Hasebe Kiyotaka, Sairyo Koichi, Hada Yasushi, Dezawa Akira, Okubo Yu, Kaneoka Koji, Nakamura Yoshio
Department of Rehabilitation, Teikyo University Mizonokuchi Hospital, Kawasaki, Japan.
Faculty of Sports Science, Waseda University, Tokorozawa, Japan.
Eur J Orthop Surg Traumatol. 2014 Jul;24(Suppl 1):193-199. doi: 10.1007/s00590-013-1303-1. Epub 2013 Oct 12.
A strong correlation between low back pain and tight hamstrings has been reported. However, the effect of tight hamstrings on spinal biomechanics remains unclear. The purpose of the study was to investigate spino-pelvic-rhythm during forward bending of the trunk and to clarify the rhythm features with regard to hamstrings tightness. Eighteen healthy male adults with no history of low back pain volunteered to participate. First, we measured the finger-to-floor distance (FFD) in the upright position and set this parameter to 100 %. Using a spinal mouse, spinal alignment was measured in the following four positions: (1) upright posture-100 % FFD; (2) forward bending-50 % FFD; (3) forward bending-25 % FFD; and (4) forward bending-0 % FFD (fingers in contact with the floor). Changes of the angle of the thoracic and lumbar spine as well as the pelvis were calculated. As an indicator of tight hamstrings, we measured straight leg raising (SLR) angle. From positions 1-2 (phase I), the entire spino-pelvic angle moved in 104°. During this phase, the lumbar spine mainly moved. In the second phase (positions 2-3), it moved in 16°. Interestingly, all but 2 subjects showed a negative angle in the thoracic motion, meaning that the thoracic spine extended 4° during trunk flexion, thus exhibiting paradoxical motion. During this phase, lumbopelvic rhythm showed 2 patterns. In 7 subjects, pelvic motion was greater than lumbar motion, while the remaining subjects showed the opposite. In subjects without tight hamstrings, 83 % showed a pelvis-dominant pattern. Only 7 subjects were capable of position 4. During this phase, only slight motion was noted in the spine, and the majority of the motion occurred in the pelvis. Lumbar and pelvic motion correlated negatively in all phases. SLR angle and pelvic motion correlated strongly during phase III, indicating dominant pelvic movement in flexible subjects. The lumbo-pelvic-rhythm comprises 2 patterns-lumbar dominant and pelvis dominant. In flexible subjects, pelvis movement was dominant. In conclusion, improving tight hamstrings may reduce lumbar loading thereby reducing low back pain.
已有报道称下背痛与腘绳肌紧张之间存在密切关联。然而，腘绳肌紧张对脊柱生物力学的影响仍不明确。本研究的目的是调查躯干前屈时的脊柱 - 骨盆节律，并阐明与腘绳肌紧张度相关的节律特征。18名无下背痛病史的健康成年男性志愿者参与了研究。首先，我们测量了直立位时手指到地面的距离（FFD），并将该参数设定为100%。使用脊柱鼠标，在以下四个位置测量脊柱排列：（1）直立姿势 - 100% FFD；（2）前屈 - 50% FFD；（3）前屈 - 25% FFD；以及（4）前屈 - 0% FFD（手指接触地面）。计算胸椎、腰椎以及骨盆角度的变化。作为腘绳肌紧张度的指标，我们测量了直腿抬高（SLR）角度。从位置1到2（第一阶段），整个脊柱 - 骨盆角度移动了104°。在此阶段，主要是腰椎移动。在第二阶段（位置2到3），移动了16°。有趣的是，除2名受试者外，所有受试者的胸椎运动角度均为负值，这意味着在躯干屈曲时胸椎伸展了4°，从而呈现出反常运动。在此阶段，腰骶骨盆节律呈现出2种模式。7名受试者中，骨盆运动大于腰椎运动，而其余受试者则相反。在没有腘绳肌紧张的受试者中，83%呈现出以骨盆为主导的模式。只有7名受试者能够达到位置4。在此阶段，脊柱仅出现轻微运动，大部分运动发生在骨盆。在所有阶段，腰椎和骨盆运动呈负相关。在第三阶段，SLR角度与骨盆运动密切相关，表明在柔韧性较好的受试者中骨盆运动占主导。腰骶骨盆节律包括2种模式——腰椎主导型和骨盆主导型。在柔韧性较好的受试者中，骨盆运动占主导。总之，改善腘绳肌紧张可能会减轻腰椎负荷，从而减轻下背痛。
