Shamsi MohammadBagher, Sarrafzadeh Javad, Jamshidi Aliashraf, Arjmand Navid, Ghezelbash Farshid
Rehabilitation and Sport Medicine Department, School of Allied Medical Sciences, Kermanshah University of Medical Sciences, Dolat Abad Street, Kermanshah, Iran.
Physiotherapy Department, School of Rehabilitation Sciences, Iran University of Medical Sciences, Mohseni Square, Tehran, Iran.
Clin Biomech (Bristol). 2017 Oct;48:42-48. doi: 10.1016/j.clinbiomech.2017.07.006. Epub 2017 Jul 8.
Motor control exercise was claimed to improve spinal stability in patients with chronic non-specific back pain, but to investigate the effectiveness of this exercise, other outcome measures have been used rather than spinal stability itself. The aim of our study is to assess motor control exercise effects on spinal stability using a biomechanical model.
Fifty-one patients were assigned to either motor control or general exercises. Before and after trainings, participants were tested for spinal stability at seven isometric tasks. Electromyography signals were recorded from ten superficial muscles, and a hybrid EMG-driven musculoskeletal model estimated spinal stability indices at each task.
Pain and disability significantly decreased in both groups. After trainings, patients had both increase and decrease in stability depending on the task, and stability did not increase/decrease uniformly in all patients. In the motor control group, stability increased at all positions but reached to significance only at right lateral pulling. In the general exercise group, except for pulling the trunk backward, stability decreased at other positions and reached to statistical significance only at pulling the trunk forward. No significant difference between groups was found in changing stability after the intervention.
Interventions yielded no significant difference in disability, pain and stability index between two groups. Significant increase of stability in the motor control group at right lateral pulling may be attributed to more activity of abdominal muscles, and significant decrease of stability in the general exercise group at forward pulling may be attributed to more optimal activity of back muscles.
运动控制训练据称可改善慢性非特异性背痛患者的脊柱稳定性，但为研究该训练的效果，人们使用了其他结局指标而非脊柱稳定性本身。我们研究的目的是使用生物力学模型评估运动控制训练对脊柱稳定性的影响。
51名患者被分配至运动控制训练组或一般训练组。在训练前后，参与者在7项等长任务中接受脊柱稳定性测试。从10块表层肌肉记录肌电图信号，并使用混合肌电图驱动的肌肉骨骼模型估计每项任务的脊柱稳定性指标。
两组的疼痛和功能障碍均显著减轻。训练后，根据任务不同，患者的稳定性既有增加也有降低，且并非所有患者的稳定性都呈一致的增加或降低。在运动控制训练组中，所有位置的稳定性均增加，但仅在右侧牵拉时达到显著水平。在一般训练组中，除了躯干后伸外，其他位置的稳定性均降低，且仅在躯干前伸时达到统计学显著水平。干预后两组在稳定性变化方面未发现显著差异。
两组在功能障碍、疼痛和稳定性指标方面的干预效果无显著差异。运动控制训练组在右侧牵拉时稳定性显著增加可能归因于腹肌的更多活动，而一般训练组在前伸时稳定性显著降低可能归因于背部肌肉的更优化活动。
