Wattananon Peemongkon, Intawachirarat Nattaporn, Cannella Marco, Sung Won, Silfies Sheri P
Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy, Mahidol University, Salaya, Nakhon Pathom, Thailand.
Rehabilitation Sciences Spine Research Lab, Drexel University, Philadelphia, PA, USA.
Eur Spine J. 2018 Jan;27(1):154-162. doi: 10.1007/s00586-017-5054-2. Epub 2017 Mar 31.
PURPOSE: The instantaneous center of rotation (ICR) can be used to investigate movement coordination and control in patients with low back pain (LBP). Tracking of the ICR in LBP patients has not been systematically investigated. This study aimed to (1) determine the within-session measurement error of ICR parameters, and (2) characterize the change in ICR among three groups of participants (no history of LBP = HC; history of LBP = HLBP; and current LBP = LBP). METHODS: Ninety-three participants (HC = 31; HLBP = 33; and LBP = 29) were recruited. Participants performed two sets of three repetitions of an active forward bend, while their lumbar and pelvic movements were recorded with an electromagnetic tracking system. Total ICR displacement and the radius of the bounding sphere containing the ICR were derived during the forward bending and the return to upright phases. Intra-class correlation coefficients (ICC) and minimal detectable difference (MDD) were used to determine measurement error and interpret findings of the group analysis. One-way ANOVAs and post hoc Bonferroni comparisons were used to determine differences among groups. RESULTS: ICC demonstrated excellent within-session test-retest reliability of the ICR parameters (ICC = 0.86-0.97). The MDD values were 0.20-3.40 mm. Comparisons between the HC and LBP groups and between the HLBP and LBP groups showed significant differences (p < 0.05) for all ICR parameters, with medium effect sizes (0.51-0.66), except for total displacement during forward bending between the HC and LBP groups. CONCLUSION: Less ICR displacement and variability in patients with LBP may indicate coping strategies to stiffen the lumbar spine. This could result from patients with LBP adopting a strategy of increased muscle activation to provide spinal stability during functional tasks.
目的:瞬时旋转中心(ICR)可用于研究腰痛(LBP)患者的运动协调性和控制情况。对LBP患者的ICR追踪尚未得到系统研究。本研究旨在:(1)确定ICR参数的组内测量误差;(2)描述三组参与者(无LBP病史=健康对照组;有LBP病史=有LBP病史组;当前患有LBP=LBP组)之间ICR的变化情况。 方法:招募了93名参与者(健康对照组=31名;有LBP病史组=33名;LBP组=29名)。参与者进行两组,每组三次主动前屈动作,同时用电磁追踪系统记录其腰椎和骨盆的运动。在前屈和恢复直立阶段计算ICR的总位移以及包含ICR的边界球半径。组内相关系数(ICC)和最小可检测差异(MDD)用于确定测量误差并解释组间分析结果。采用单因素方差分析和事后Bonferroni比较来确定组间差异。 结果:ICC显示ICR参数在组内具有出色的重测信度(ICC=0.86 - 0.97)。MDD值为0.20 - 3.40毫米。健康对照组与LBP组之间以及有LBP病史组与LBP组之间的比较显示,所有ICR参数均存在显著差异(p<0.05),效应量中等(0.51 - 0.66),健康对照组与LBP组在前屈过程中的总位移除外。 结论:LBP患者较小的ICR位移和变异性可能表明其采取了使腰椎变硬的应对策略。这可能是因为LBP患者采用了增加肌肉激活的策略,以便在功能任务期间提供脊柱稳定性。
Spine (Phila Pa 1976). 2014-5-1
Spine (Phila Pa 1976). 2013-7-1
J Orthop Sports Phys Ther. 2015-7-9
Entropy (Basel). 2022-3-22
J Orthop Sports Phys Ther. 2014-4
Comput Methods Biomech Biomed Engin. 2013
BMC Musculoskelet Disord. 2008-12-24