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健康年轻受试者姿势下本能自我矫正动作对脊柱本体感觉/运动控制的 3D 定量评估:一项观察性研究。

3D quantitative evaluation of spine proprioceptive perception/motor control through instinctive self-correction maneuver in healthy young subjects' posture: an observational study.

机构信息

SMART Lab, Bioengineering and Biomedicine Company, Pescara, Italy -

Department of Rheumatology and Rehabilitation, Clinic of Rehabilitation, University of Medical Sciences, Poznan, Poland.

出版信息

Eur J Phys Rehabil Med. 2018 Jun;54(3):428-439. doi: 10.23736/S1973-9087.17.04738-4. Epub 2017 Jul 18.

Abstract

BACKGROUND

Conservative treatment in spine deformities and spine related disorders is mainly based on proper individual proprioceptive and motor control training. For these reasons, conservative treatment involves the stimulation of individual capability of perceiving/reducing deformities, blocks and/or improper spine posture by voluntary control. The literature describes that habitually adopted relaxed postures often exacerbate low back pain. Typically, youths can be referred to therapeutic programs aimed at improving the quality of body posture along with fostering the awareness of the importance of correct posture. Few studies in literature outline the subject's individual instinctive ability to perceive properly and control his/her posture and produce an improvement through a self-correction maneuver.

AIM

How do healthy young adult subjects perceive and control their posture and spine shape? Are they able to modify them in a correct way through an instinctive self-correction maneuver?

DESIGN

Cross-sectional observational study.

SETTING

A cohort of asymptomatic young adult university students and workers were recruited at Clinic of Rehabilitation, University of Medical Sciences, Poznan, Poland.

POPULATION

One hundred and twenty-one healthy subjects (57 females, 64 males), aged 19-34 years (mean age: 23.5±3.2 years).

METHODS

Subject's full body posture including 3D spine shape reconstruction, identified using 27 retro-reflective markers suitably located on anatomical landmarks has been measured by using a non-ionizing 3D optoelectronic stereo-photogrammetric approach and a 3D full skeleton biomechanical model.

RESULTS

From the 3D full skeleton and spine reconstruction, eleven quantitative biomechanical parameters describing the nature of body posture have been computed to compare natural erect versus self-corrected standing attitudes. A great number of healthy participants (105, 87%) was unable to modify its spinal shape in the frontal plane. Conversely, the sagittal plane presented significant clinical changes in the thoracic spine, as males reached a greater thoracic spine extension (36.4±8.3) than females (40.8±8.7). When changes occurred, subjects were not able to focus and control their posture globally, but only on few aspects at a time.

CONCLUSIONS

Instinctive posture proprioception and motor control do not produce an effective self-correction maneuver yielding a global improvement of body posture and spine shape.

CLINICAL REHABILITATION IMPACT

Self-correction maneuver producing an improvement of body posture and spine shape has to be learned with specific postural training. The 3D stereo-photogrammetric approach is effective in quantitatively describe subject's posture, motor control and proprioceptive capability.

摘要

背景

脊柱畸形和脊柱相关疾病的保守治疗主要基于适当的个体本体感觉和运动控制训练。出于这些原因,保守治疗涉及通过自愿控制来刺激个体感知/减少畸形、阻滞和/或不当脊柱姿势的能力。文献描述说,习惯性采用放松姿势往往会加剧下腰痛。通常情况下,年轻人可以参加旨在提高身体姿势质量和培养正确姿势重要性意识的治疗计划。文献中很少有研究概述了个体本能地感知和控制自己的姿势并通过自我纠正动作产生改善的能力。

目的

健康的年轻成年受试者如何感知和控制他们的姿势和脊柱形状?他们是否能够通过本能的自我纠正动作以正确的方式对其进行修正?

设计

横断面观察性研究。

地点

波兰波兹南医科大学康复诊所招募了一组无症状的年轻成年大学生和工作人员。

人群

121 名健康受试者(57 名女性,64 名男性),年龄 19-34 岁(平均年龄:23.5±3.2 岁)。

方法

使用非电离性 3D 光电立体摄影测量法和 3D 全骨骼生物力学模型,通过在解剖学标志上适当定位 27 个反光标记,测量受试者的全身姿势,包括 3D 脊柱形状重建。

结果

从 3D 全骨骼和脊柱重建中,计算了 11 个定量生物力学参数来比较自然直立与自我纠正站立姿势的差异。大量健康参与者(105 名,87%)无法在额状面修正其脊柱形状。相反,矢状面显示胸椎有显著的临床变化,男性胸椎伸展度大于女性(男性 36.4±8.3,女性 40.8±8.7)。当发生变化时,受试者无法集中注意力并全面控制自己的姿势,而是一次只能控制几个方面。

结论

本能的姿势本体感觉和运动控制并不能产生有效的自我纠正动作,从而全面改善身体姿势和脊柱形状。

临床康复影响

产生身体姿势和脊柱形状改善的自我纠正动作必须通过特定的姿势训练来学习。3D 立体摄影测量法可有效定量描述受试者的姿势、运动控制和本体感觉能力。

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