非特异性慢性下腰痛男性的腰椎轴向旋转运动学

Lumbar axial rotation kinematics in men with non-specific chronic low back pain.

作者信息

Haj Alaa, Weisman Asaf, Masharawi Youssef

机构信息

The Spinal Research Laboratory, Department of Physical Therapy, the Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv 69978, Israel; Clalit Health Services, Department of Physical Therapy, Haifa and Western Galilee District, 104 Sderot HaMeginim, Haifa, Israel.

The Spinal Research Laboratory, Department of Physical Therapy, the Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv 69978, Israel; Clalit Health Services, Department of Physical Therapy, Tel Aviv-Jaffa District, 16 Naomi Shemer Street, Holon, Israel.

出版信息

Clin Biomech (Bristol). 2019 Jan;61:192-198. doi: 10.1016/j.clinbiomech.2018.12.022. Epub 2018 Dec 22.

DOI:10.1016/j.clinbiomech.2018.12.022

PMID:30594767

Abstract

BACKGROUND

Lumbar flexion, coupled with rotation, is a dominant factor in the etiology and exacerbation of low back pain. Yet, no study has examined its kinematics in patients with non-specific chronic low back pain (NSCLBP). The aim of the study was to evaluate the lumbar rotation kinematics in neutral standing and with full flexion in men with NSCLBP.

METHODS

ROM, average velocity, maximum velocity and maximal acceleration of lumbar rotation in neutral standing and with full flexion were measured using an industrial lumbar motion monitor in 50 men (25 with NSCLBP and 25 controls). VAS and Rolland Morris questionnaire were also included.

FINDINGS

All examined kinematical parameters were significantly lower in men with NSCLBP compared with controls (↓ROM = 29%-45%; ↓AV = 40%-68%; ↓MV = 25%-50%; ↓MA = 20%-37%). Left rotation manifested smaller kinematic values (except for MA) than right rotation (Δ ROM = 35%; Δ AV = 66%; Δ MV = 19%) in NSCLBP. Most kinematical parameters significantly decreased from neutral standing to standing with flexion (right rotation: ↓ROM = 43%-45%, ↓AV = 38%-45%, ↓MV = 24%-27%, ↓MA for the NSCLBP group = 21%; left rotation: ↓ROM = 25%-38%, ↓AV in the control group: =34%, ↓MV in the control group: =23%, ↓MA in the control group = 25%). No correlations were found between all measured kinematical parameters, VAS and RMQ total score in the NSCLBP group.

INTERPRETATION

The kinematic parameters of lumbar rotation were reduced in men with NSCLBP compared with controls both in neutral standing and with fully forward bending. Most lumbar rotation kinematics decreased from neutral standing to standing with flexion.

摘要

背景

腰椎前屈伴旋转是下腰痛病因及病情加重的主要因素。然而，尚无研究对非特异性慢性下腰痛（NSCLBP）患者的该运动学进行研究。本研究的目的是评估NSCLBP男性患者中立位站立及完全前屈时的腰椎旋转运动学。

方法

使用工业腰椎运动监测仪测量50名男性（25例NSCLBP患者和25例对照）中立位站立及完全前屈时腰椎旋转的活动度（ROM）、平均速度（AV）、最大速度（MV）和最大加速度（MA）。还纳入了视觉模拟评分法（VAS）和罗兰·莫里斯问卷。

结果

与对照组相比，NSCLBP男性患者所有检测的运动学参数均显著降低（ROM降低29%-45%；AV降低40%-68%；MV降低25%-50%；MA降低20%-37%）。在NSCLBP患者中，左旋的运动学值（MA除外）小于右旋（ROM差值=35%；AV差值=66%；MV差值=19%）。从中立位站立到前屈站立，大多数运动学参数显著降低（右旋：NSCLBP组ROM降低43%-45%，AV降低38%-45%，MV降低24%-27%，MA降低21%；左旋：ROM降低25%-38%，对照组AV降低34%，对照组MV降低23%，对照组MA降低25%）。NSCLBP组所有测量的运动学参数、VAS和RMQ总分之间均未发现相关性。