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非特异性慢性下腰痛患者下肢肌肉疲劳对落地时地面反作用力分量的影响

Effect of Lower Limb Muscle Fatigue on Ground Reaction Force Components During Landing in People With Nonspecific Chronic Low Back Pain.

作者信息

Jalalvand Ali, Anbarian Mehrdad

出版信息

J Sport Rehabil. 2019 Nov 1;28(8):847-853. doi: 10.1123/jsr.2018-0153.

Abstract

CONTEXT

The link between landing parameters and lower limb muscle fatigue in association with chronic low back pain (CLBP) is not well understood.

OBJECTIVE

To examine the effects of fatigue on the ground reaction force components during landing in people with nonspecific CLBP.

DESIGN

Quasi-experimental study.

SETTING

Clinical biomechanics laboratory.

PARTICIPANTS

A total of 44 subjects were equally divided into a healthy group and a group with CLBP.

MAIN OUTCOME MEASURES

The ground reaction force along anterior-posterior (y) and medial-lateral (x) and vertical (z) axes, time to peak (TTP), the rate of force development, and impulses for all axes were calculated. A repeated-measures analysis of variance (group × fatigue) was used to compare the data among groups.

RESULTS

In the unfatigued conditions, the amplitudes of Fy3, Fz2, and TTP of Fy1, Fy2, Fz1, Fz2, Fz3, Fz4, rate of force development in Y in the CLBP subjects are significantly different than those in the healthy subjects (P < .05). In the fatigued conditions, the amplitudes of Fz2, Fz3, Fz4, and TTP of Fy2, Fy3, Fy4, Fz2, impulses of X2, Z in the CLBP group were significantly different than those in the healthy subjects (P < .05). Within-group comparisons of measured Fx1, Fy1, Fy2, Fz2, Fz4 and TTP of Fx1, Fy1, Fy2, Fz2, Fz3, Fz4, impulses of X2, z were significantly different from prefatigue to postfatigue in the healthy group (P < .05). Within-group comparisons of measured Fx1, Fy1, Fz1, Fz2 and TTP of Fx5, Fz1, impulses of X2 were significantly differed from prefatigue to postfatigue in the CLBP group (P < .05).

CONCLUSIONS

It seems that TTP of ground reaction force variables in CLBP may have clinical values for rehabilitation. Muscle fatigue altered landing performance. However, patients with CLBP will respond differently to lower-extremity fatigue. These altered variables in patients with low back pain are the cause of future injuries or lower-extremity injuries that need to be addressed in further studies.

摘要

背景

着陆参数与慢性下腰痛(CLBP)相关的下肢肌肉疲劳之间的联系尚未完全明确。

目的

研究非特异性CLBP患者着陆过程中疲劳对地面反作用力分量的影响。

设计

准实验研究。

地点

临床生物力学实验室。

参与者

共44名受试者,平均分为健康组和CLBP组。

主要观察指标

计算前后(y)、内外侧(x)和垂直(z)轴方向的地面反作用力、峰值时间(TTP)、力发展速率以及各轴的冲量。采用重复测量方差分析(组×疲劳)比较组间数据。

结果

在未疲劳状态下,CLBP组受试者的Fy3、Fz2以及Fy1、Fy2、Fz1、Fz2、Fz3、Fz4的Fy1峰值时间、Y方向的力发展速率与健康组相比有显著差异(P < 0.05)。在疲劳状态下,CLBP组的Fz2、Fz3、Fz4以及Fy2、Fy3、Fy4、Fz2的峰值时间、X2、Z轴的冲量与健康组相比有显著差异(P < 0.05)。健康组内测量的Fx1、Fy1、Fy2、Fz2、Fz4以及Fx1、Fy1、Fy2、Fz2、Fz3、Fz4的峰值时间、X2、z轴的冲量在疲劳前和疲劳后组内比较有显著差异(P < 0.05)。CLBP组内测量的Fx1、Fy1、Fz1、Fz2以及Fx5、Fz1的峰值时间、X2轴的冲量在疲劳前和疲劳后组内比较有显著差异(P < 0.05)。

结论

似乎CLBP患者地面反作用力变量的峰值时间可能具有康复临床价值。肌肉疲劳改变了着陆表现。然而,CLBP患者对下肢疲劳的反应会有所不同。腰痛患者这些改变的变量是未来受伤或下肢损伤的原因,需要在进一步研究中加以解决。

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