Passmore Steven R, Johnson Michael, Pelleck Valerie, Ramos Erica, Amad Yasmine, Glazebrook Cheryl M
Assistant Professor, Canadian Chiropractic Research Foundation Professorship, Faculty of Medicine, School of Medical Rehabilitation, University of Manitoba, Winnipeg, Manitoba, Canada; Adjunct Assistant Professor, Research Department, New York Chiropractic College, Seneca Falls, NY.
Assistant Professor, University of Manitoba, Faculty of Medicine, Department of Surgery, Section of Orthopedics and Neurosurgery, Winnipeg, Manitoba, Canada.
J Manipulative Physiol Ther. 2014 Oct;37(8):602-9. doi: 10.1016/j.jmpt.2014.08.004. Epub 2014 Sep 8.
The primary objective of this study was to quantify the lower extremity movements and capabilities of a population with lumbar spinal stenosis (LSS) compared with healthy age-matched controls under conditions of strain and no strain. The secondary objective was to identify challenging movement conditions for a population with LSS, on a lower limb aiming task with different levels of difficulty, compared with healthy age-matched controls under conditions of strain and no strain.
Using a nonrandomized, controlled, before-and-after design, LSS patients (n = 16) and healthy controls (n = 16) performed 2 blocks of great toe-pointing movements to a series of projected squares. Following block 1, participants completed a 12-minute progressive exercise treadmill test. Pointing movements were analyzed using 3D motion analysis. Behavioral and kinematic measures evaluated performance.
Both groups' reaction times (RTs) lengthened as task difficulty increased. An interaction revealed that LSS patients were more adversely impacted by task difficulty, F (3,372) = 4.207; P = .006. The progressive exercise treadmill test facilitated RT for both groups, F (1,124) = 5.105; P = .026. Control participants showed less variability in time-to-peak velocity poststrain, a benefit not shared by LSS patients, t (31) = 2.149; P = .040.
A lower extremity movement task captured differences under strain between healthy and LSS populations. The lower extremity Fitts' Law task accurately measured differences between healthy and LSS participants. For the subjects in this study, strain was sufficient to prevent LSS patients from demonstrating improvement in the variability of the ballistic phase of movement execution, whereas LSS patients' movement performance remained unchanged. This study also showed that regardless of strain, as task difficulty increased, LSS patients were more adversely impacted in the planning and execution of their lower limb movements than healthy control participants. The lower extremity motor control task (Fitts' task) can be used as a performance-based outcome measure to measure differences between healthy and LSS populations.
本研究的主要目的是量化腰椎管狭窄症（LSS）患者与年龄匹配的健康对照组在有应变和无应变条件下的下肢运动及能力。次要目的是在有应变和无应变条件下，与年龄匹配的健康对照组相比，确定LSS患者在不同难度水平的下肢瞄准任务中具有挑战性的运动条件。
采用非随机、对照、前后设计，LSS患者（n = 16）和健康对照组（n = 16）对一系列投影方块进行2组大脚趾指向运动。在第1组之后，参与者完成了一项12分钟的渐进式运动跑步机测试。使用三维运动分析来分析指向运动。行为和运动学指标评估表现。
随着任务难度增加，两组的反应时间（RTs）均延长。交互作用表明，任务难度对LSS患者的负面影响更大，F（3,372）= 4.207；P = 0.006。渐进式运动跑步机测试使两组的RTs加快，F（1,124）= 5.105；P = 0.026。对照组参与者在应变后达到峰值速度的时间变异性较小，而LSS患者没有这种优势，t（31）= 2.149；P = 0.040。
一项下肢运动任务揭示了健康人群和LSS人群在应变情况下的差异。下肢菲茨定律任务准确测量了健康参与者和LSS参与者之间的差异。对于本研究中的受试者，应变足以阻止LSS患者在运动执行的弹道阶段变异性方面表现出改善，而LSS患者的运动表现保持不变。本研究还表明，无论有无应变，随着任务难度增加，LSS患者在下肢运动的计划和执行方面比健康对照参与者受到的负面影响更大。下肢运动控制任务（菲茨任务）可作为一种基于表现的结局指标，用于测量健康人群和LSS人群之间的差异。
