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腹部凹陷和支撑动作对有或无慢性下腰痛受试者俯卧位髋关节伸展时腰骶部肌肉活动模式的影响:一项初步研究

Effect of the Abdominal Hollowing and Bracing Maneuvers on Activity Pattern of the Lumbopelvic Muscles During Prone Hip Extension in Subjects With or Without Chronic Low Back Pain: A Preliminary Study.

作者信息

Kahlaee Amir H, Ghamkhar Leila, Arab Amir M

机构信息

Department of Physical Therapy, University of Social Welfare and Rehabilitation Science, Evin, Tehran, Iran.

Department of Physical Therapy, University of Social Welfare and Rehabilitation Science, Evin, Tehran, Iran.

出版信息

J Manipulative Physiol Ther. 2017 Feb;40(2):106-117. doi: 10.1016/j.jmpt.2016.10.009. Epub 2016 Dec 22.

DOI:10.1016/j.jmpt.2016.10.009
PMID:28017604
Abstract

OBJECTIVE

The purpose of this study was to compare the effect of abdominal hollowing (AH) and abdominal bracing (AB) maneuvers on the activity pattern of lumbopelvic muscles during prone hip extension (PHE) in participants with or without nonspecific chronic low back pain (CLBP).

METHODS

Twenty women with or without CLBP participated in this cross-sectional observational study. The electromyographic activity (amplitude and onset time) of the contralateral erector spinae (CES), ipsilateral erector spinae (IES), gluteus maximus, and biceps femoris muscles was measured during PHE with and without abdominal maneuvers. A 3-way mixed model analysis of variance and post hoc tests were used for statistical analysis.

RESULTS

Between-group comparisons showed that the CES onset delay during PHE alone was greater (P = .03) and the activity level of IES, CES, and biceps femoris in all maneuvers (P < .05) was higher in patients with CLBP than in asymptomatic participants. In asymptomatic participants, PHE + AH significantly decreased the signal amplitude (AMP) of IES (P = .01) and CES (P = .02) muscles. In participants with CLBP, IES muscle AMP was lower during PHE + AH compared with PHE + AB and PHE alone. With regard to onset delay, the results also showed no significant difference between maneuvers within either of the 2 groups (P > .05).

CONCLUSIONS

Performance of the AH maneuver decreased the erector spinae muscle AMP in both groups, and neither maneuver altered the onset delay of any of the muscles in either group. The low back pain group showed higher levels of activity in all muscles (not statistically significant in gluteus maximus during all maneuvers). The groups were similar according to the onset delay of any of the muscles during either maneuver.

摘要

目的

本研究旨在比较腹部凹陷(AH)和腹部支撑(AB)动作对有或无非特异性慢性下腰痛(CLBP)的参与者在俯卧位髋关节伸展(PHE)过程中腰骨盆肌肉活动模式的影响。

方法

20名有或无CLBP的女性参与了这项横断面观察研究。在进行和不进行腹部动作的PHE过程中,测量对侧竖脊肌(CES)、同侧竖脊肌(IES)、臀大肌和股二头肌的肌电活动(幅度和起始时间)。采用三因素混合方差分析和事后检验进行统计分析。

结果

组间比较显示,仅在PHE期间,CLBP患者的CES起始延迟更大(P = 0.03),并且在所有动作中IES、CES和股二头肌的活动水平(P < 0.05)均高于无症状参与者。在无症状参与者中,PHE + AH显著降低了IES(P = 0.01)和CES(P = 0.02)肌肉的信号幅度(AMP)。在CLBP参与者中,与PHE + AB和仅PHE相比,PHE + AH期间IES肌肉的AMP更低。关于起始延迟,结果还显示两组中任何一组内的动作之间均无显著差异(P > 0.05)。

结论

AH动作的执行降低了两组中竖脊肌的AMP,并且两种动作均未改变两组中任何肌肉的起始延迟。下腰痛组在所有肌肉中的活动水平更高(在所有动作中臀大肌无统计学显著差异)。根据任何一种动作期间任何一块肌肉的起始延迟,两组相似。

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