Institute of Sport, Physical Education and Health Sciences, University of Edinburgh, St Leonard's Land, Holyrood Road, Edinburgh EH8 8AQ, United Kingdom.
Institute of Sport, Physical Education and Health Sciences, University of Edinburgh.
Phys Ther. 2019 Mar 1;99(3):297-310. doi: 10.1093/ptj/pzy150.
Chronic low back pain (CLBP) is the most prevalent musculoskeletal disorder. Aquatic exercises are commonly used by physical therapists for CLBP treatment and management; however, there are no data on trunk muscle activation during aquatic exercises in people with CLBP.
We quantified activation of trunk and gluteal muscles, exercise intensity, pain, and perceived exertion in people with and without CLBP when performing water and land exercises.
The study used a cross-sectional design.
Twenty participants with nonspecific CLBP and 20 healthy participants performed 15 aquatic exercises and 15 similar land exercises. Mean and peak muscle activation were measured bilaterally from erector spinae, multifidus, gluteus maximus, gluteus medius, rectus abdominis, external oblique, and internal oblique using waterproof and wireless surface electromyography. Exercise intensity (heart rate), perceived exertion (Borg scale), and, for the CLBP group, pain (visual analog scale) were recorded.
There were no significant between-group differences. Significant between-environment differences were found in heart rate (always higher on land), exertion (higher in the water for 3 exercises and on land for 6 exercises), and muscle activation (higher on land in 29% and in the water in 5% of comparisons). Pain levels were low, but pain was reported more than twice as frequently on land than in water (7.7% vs 3.7%, respectively).
People with high levels of disability and CLBP classification were not included.
People with mild-to-moderate CLBP had similar exercise responses to healthy controls. Aquatic exercise produced sufficient muscle activation, intensity, and exertion, and should not be assumed to be less strenuous or less effective in activating trunk and pelvic muscles than exercise on land. These data can be used to inform design and prescription of rehabilitation programs and interventions.
慢性下背痛（CLBP）是最常见的肌肉骨骼疾病。物理治疗师常采用水中运动来治疗和管理 CLBP；然而，目前尚无关于 CLBP 患者进行水中运动时躯干肌肉激活的相关数据。
我们旨在量化 CLBP 患者和健康对照者在进行水疗和陆疗时，躯干和臀肌的激活情况、运动强度、疼痛和感知用力情况。
本研究采用了横断面设计。
20 名非特异性 CLBP 患者和 20 名健康对照者分别进行了 15 项水疗运动和 15 项类似的陆疗运动。使用防水、无线表面肌电图，双侧测量竖脊肌、多裂肌、臀大肌、臀中肌、腹直肌、腹外斜肌和腹内斜肌的平均和峰值肌肉激活度。记录运动强度（心率）、感知用力（Borg 量表），以及 CLBP 组的疼痛（视觉模拟评分）。
组间无显著差异。在心率（陆地时总是更高）、用力（3 项运动水中更高，6 项运动陆地更高）和肌肉激活度（陆地 29%、水中 5%的比较中更高）方面，环境间存在显著差异。疼痛程度较低，但陆地运动时疼痛报告频率是水中的两倍多（分别为 7.7%和 3.7%）。
未纳入高残疾水平和 CLBP 分类的患者。
轻度至中度 CLBP 患者的运动反应与健康对照者相似。水中运动可产生足够的肌肉激活、强度和用力，不应认为其对激活躯干和骨盆肌肉的效果不如陆地运动，或对肌肉的刺激程度较轻。这些数据可用于为康复方案和干预措施的设计和处方提供信息。
