Ghamkhar Leila, Kahlaee Amir Hossein
Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran(∗).
Department of Physical Therapy, University of Social Welfare and Rehabilitation Sciences, Koodakyar street, Daneshjoo Blvd., Evin., Postal Code: 1985713831, Tehran, Iran(†).
PM R. 2015 May;7(5):519-26. doi: 10.1016/j.pmrj.2015.01.013. Epub 2015 Jan 26.
The purpose of this study was to identify how activity patterns of trunk muscles change in chronic LBP during walking. TYPE: This was a systematic review
ELSEVIER, Pro Quest, PubMed, Google scholar and MEDLINE electronic databases were explored for the period from the earliest researchable time to August 2014. Articles investigating patients with chronic LBP and analyzing trunk muscles with surface electromyography (EMG) during walking were included.
All studies had a case-control design. Characteristics of the LBP patients, sample size, studied muscles and EMG parameters, and gait condition and velocity were investigated. Studies were rated as "A" to "E" (5 grades defined) based on study design and performance.
Multifidus (MF), erector spinae (ES), external oblique (EO), and rectus abdominus (RA) muscle activity level were found to be increased in LBP subjects in comparison with controls. ES activity in subjects with LBP was found not to be as adaptive to walking velocity alterations as in healthy controls.
Individuals with chronic LBP exhibit higher global trunk muscle activity. However, the activation pattern appears to vary depending on subphases of gait. It seems that increased walking velocity challenges the stability of the spine and the control system increases muscular activation and variability level to cope with this problem. Further standardized studies with subtyped LBP cases are needed to clarify the controversial findings.
本研究旨在确定慢性下腰痛患者在行走过程中躯干肌肉的活动模式是如何变化的。
这是一项系统评价。
检索了爱思唯尔、Pro Quest、PubMed、谷歌学术和MEDLINE电子数据库，检索时间从最早可检索到的时间至2014年8月。纳入了调查慢性下腰痛患者并在行走过程中使用表面肌电图（EMG）分析躯干肌肉的文章。
所有研究均采用病例对照设计。调查了下腰痛患者的特征、样本量、所研究的肌肉和EMG参数，以及步态状况和速度。根据研究设计和表现，将研究评为“A”至“E”（共定义了5个等级）。
与对照组相比，发现多裂肌（MF）、竖脊肌（ES）、腹外斜肌（EO）和腹直肌（RA）的肌肉活动水平在下腰痛受试者中有所增加。发现下腰痛受试者的ES活动不像健康对照组那样能适应行走速度的改变。
慢性下腰痛患者表现出更高的整体躯干肌肉活动。然而，激活模式似乎因步态的不同阶段而有所变化。似乎行走速度的增加对脊柱稳定性构成挑战，控制系统会增加肌肉激活和变异性水平以应对这一问题。需要对下腰痛病例进行进一步的标准化研究以阐明有争议的研究结果。
