Berry David B, Rodríguez-Soto Ana E, Su Jeannie, Gombatto Sara P, Shahidi Bahar, Palombo Laura, Chung Christine, Jensen Andrew, Kelly Karen R, Ward Samuel R
Department of Bioengineering, University of California San Diego, La Jolla, California.
Department of Radiology, University of California San Diego, La Jolla, California.
J Orthop Res. 2017 Oct;35(10):2145-2153. doi: 10.1002/jor.23510. Epub 2017 Jan 30.
Low back pain has a 70% higher prevalence in members of the armed forces than in the general population, possibly due to the loads and positions soldiers experience during training and combat. Although the influence of heavy load carriage on standing lumbar spine posture in this population is known, postures in other operationally relevant positions are unknown. Therefore, the purpose of this study was to characterize the effect of simulated military operational positions under relevant loading conditions on global and local lumbar spine postures in active duty male US Marines. Secondary objectives were to evaluate if intervertebral disc degeneration and low back pain affect lumbar spine postures. Magnetic resonance images were acquired on an upright scanner in the following operational positions: Natural standing with no external load, standing with body armor (11.3 kg), sitting with body armor, and prone on elbows with body armor. Custom software was used to measure global lumbar spine posture: Lumbosacral flexion, sacral slope, lordosis, local measures of intervertebral angles, and intervertebral distances. Sitting resulted in decreased lumbar lordosis at all levels of the spine except L1-L2. When subjects were prone on elbows, a significant increase in local lordosis was observed only at L5-S1 compared with all other positions. Marines with disc degeneration (77%) or history of low back pain (72%) had decreased lumbar range of motion and less lumbar extension than healthy Marines. These results indicate that a male Marine's pathology undergoes a stereotypic set of postural changes during functional tasks, which may impair performance. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2145-2153, 2017.
与普通人群相比，武装部队成员的腰痛患病率高70%，这可能是由于士兵在训练和战斗中所承受的负荷及姿势所致。尽管已知重物携带对该人群站立时腰椎姿势的影响，但其他与作战相关姿势下的情况尚不清楚。因此，本研究的目的是在相关负荷条件下，对现役美国海军陆战队男性在模拟军事作战姿势下对整体和局部腰椎姿势的影响进行特征描述。次要目标是评估椎间盘退变和腰痛是否会影响腰椎姿势。在直立式扫描仪上采集了以下作战姿势的磁共振图像：无外部负荷自然站立、穿着防弹衣站立（11.3千克）、穿着防弹衣坐着以及穿着防弹衣肘部支撑俯卧。使用定制软件测量整体腰椎姿势：腰骶部前屈、骶骨倾斜度、脊柱前凸、椎间角度的局部测量值以及椎间距离。除L1-L2外，坐着会导致脊柱各节段的腰椎前凸减小。当受试者肘部支撑俯卧时，与所有其他姿势相比，仅在L5-S1观察到局部脊柱前凸显著增加。患有椎间盘退变（77%）或有腰痛病史（72%）的海军陆战队队员的腰椎活动范围减小，腰椎伸展度低于健康的海军陆战队队员。这些结果表明男性海军陆战队队员在执行功能性任务时，其病理状况会经历一系列刻板的姿势变化，这可能会影响其表现。©2017年骨科研究协会。由威利期刊公司出版。《矫形外科学研究》35:2145 - 2153，2017年。
