紧张度。在为机械性LBP患者制定有效的康复方案时，应考虑这些发现及其可能的病理力学后果。
