Müller Roy, Ertelt Thomas, Blickhan Reinhard
Motionscience, Institute of Sport Sciences, Friedrich-Schiller University Jena, Seidelstraße 20, 07749 Jena, Germany.
Hochschule für Gesundheit und Sport, Technik und Kunst, Vulkanstraße 1, 10367 Berlin, Germany.
J Biomech. 2015 Apr 13;48(6):1009-14. doi: 10.1016/j.jbiomech.2015.01.042. Epub 2015 Feb 7.
Up to now, most gait analyses on low back pain concentrate on changes in trunk coordination during walking on a treadmill. Locomotion on uneven ground as well as lower limb changes receives little attention in association with low back pain. The present study focuses on how chronic non-specific low back pain causes modifications in lower limb and trunk movements, in level and uneven walking and running. We found that trunk as well as lower limb movement was influenced by chronic non-specific low back pain. A consistent finding across all gaits and ground level changes is that patients with chronic non-specific low back pain show less pelvis and unchanged thorax rotation as compared to healthy controls. Furthermore, in chronic non-specific low back pain patients the trunk rotation decreased only during level and uneven running whereas the sagittal trunk inclination at touchdown increased only during uneven walking as compared to healthy controls. Besides significant changes in the upper body, in chronic non-specific low back pain patients the knee joint angle at touchdown was more extended during level walking but also during uneven walking and running as compared to healthy controls. We assume that trunk movements interact with lower limb movements or vice versa. Therefore, we recommend that further investigations on low back pain should consider both trunk (primarily pelvis) and lower limb (primarily knee) movements.
到目前为止，大多数针对腰痛的步态分析都集中在跑步机上行走时躯干协调性的变化。在与腰痛相关的研究中，不平地面上的行走以及下肢变化很少受到关注。本研究关注慢性非特异性腰痛如何导致在平路和不平路面行走及跑步时下肢和躯干运动的改变。我们发现慢性非特异性腰痛会影响躯干以及下肢的运动。在所有步态和地面状况变化中一致的发现是，与健康对照组相比，慢性非特异性腰痛患者的骨盆旋转减少，胸廓旋转不变。此外，与健康对照组相比，慢性非特异性腰痛患者仅在平路和不平路面跑步时躯干旋转减少，而在不平路面行走时着地瞬间矢状面躯干倾斜度增加。除了上半身的显著变化外，与健康对照组相比，慢性非特异性腰痛患者在平路行走时以及在不平路面行走和跑步时着地瞬间膝关节角度伸展得更多。我们假设躯干运动与下肢运动相互作用，反之亦然。因此，我们建议对腰痛的进一步研究应同时考虑躯干（主要是骨盆）和下肢（主要是膝关节）的运动。
