Frost Lydia R, Brown Stephen H M
Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada.
Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada.
Clin Biomech (Bristol). 2016 Feb;32:124-30. doi: 10.1016/j.clinbiomech.2015.12.001. Epub 2015 Dec 14.
Patients with chronic low back pain and associated radiculopathy present with neuromuscular symptoms both in their lower back and down their leg; however, investigations of muscle activation have so far been isolated to the lower back. During balance perturbations, it is necessary that lower limb muscles activate with proper timing and sequencing along with the lower back musculature to efficiently regain balance control.
Patients with chronic low back pain and radiculopathy and matched controls completed a series of balance perturbations (rapid bilateral arm raise, unanticipated and anticipated sudden loading, and rapid rise to toe). Muscle activation timing and sequencing as well as kinetic response to the perturbations were analyzed.
Patients had significantly delayed lower limb muscle activation in rapid arm raise trials as compared to controls. In sudden loading trials, muscle activation timing was not delayed in patients; however, some differences in posterior chain muscle activation sequencing were present. Patients demonstrated less anterior-posterior movement in unanticipated sudden loading trials, and greater medial-lateral movement in rise to toe trials.
Patients with low back pain and radiculopathy demonstrated some significant differences from control participants in terms of muscle activation timing, sequencing, and overall balance control. The presence of differences between patients and controls, specifically in the lower limb, indicates that radiculopathy may play a role in altering balance control in these patients.
患有慢性下腰痛及相关神经根病的患者，其下背部和腿部均会出现神经肌肉症状；然而，迄今为止，对肌肉激活的研究仅局限于下背部。在平衡扰动期间，下肢肌肉有必要与下背部肌肉组织同步且按适当的顺序激活，以便有效地重新获得平衡控制。
患有慢性下腰痛和神经根病的患者及匹配的对照组完成了一系列平衡扰动测试（快速双侧举臂、意外和预期的突然加载以及快速踮脚起身）。分析了肌肉激活的时间和顺序以及对扰动的动力学反应。
与对照组相比，在快速举臂测试中，患者下肢肌肉激活明显延迟。在突然加载测试中，患者的肌肉激活时间未延迟；然而，后链肌肉激活顺序存在一些差异。在意外突然加载测试中，患者的前后向移动较少，而在踮脚起身测试中，患者的内外侧移动较多。
患有下腰痛和神经根病的患者在肌肉激活时间、顺序和整体平衡控制方面与对照组存在一些显著差异。患者与对照组之间存在差异，特别是在下肢，这表明神经根病可能在改变这些患者的平衡控制方面发挥作用。
