Shojaei Iman, Salt Elizabeth G, Hooker Quenten, Van Dillen Linda R, Bazrgari Babak
F. Joseph Halcomb III, M.D. Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506, USA.
College of Nursing, University of Kentucky, Lexington, KY 40506, USA.
Clin Biomech (Bristol). 2017 Jan;41:66-71. doi: 10.1016/j.clinbiomech.2016.12.005. Epub 2016 Dec 10.
Prior studies have reported differences in lumbo-pelvic kinematics during a trunk forward bending and backward return task between individuals with and without chronic low back pain; yet, the literature on lumbo-pelvic kinematics of patients with acute low back pain is scant. Therefore, the purpose of this study was set to investigate lumbo-pelvic kinematics in this cohort.
A case-control study was conducted to investigate the differences in pelvic and thoracic rotation along with lumbar flexion as well as their first and second time derivatives between females with and without acute low back pain. Participants in each group completed one experimental session wherein they performed trunk forward bending and backward return at self-selected and fast paces.
Compared to controls, individuals with acute low back pain had larger pelvic range of rotations and smaller lumbar range of flexions. Patients with acute low back pain also adopted a slower pace compared to asymptomatic controls which was reflected in smaller maximum values for angular velocity, deceleration and acceleration of lumbar flexion. Irrespective of participant group, smaller pelvic range of rotation and larger lumbar range of flexion were observed in younger vs. older participants.
Reduced lumbar range of flexion and slower task pace, observed in patients with acute low back pain, may be the result of a neuromuscular adaptation to reduce the forces and deformation in the lower back tissues and avoid pain aggravation.
先前的研究报道了慢性下腰痛患者与无慢性下腰痛患者在躯干前屈和后伸任务期间腰骨盆运动学的差异;然而,关于急性下腰痛患者腰骨盆运动学的文献却很少。因此,本研究的目的是调查该队列中的腰骨盆运动学。
进行了一项病例对照研究,以调查有和没有急性下腰痛的女性在骨盆和胸廓旋转以及腰椎前屈及其一阶和二阶导数方面的差异。每组参与者完成一次实验,在实验中他们以自我选择的速度和快速的速度进行躯干前屈和后伸。
与对照组相比,急性下腰痛患者的骨盆旋转范围更大,腰椎前屈范围更小。与无症状对照组相比,急性下腰痛患者的速度也较慢,这体现在腰椎前屈角速度、减速度和加速度的最大值较小。无论参与者组如何,年轻参与者与年长参与者相比,骨盆旋转范围较小,腰椎前屈范围较大。
急性下腰痛患者中观察到的腰椎前屈范围减小和任务速度较慢,可能是神经肌肉适应的结果,以减少下背部组织中的力和变形并避免疼痛加重。