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反复进行坐位时脊柱末端活动可消除长时间屈髋坐姿引起的本体感觉缺失。一项评估脊柱位置觉的统计学和临床意义的研究。

Repeated end range spinal movement while seated abolishes the proprioceptive deficit induced by prolonged flexed sitting posture. A study assessing the statistical and clinical significance of spinal position sense.

机构信息

Faculty of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece; Aspetar, Orthopaedic and Sports Medicine Hospital, Doha, Qatar; Hellenic Orthopaedic Manipulative Therapy Diploma (HOMTD), Athens, Greece.

Faculty of Physical Education and Sport Sciences, University of Thessaly, Trikala, Greece.

出版信息

Musculoskelet Sci Pract. 2017 Oct;31:9-20. doi: 10.1016/j.msksp.2017.06.003. Epub 2017 Jun 10.

Abstract

BACKGROUND

Sustained spinal flexion has been proposed to affect the properties of spinal tissues, increase postural muscle's activation latency and act detrimentally on proprioception.

OBJECTIVES

This study evaluated the effect of flexed posture (FP) on spinal proprioception and assessed the immediate effect of spinal movement on the presumable flexion-induced proprioceptive deficit.

DESIGN

Clinical measurement study.

METHODS

Marker-based kinematic analyses of the head, spine, and pelvis were conducted on 50 individuals. Subjects were educated in a lordotic sitting posture (IOSP) that they reproduced immediately; after 10 and 30 min in FP; and after sagittal spinal movement. Nine sagittal angles were calculated. Absolute error (AE) and constant error (CE) were used to evaluate repositioning accuracy. Repeated measures ANOVA was used to test for significant differences in angles obtained among postures, as well as for the AE and CE calculated from the trials.

RESULTS

No significant differences were found in reposition error (RE) after immediate reproduction of IOSP (all p > 0.0083). Following FP AEs presented significant differences for head (4.1°), head protraction (1.9°), head tilt (2.1°), lumbar (3.2°) and pelvis angle (2.1°). CEs revealed significant differences for head protraction (-1.8°) and lumbar angle (-3.5°). No significant differences were found for AE and CE after spinal sagittal movement (all p > 0.0083).

CONCLUSIONS

Prolonged FP can affect spinal position sense, but sagittal spinal movement can abolish the proprioceptive deficit. The significant differences documented, may be of limited clinical utility given their magnitude, and the reliability data presented may be of use in reinterpreting previously documented proprioceptive analyses.

摘要

背景

持续的脊柱前屈被认为会影响脊柱组织的特性,增加姿势肌的激活潜伏期,并对本体感觉产生不利影响。

目的

本研究评估了前屈姿势(FP)对脊柱本体感觉的影响,并评估了脊柱运动对可能因前屈引起的本体感觉缺陷的即时影响。

设计

临床测量研究。

方法

对 50 名个体的头部、脊柱和骨盆进行基于标志物的运动学分析。受试者接受了关于腰椎前凸坐姿(IOSP)的教育,他们立即重复该坐姿;然后分别在 FP 中保持 10 分钟和 30 分钟;最后进行矢状面脊柱运动。计算了九个矢状角。绝对误差(AE)和恒定误差(CE)用于评估重新定位的准确性。重复测量方差分析用于测试不同姿势下获得的角度、以及从试验中计算的 AE 和 CE 是否存在显著差异。

结果

立即重复 IOSP 后,重新定位误差(RE)没有显著差异(所有 p 值均>0.0083)。FP 后,头部(4.1°)、头部前伸(1.9°)、头部倾斜(2.1°)、腰椎(3.2°)和骨盆角度(2.1°)的 AE 存在显著差异。CE 显示头部前伸(-1.8°)和腰椎角度(-3.5°)有显著差异。脊柱矢状运动后,AE 和 CE 无显著差异(所有 p 值均>0.0083)。

结论

长时间的 FP 会影响脊柱位置感,但脊柱矢状运动可以消除本体感觉缺陷。记录到的显著差异,由于其幅度较小,可能具有有限的临床实用性,并且提出的可靠性数据可能有助于重新解释以前记录的本体感觉分析。

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