Boucher Jean-Alexandre, Roy Nicolas, Preuss Richard, Larivière Christian
School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada; Occupational Health and Safety Research Institute Robert-Sauvé (IRSST), 505, boulevard de Maisonneuve-O., Montréal, QC, H3A 3C2, Canada.
School of Rehabilitation, Faculty of Medicine, Université de Sherbrooke, 150, place Charles-Le Moyne, Longueuil, QC, J4K 0A8, Canada.
Ann Phys Rehabil Med. 2017 Sep;60(5):306-311. doi: 10.1016/j.rehab.2017.03.002. Epub 2017 Apr 29.
Low back pain (LBP) has previously been associated with impaired lumbar proprioception, which may lead to and/or perpetuate joint instability as a cause of LBP. Wearing a lumbar belt (LB) may be beneficial in this regard. The primary aim was to determine the effect of 2 LB designs (extensible and non-extensible) on trunk repositioning sense in people with and without LBP. A secondary aim was to evaluate whether patients showing different clinical signs of lumbar instability differentially benefit from LBs in terms of lumbar proprioception.
Within-group experimental study with a healthy control group.
In total, 38 patients with LBP and 19 healthy controls participated in this study. Lumbar proprioception (position sense) was measured with participants sitting in a device that allowed for generating movements in axial rotation. Three experimental conditions were compared: (1) no LB, (2) extensible LB, (3) non-extensible LB. Four repositioning errors were computed for each experimental condition: constant error (CE), absolute error (AE), variable error (VE) and total variability (E).
CE and AE scores were higher for LBP patients than healthy controls (all P<0.001), but scores did not significantly differ by condition. Additional subgroup analyses of clinical signs of instability were inconclusive, showing the same results in LBP patients with low and high instability scores (all P<0.001).
This study confirms a significant loss of proprioception in trunk axial rotation in patients with LBP. Wearing an LB did not improve proprioception, but the contact between the LB and the skin might depend on the movement direction. Future studies should investigate the 3 planes of motion while eliminating the effect of the vestibular system.
下背痛（LBP）先前已被认为与腰椎本体感觉受损有关，这可能导致和/或使关节不稳定持续存在，进而引发LBP。在这方面，佩戴腰托（LB）可能有益。主要目的是确定两种腰托设计（可伸展和不可伸展）对有无LBP人群躯干重新定位感觉的影响。次要目的是评估表现出不同腰椎不稳定临床体征的患者在腰椎本体感觉方面是否从腰托中获得不同程度的益处。
有健康对照组的组内实验研究。
共有38例LBP患者和19名健康对照者参与本研究。通过让参与者坐在一个允许进行轴向旋转运动的装置中来测量腰椎本体感觉（位置觉）。比较了三种实验条件：（1）不佩戴腰托，（2）佩戴可伸展腰托，（3）佩戴不可伸展腰托。针对每种实验条件计算了四个重新定位误差：恒定误差（CE）、绝对误差（AE）、可变误差（VE）和总变异性（E）。
LBP患者的CE和AE评分高于健康对照组（所有P<0.001），但各条件下评分无显著差异。对不稳定临床体征的额外亚组分析尚无定论，在不稳定评分低和高的LBP患者中结果相同（所有P<0.001）。
本研究证实LBP患者在躯干轴向旋转时本体感觉明显丧失。佩戴腰托并未改善本体感觉，但腰托与皮肤之间的接触可能取决于运动方向。未来的研究应在消除前庭系统影响的同时研究三个运动平面。
