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有症状的退行性腰椎疾病患者与无症状者在静态和动态平衡任务中的姿势稳定性及躯干肌肉反应。

Postural stability and trunk muscle responses to the static and perturbed balance tasks in individuals with and without symptomatic degenerative lumbar disease.

作者信息

Lin Yun-Chung, Niu Chi-Chien, Nikkhoo Mohammad, Lu Meng-Ling, Chen Wen-Chien, Fu Chen-Ju, Cheng Chih-Hsiu

机构信息

School of Medicine, Chang Gung University, Taoyuan, Taiwan, ROC.

Bone and Joint Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan, ROC; Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Linkou, Taiwan, ROC.

出版信息

Gait Posture. 2018 Jul;64:159-164. doi: 10.1016/j.gaitpost.2018.06.021. Epub 2018 Jun 11.

DOI:10.1016/j.gaitpost.2018.06.021
PMID:29909230
Abstract

BACKGROUND

Degenerative lumbar diseases (DLDs) are characterized by motor functional deficits and postural instability. In this study, we investigated the differences in the trunk muscle responses to postural control between the presurgical DLD patients and healthy individuals while performing the static and perturbed balance tasks.

METHODS

Thirty-five DLD patients (aged 61.1 ± 8.0 years) and thirty-five asymptomatic controls (aged 62.9 ± 3.7 years) participated in this study. All participants stood on a force plate and performed the quiet standing (QS) and in situ weight-lifting (WL) tasks. The participants' performance in the QS task was tested under the eyes-open, eyes-closed, wide-base, and narrow-base conditions. Center of pressure (CoP) movements and electromyography of the erector spinae (ES) were recorded. The Mann-Whitney U test was applied for statistical analysis.

RESULTS

The DLD group showed a significantly greater CoP movements and muscle activations during the QS task. Nevertheless, smaller CoP movements were noted during the WL task in the DLD group. Under the eyes-closed and narrow-base conditions, the DLD group showed even higher muscle activations and CoP movements.

SIGNIFICANCE

The DLD patients demonstrated a poor postural control ability and tended to rely on the visual feedback and wide-base standing posture. A rigid and restricted posture was also adopted during the perturbed WL task. A high level of ES activation was required to maintain their postural steadiness. This study reveals an aberrant pattern of postural control and trunk muscle activations in symptomatic DLD patients which potentially contributes to the development of beneficial rehabilitation programs.

摘要

背景

退行性腰椎疾病(DLD)的特征是运动功能缺陷和姿势不稳定。在本研究中,我们调查了术前DLD患者和健康个体在执行静态和干扰平衡任务时,躯干肌肉对姿势控制的反应差异。

方法

35名DLD患者(年龄61.1±8.0岁)和35名无症状对照者(年龄62.9±3.7岁)参与了本研究。所有参与者站在测力平台上,执行安静站立(QS)和原地举重(WL)任务。在睁眼、闭眼、宽基底和窄基底条件下测试参与者在QS任务中的表现。记录压力中心(CoP)运动和竖脊肌(ES)的肌电图。采用曼-惠特尼U检验进行统计分析。

结果

DLD组在QS任务期间显示出明显更大的CoP运动和肌肉激活。然而,DLD组在WL任务期间记录到较小的CoP运动。在闭眼和窄基底条件下,DLD组显示出更高的肌肉激活和CoP运动。

意义

DLD患者表现出较差的姿势控制能力,倾向于依赖视觉反馈和宽基底站立姿势。在受干扰的WL任务中也采用了僵硬和受限的姿势。需要高水平的ES激活来维持他们的姿势稳定性。本研究揭示了有症状的DLD患者姿势控制和躯干肌肉激活的异常模式,这可能有助于制定有益的康复计划。

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