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手法治疗对单侧无名骨旋转患者腰椎运动学的影响及与无症状受试者的比较。

Manipulation Effect on Lumbar Kinematics in Patients with Unilateral Innominate Rotation and Comparison with Asymptomatic Subjects.

作者信息

M Zamanlou, M Akbari, A A Jamshidi, A Amiri, I Nabiyouni

机构信息

School of Rehabilitation Sciences, Department of Physical Therapy, Iran University of Medical Sciences, Tehran, Iran.

School of Public Health, Department of Kinesiology, Indiana University, Bloomington, United State of America.

出版信息

J Biomed Phys Eng. 2019 Jun 1;9(3):295-302. doi: 10.31661/jbpe.v0i0.760. eCollection 2019 Jun.

Abstract

BACKGROUND

Lumbar motion analysis is used as a clinical method in the diagnosis and treatment of low back pain (LBP). So far, no studies have shown if manipulating the sacroiliac joint (SIJ) will change spinal kinematics.

OBJECTIVE

The main objectives of this study were to investigate the effects of SIJ manipulation on the lumbar kinematics in subjects with innominate rotation and to compare lumbar kinematics among experiment and control groups.

MATERIAL AND METHODS

This study was a quasi-experiment-control trial study. 21 LBP patients with anterior or posterior innominate rotations in experiment group and 22 asymptomatic subjects in control group were evaluated. Lumbar kinematic variables (LKV) include lumbar range of motion (ROM) and speed, lumbar lateral flexion and rotation asymmetry were evaluated using Qualysis Track Manager (QTM) twice within two days in control group, and these parameters with pelvic asymmetry and disability were tested before and after intervention in the experiment group.

RESULTS

While pre-intervention experiment group exhibited significantly lower lumbar lateral flexion (p=0.0001), rotation (p=0.008) ROM and lower lateral flexion speed (p=0.014), post-intervention experiment group exhibited significantly lower lumbar lateral flexion (p=0.01) ROM in comparison with control group. Pelvic asymmetry (p=0.049) and disability (p=0.01) significantly decreased in the experiment group after manipulation, but LKV did not change significantly after the intervention (p˃0.05).

CONCLUSION

Experiment groups had different lumbar kinematics in comparison with control group before and after SIJ manipulation. Despite the changes in pelvic asymmetry and disability, intervention had no effect on lumbar kinematics.

摘要

背景

腰椎运动分析作为一种临床方法用于腰痛(LBP)的诊断和治疗。到目前为止,尚无研究表明对骶髂关节(SIJ)进行手法操作是否会改变脊柱运动学。

目的

本研究的主要目的是调查SIJ手法操作对伴有髋骨旋转的受试者腰椎运动学的影响,并比较实验组和对照组之间的腰椎运动学。

材料与方法

本研究为准实验对照试验研究。对实验组21例有髋骨前旋或后旋的LBP患者和对照组22例无症状受试者进行评估。腰椎运动学变量(LKV)包括腰椎活动范围(ROM)和速度、腰椎侧屈和旋转不对称性,对照组在两天内使用Qualysis Track Manager(QTM)评估两次,实验组在干预前后测试这些参数以及骨盆不对称性和残疾情况。

结果

干预前,实验组腰椎侧屈(p = 0.0001)、旋转(p = 0.008)ROM及侧屈速度(p = 0.014)显著降低;干预后,与对照组相比,实验组腰椎侧屈(p = 0.01)ROM显著降低。手法操作后,实验组骨盆不对称性(p = 0.049)和残疾情况(p = 0.01)显著改善,但干预后LKV无显著变化(p>0.05)。

结论

SIJ手法操作前后,实验组与对照组的腰椎运动学存在差异。尽管骨盆不对称性和残疾情况有所改善,但干预对腰椎运动学无影响。

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