Schmid Stefan, Stauffer Michèle, Jäger Judit, List Renate, Lorenzetti Silvio
Bern University of Applied Sciences, Department of Health Professions, Bern, Switzerland; ETH Zurich, Institute for Biomechanics, Zurich, Switzerland.
Bern University of Applied Sciences, Department of Health Professions, Bern, Switzerland; Fios - Praxis für Physio- und Ergotherapie, Herzogenbuchsee, Switzerland.
Gait Posture. 2019 Jan;67:172-180. doi: 10.1016/j.gaitpost.2018.10.013. Epub 2018 Oct 12.
Regular infant carrying might be a contributing factor for the development and progression of low back and pelvic girdle pain in mothers after childbirth. However, the neuromechanical adaptations of the spine due to different sling-based carrying techniques are not sufficiently well understood in order to provide evidence-based carrying recommendations.
What are the immediate effects of different sling-based infant carrying techniques on trunk neuromechanics?
Using a Vicon motion capture and a wireless surface electromyography system, three-dimensional pelvis and spinal kinematics as well as activation patterns of eight trunk muscles were derived from fifteen healthy young women during upright standing and level walking without carrying a load and while carrying a 6 kg-dummy with a sling in front and on either side. Data were analyzed using Statistical Parametric Mapping, allowing group comparisons of discrete parameters (standing) as well as continuous data (walking). To distinguish between clinically relevant and clinically not relevant kinematic findings, statistically significant differences were only considered in case of ≥5°.
Compared to unloaded walking, carrying the dummy in front was mainly associated with increased lumbar lordosis (standing: (Δ8.8°, p = 0.006; walking: (Δ ≥ 8.2°, 1-100% of gait cycle [%GC], p < 0.001). When carrying the dummy on the preferred side, increased thoracic kyphosis (standing: ≥6.4°, p ≤ 0.003; walking: Δ ≥ 5.6°, 1-100%GC, p < 0.001) and axial rotation towards the ipsilateral side (standing: Δ5.3°, p = 0.003; walking: Δ ≥ 5.0°, 46-58%GC, p = 0.002) were observed. All three conditions entailed increased paraspinal muscle activity during walking, although only unilaterally in side carrying (lumbar, preferred condition: Δ ≥ 13.2%maxMVIC, 49-57%GC, p < 0.001; thoracic, non-preferred condition: Δ ≥ 5.3%maxMVIC, 47-58%GC, p < 0.001).
Carrying an infant alternating on both sides using a sling could be advantageous for preventing musculoskeletal pain resulting from excessive lumbar hyperextension and paraspinal muscle hyperactivation in women after childbirth.
经常抱婴儿可能是产后母亲下背部和骨盆带疼痛发展和加重的一个促成因素。然而，由于不同的基于背带的抱婴技术导致的脊柱神经力学适应性尚未得到充分理解，以便提供基于证据的抱婴建议。
不同的基于背带的婴儿抱持技术对躯干神经力学的即时影响是什么？
使用Vicon运动捕捉和无线表面肌电图系统，从15名健康年轻女性在无负重直立站立和平地行走时，以及使用背带在身前和身体两侧携带6公斤假人时，获取三维骨盆和脊柱运动学以及八块躯干肌肉的激活模式。使用统计参数映射分析数据，允许对离散参数（站立）以及连续数据（行走）进行组间比较。为了区分临床相关和临床不相关的运动学发现，仅在差异≥5°时才考虑具有统计学意义的差异。
与无负重行走相比，在身前携带假人主要与腰椎前凸增加有关（站立时：（Δ8.8°，p = 0.006；行走时：（Δ≥8.2°，步态周期的1 - 100% [%GC]，p < 0.001）。当在偏好侧携带假人时，观察到胸椎后凸增加（站立时：≥6.4°，p≤0.003；行走时：Δ≥5.6°，1 - 100%GC，p < 0.001）以及向同侧的轴向旋转（站立时：Δ5.3°，p = 0.003；行走时：Δ≥5.0°，46 - 58%GC，p = 0.002）。所有三种情况在行走过程中均导致椎旁肌活动增加，尽管在侧面携带时仅为单侧增加（腰部，偏好侧：Δ≥13.2%最大MVIC，49 - 57%GC，p < 0.001；胸部，非偏好侧：Δ≥5.3%最大MVIC，47 - 58%GC，p < 0.001）。
使用背带在两侧交替抱婴儿可能有利于预防产后女性因过度腰椎过伸和椎旁肌过度激活而导致的肌肉骨骼疼痛。
