Département des Sciences de la Santé, Programme de physiothérapie de l'Université McGill offert en extension à l'Université du Québec à Chicoutimi (UQAC), Centre de recherche Intersectoriel en santé durable - UQAC, Laboratoire de recherche BioNR - UQAC, Saguenay, Québec, Canada; Laboratory of Functional Evaluation and Human Motor Performance (LAFUP), UNOPAR University, Doctoral and Masters Program in Rehabilitation Sciences UEL/UNOPAR, Londrina, PR, Brazil.
Florida International University (FIU), Physical Therapy & Neuroscience Departments, Wertheim Colleges of Nursing and Health Sciences & Medicine, 11200 SW 8th St., AHC3-430, Miami, FL, USA.
Gait Posture. 2019 Mar;69:25-30. doi: 10.1016/j.gaitpost.2019.01.016. Epub 2019 Jan 11.
Postural control declines with age and can be affected by low back pain. Poor balance has been reported in people with chronic low back pain (CLBP), which in turn could be explained by the changes in trunk muscle activation.
Are there differences between younger and older adults with and without chronic low back pain (CLBP) on trunk muscle activity during one-legged stance task?
Twenty (20) with, and 20 subjects without nonspecific CLBP participated in the study. Each group was comprised of 10 younger (50% males; mean age: 31 years) and 10 older adults (50% males; mean age: 71 years). Subjects performed 3 × 30-second trials of one-legged stance, with eyes open, on a force platform, while surface electromyography (EMG) measurements were obtained bilaterally on the multifidus at L5, iliocostalis lumborum at L3, rectus abdominis and biceps femoris muscles.EMG amplitude analysis was processed by the Root Mean Square (250 ms window epochs) and normalized by the peak of activation during the balance tasks, to determine the muscular activity of each muscle.
Participants with CLBP presented 15% lower lumbar muscle activation (p < 0.05), and 23% higher co-activation (ratio between rectus adominis by multifidus) than participants without CLBP, regardless of age. Significant differences (p < 0.05) between older and young groups were observed only for lower lumbar muscles (mean 24% lower in older than younger adults) and rectus adominis muscles (mean 17% lower in older than younger adults).
CLBP individuals have different trunk muscle activity than those without CLBP, and older adults exhibit lower trunk activation during one-legged stance balance task. The use of the EMG in evaluation of trunk neuromuscular function during one-legged stance may thus be a valuable tool when assessing balance in CLBP and older people.
姿势控制随着年龄的增长而下降，并且可能受到下背痛的影响。患有慢性下背痛（CLBP）的人报告说平衡能力较差，这可以解释为躯干肌肉激活的变化。
在单腿站立任务中，患有和不患有慢性下背痛（CLBP）的年轻和年长成年人之间，躯干肌肉活动是否存在差异？
20 名患有和 20 名无非特异性 CLBP 的成年人参加了这项研究。每个组都由 10 名年轻（50%男性；平均年龄：31 岁）和 10 名年长成年人（50%男性；平均年龄：71 岁）组成。在测力台上，参与者睁开眼睛进行了 3 次×30 秒的单腿站立试验，同时在 L5 的多裂肌、L3 的髂肋肌、腹直肌和股二头肌上获得双侧表面肌电图（EMG）测量。通过均方根（250ms 窗口时程）对 EMG 幅度进行分析，并通过平衡任务中的激活峰值对其进行归一化，以确定每个肌肉的肌肉活动。
患有 CLBP 的参与者的腰椎肌肉激活度低 15%（p<0.05），与无 CLBP 的参与者相比，协同激活度高 23%（腹直肌与多裂肌的比值），无论年龄大小。仅在年轻组和年长组之间观察到下腰椎肌肉（年长组比年轻组低 24%）和腹直肌（年长组比年轻组低 17%）有显著差异（p<0.05）。
患有 CLBP 的个体的躯干肌肉活动与无 CLBP 的个体不同，并且年长成年人在单腿站立平衡任务中表现出较低的躯干激活。因此，在单腿站立时使用 EMG 评估躯干神经肌肉功能可能是评估 CLBP 和老年人平衡的有价值工具。
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