Arena John G, Sherman Richard A, Bruno Glenda M, Young Timothy R
Veterans Administration Medical Center, and Medical College of Georgia, Augusta, GA 30910 U.S.A. Fitzsimons Army Medical Center, Aurora, COU.S.A.
Pain. 1989 Apr;37(1):57-65. doi: 10.1016/0304-3959(89)90153-X.
Surface EMG recordings of bilateral paraspinal muscle tension were measured on 207 subjects (29 non-back pain controls, 20 individuals with spondyloarthritis, 52 with intervertebral disk disorders, 66 with unspecified musculoskeletal backache, 17 with some combination of the above 3 groups and 23 subjects with other types of back pain, including unknown, scoliosis and psychogenic) in 6 positions: standing, bending from the waist, rising, sitting with back unsupported, sitting with back supported and prone. Results of both individual and group analyses revealed a significant main effect of diagnosis. Post hoc analyses (Duncan's) revealed controls to have significantly lower overall EMG levels than the intervertebral disk disorders and unspecified musculoskeletal backache groups. A significant diagnosis by position interaction was observed. Analysis of simple main effects revealed this to be due primarily to control subjects during the standing position having lower EMG levels than all other groups, and intervertebral disk disorder subjects having higher EMG levels than all other groups during the supported sitting position. The importance of clearly defined diagnostic categories in low back pain research and the utility of measuring subjects in various positions are discussed.
在207名受试者(29名无背痛对照组、20名脊柱关节炎患者、52名椎间盘疾病患者、66名未明确的肌肉骨骼性背痛患者、17名上述3组情况的某种组合患者以及23名其他类型背痛患者,包括不明原因、脊柱侧弯和心因性背痛患者)身上,在6种姿势下测量了双侧椎旁肌张力的表面肌电图记录:站立、弯腰、起身、无支撑坐姿、有支撑坐姿和俯卧位。个体分析和组间分析结果均显示诊断具有显著的主效应。事后分析(邓肯检验)显示,对照组的整体肌电图水平显著低于椎间盘疾病组和未明确的肌肉骨骼性背痛组。观察到诊断与姿势存在显著交互作用。简单主效应分析表明,这主要是因为对照组在站立位时的肌电图水平低于所有其他组,而椎间盘疾病患者在有支撑坐姿时的肌电图水平高于所有其他组。文中讨论了在腰痛研究中明确定义诊断类别的重要性以及在不同姿势下测量受试者的实用性。