Sánchez-Zuriaga Daniel, López-Pascual Juan, Garrido-Jaén David, García-Mas Maria Amparo
Associate Professor, Department of Anatomy and Human Embryology, Universitat de València, Valencia, Spain.
Researcher, Research and Development Area, Instituto de Biomecánica de Valencia, Valencia, Spain.
J Manipulative Physiol Ther. 2015 Feb;38(2):130-7. doi: 10.1016/j.jmpt.2014.11.002. Epub 2014 Dec 12.
OBJECTIVES: The purpose of this study was to determine the patterns of lumbopelvic motion and erector spinae (ES) activity during trunk flexion-extension movements and to compare these patterns between patients with recurrent low back pain (LBP) in their pain-free periods and matched asymptomatic subjects. METHODS: Thirty subjects participated (15 patients with disc herniation and recurrent LBP in their pain-free periods and 15 asymptomatic control subjects). A 3-dimensional videophotogrammetric system and surface electromyography (EMG) were used to record the angular displacements of the lumbar spine and hip in the sagittal plane and the EMG activity of the ES during standardized trunk flexion-extension cycles. Variables were maximum ranges of spine and hip flexion; percentages of maximum lumbar and hip flexion at the start and end of ES relaxation; average percentages of EMG activity during flexion, relaxation, and extension; and flexion-extension ratio of myoelectrical activity. RESULTS: Recurrent LBP patients during their pain-free period showed significantly greater ES activation both in flexion and extension, with a higher flexion-extension ratio than controls. Maximum ranges of lumbar and hip flexion showed no differences between controls and patients, although patients spent less time with their lumbar spine maximally flexed. CONCLUSIONS: This study showed that reduced maximum ranges of motion and absence of ES flexion-relaxation phenomenon were not useful to identify LBP patients in the absence of acute pain. However, these patients showed subtle alterations of their lumbopelvic motion and ES activity patterns, which may have important clinical implications.
目的:本研究旨在确定躯干屈伸运动过程中腰骨盆运动模式和竖脊肌(ES)活动情况,并比较复发性下腰痛(LBP)患者无痛期与匹配的无症状受试者之间的这些模式。 方法:30名受试者参与研究(15名无痛期椎间盘突出和复发性LBP患者以及15名无症状对照受试者)。使用三维视频摄影测量系统和表面肌电图(EMG)记录标准化躯干屈伸周期中腰椎和髋关节在矢状面的角位移以及ES的EMG活动。变量包括脊柱和髋关节最大屈曲范围;ES放松开始和结束时腰椎和髋关节最大屈曲的百分比;屈伸和伸展过程中EMG活动的平均百分比;以及肌电活动的屈伸比。 结果:无痛期复发性LBP患者在屈伸时均表现出明显更大的ES激活,屈伸比高于对照组。对照组和患者之间腰椎和髋关节最大屈曲范围无差异,尽管患者腰椎最大屈曲的时间较短。 结论:本研究表明,在无急性疼痛的情况下,运动范围减小和ES屈伸放松现象的缺失对识别LBP患者并无帮助。然而,这些患者的腰骨盆运动和ES活动模式存在细微改变,这可能具有重要的临床意义。
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