Vulfsons S, Chervonenko S, Haddad M, Weisman M H, Lavi N, Dar G
Institute for Pain Medicine, Rambam Health Care Campus, Technion-Israel Institute of Technology, Haifa, Israel.
Department of Physical Therapy, Faculty of Social Welfare and Health Studies, University of Haifa, Haifa, Israel.
J Back Musculoskelet Rehabil. 2018;31(4):785-793. doi: 10.3233/BMR-160627.
The concept of myofascial continuity suggests that muscles activate along kinematic chains with common fascial coverings. Yet, the literature lacks evidence in regards to the function of anatomical chains in populations suffering from low back pain (LBP).
To examine muscle activations along the superficial back line in LBP patients compared to healthy controls.
The sample study included 20 males with chronic LBP (mean age 28.7 (± 3.05) years, mean BMI 24.91 (± 2.76)) and 17 healthy controls (mean age 31.06 (± 7.76) years, mean BMI 23.46 (± 3.43)). Muscle activation (gastrocnemius, hamstrings, erector spine, and upper trapezius) along the superficial back line was measured using surface EMG. All subjects underwent five test conditions: Conditions 1-3 involved passive movement, active movement and active movement against maximum isometric resistance of the right gastrocnemius muscle. Conditions 4 and 5 involved neck extension without and with isometric resistance from the prone position. The main outcome was relative muscle activation amplitude between research and control subjects.
Muscle activation along the posterior anatomical chain was observed during distal movement (plantar flexion or neck extension). LBP patients showed significant lower muscle activation in the erector spine of lower back region compared with the control group during active plantar flexion and active neck extension (p< 0.05). Lower muscle activation in other regions (gastrocnemius, hamstrings, erector spine level T6) was observed in the research group (although not significant).
LBP may cause or result in a lower muscle activation of the posterior kinematic myofascial chain muscles.
肌筋膜连续性的概念表明，肌肉沿着具有共同筋膜覆盖的运动链激活。然而，关于解剖链在腰痛（LBP）人群中的功能，文献中缺乏证据。
比较LBP患者与健康对照者沿背部浅线的肌肉激活情况。
样本研究包括20名患有慢性LBP的男性（平均年龄28.7（±3.05）岁，平均BMI 24.91（±2.76））和17名健康对照者（平均年龄31.06（±7.76）岁，平均BMI 23.46（±3.43））。使用表面肌电图测量沿背部浅线的肌肉激活情况（腓肠肌、腘绳肌、竖脊肌和上斜方肌）。所有受试者接受五种测试条件：条件1 - 3涉及被动运动、主动运动以及对抗右侧腓肠肌最大等长阻力的主动运动。条件4和5涉及从俯卧位进行无等长阻力和有等长阻力的颈部伸展。主要结果是研究对象与对照对象之间的相对肌肉激活幅度。
在远端运动（跖屈或颈部伸展）期间观察到沿后解剖链的肌肉激活。与对照组相比，LBP患者在主动跖屈和主动颈部伸展期间，下背部区域竖脊肌的肌肉激活明显较低（p < 0.05）。在研究组中观察到其他区域（腓肠肌、腘绳肌、T6水平竖脊肌）的肌肉激活较低（尽管不显著）。
LBP可能导致后运动肌筋膜链肌肉的肌肉激活降低。
