Penney Tracy, Ploughman Michelle, Austin Mark W, Behm David G, Byrne Jeannette M
Eastern Health Authority, St. John's, Newfoundland and Labrador, Canada.
Recovery and Performance Laboratory, Physical Medicine & Rehabilitation, Faculty of Medicine, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Canada.
Arch Phys Med Rehabil. 2014 Oct;95(10):1969-76. doi: 10.1016/j.apmr.2014.06.009. Epub 2014 Jun 30.
To determine the activation of the gluteus medius in persons with chronic, nonspecific low back pain compared with that in control subjects, and to determine the association of the clinical rating of the single leg stance (SLS) with chronic low back pain (CLBP) and gluteus medius weakness.
Cohort-control comparison.
Academic research laboratory.
Convenience sample of people (n=21) with CLBP (>12wk) recruited by local physiotherapists, and age- and sex-matched controls (n=22). Subjects who received specific pain diagnoses were excluded.
Not applicable.
Back pain using the visual analog scale (mm); back-related disability using the Oswestry Back Disability Index (%); strength of gluteus medius measured using a hand dynamometer (N/kg); SLS test; gluteus medius onset and activation using electromyography during unipedal stance on a forceplate.
Individuals in the CLBP group exhibited significant weakness in the gluteus medius compared with controls (right, P=.04; left, P=.002). They also had more pain (CLBP: mean, 20.50mm; 95% confidence interval [CI], 13.11-27.9mm; control subjects: mean, 1.77mm; 95% CI, -.21 to 3.75mm) and back-related disability (CLBP: mean, 18.52%; 95% CI, 14.46%-22.59%; control subjects: mean, .68%; 95% CI, -.41% to 1.77%), and reported being less physically active. Weakness was accompanied by increased gluteus medius activation during unipedal stance (R=.50, P=.001) but by no difference in muscle onset times. Although greater gluteus medius weakness was associated with greater pain and disability, there was no difference in muscle strength between those scoring positive and negative on the SLS test (right: F=.002, P=.96; left: F=.1.75, P=.19).
Individuals with CLBP had weaker gluteus medius muscles than control subjects without back pain. Even though there was no significant difference in onset time of the gluteus medius when moving to unipedal stance between the groups, the CLBP group had greater gluteus medius activation. A key finding was that a positive SLS test did not distinguish the CLBP group from the control group, nor was it a sign of gluteus medius weakness.
确定慢性非特异性下腰痛患者与对照组相比臀中肌的激活情况，并确定单腿站立（SLS）临床评分与慢性下腰痛（CLBP）及臀中肌无力之间的关联。
队列对照比较。
学术研究实验室。
由当地物理治疗师招募的CLBP（>12周）患者的便利样本（n = 21），以及年龄和性别匹配的对照组（n = 22）。排除接受特定疼痛诊断的受试者。
不适用。
使用视觉模拟量表（mm）评估背痛；使用Oswestry背部功能障碍指数（%）评估与背部相关的功能障碍；使用握力计（N/kg）测量臀中肌力量；SLS测试；在测力板上单腿站立期间使用肌电图测量臀中肌的起始和激活情况。
与对照组相比，CLBP组个体的臀中肌明显较弱（右侧，P = .04；左侧，P = .002）。他们也有更多疼痛（CLBP组：平均值，20.50mm；95%置信区间[CI]，13.11 - 27.9mm；对照组：平均值，1.77mm；95%CI， - 0.21至3.75mm）和与背部相关的功能障碍（CLBP组：平均值，18.52%；95%CI，14.46% - 22.59%；对照组：平均值，0.68%；95%CI， - 0.41%至1.77%），并且报告身体活动较少。在单腿站立期间，无力伴随着臀中肌激活增加（R = .50，P = .001），但肌肉起始时间无差异。尽管臀中肌无力程度越大与疼痛和功能障碍越严重相关，但SLS测试得分阳性和阴性的患者之间肌肉力量没有差异（右侧：F = .002，P = .96；左侧：F = 1.75，P = .19）。
与无背痛的对照组相比，CLBP患者的臀中肌较弱。尽管两组在单腿站立时臀中肌的起始时间没有显著差异，但CLBP组的臀中肌激活程度更高。一个关键发现是，SLS测试阳性并不能区分CLBP组和对照组，也不是臀中肌无力的标志。
