屈伸比不对称与伴有和不伴有慢性非特异性下腰痛个体躯干侧屈 ROM 的关系。
Flexion-Relaxation Ratio Asymmetry and Its Relation With Trunk Lateral ROM in Individuals With and Without Chronic Nonspecific Low Back Pain.
机构信息
Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, Geneva, Switzerland.
University Grenoble Alpes, AGEIS, Grenoble, France.
出版信息
Spine (Phila Pa 1976). 2020 Jan 1;45(1):E1-E9. doi: 10.1097/BRS.0000000000003196.
STUDY DESIGN
A cross-sectional comparative study.
OBJECTIVE
The present study aimed to investigate the relationship between the FR phenomenon asymmetry of lumbar muscles and trunk lateral range of motion (ROM) asymmetry in nonspecific chronic low back pain (NSCLBP) patients.
SUMMARY OF BACKGROUND DATA
Imbalance in trunk muscle activation between right and left sides can induce pain by loading the spine incorrectly, especially in patients with NSCLBP. A previous study reported a greater asymmetry in the FR phenomenon of the erector spinae in NSCLBP patients than in asymptomatic participants (APs). Imbalance of muscle properties, such as trunk ROM, has been suggested as a possible cause of this observed asymmetry.
METHODS
Twenty-eight NSCLBP patients and 22 AP performed 3 standing maximal trunk flexions. Surface electromyography was recorded bilaterally for erector spinae longissimus and lumbar multifidus. A FR ratio was calculated for each muscle. The fingertip-to-thigh test was performed to assess trunk lateral ROM. Each parameter's asymmetry was calculated as the absolute difference between right and left sides.
RESULTS
NSCLBP patients present a significantly lower trunk lateral ROM than AP. FR ratio asymmetry of the erector spinae was significantly greater in NSCLBP patients than in AP (P < 0.05). FR ratio asymmetry of the multifidus and trunk lateral ROM asymmetry were not significantly different between groups. Significant correlation (r = 0.49) between FR ratio asymmetry of erector spinae and trunk lateral ROM asymmetry was observed only for patients with NSCLBP.
CONCLUSION
The present findings showed that FR ratio asymmetry of erector spinae longissimus is moderately correlated with trunk lateral ROM asymmetry. In addition, the results confirmed that patients with NSCLBP present a reduced trunk lateral ROM, a FR ratio asymmetry of the erector spinae which is correlated with trunk rotation. These findings suggested an imbalance spine loading which can contribute to the persistence of pain.
LEVEL OF EVIDENCE
研究设计
一项横断面对比研究。
目的
本研究旨在探讨非特异性慢性下腰痛（NSCLBP）患者腰椎 FR 现象不对称与躯干侧向活动范围（ROM）不对称之间的关系。
背景资料总结
躯干肌肉两侧的激活不平衡会导致脊柱不正确加载，从而引起疼痛，尤其是在 NSCLBP 患者中。先前的研究报告称，NSCLBP 患者的竖脊肌 FR 现象的不对称性大于无症状参与者（AP）。肌肉特性（如躯干 ROM）的不平衡已被认为是观察到的这种不对称的可能原因。
方法
28 名 NSCLBP 患者和 22 名 AP 进行了 3 次最大站立躯干屈曲。双侧记录竖脊肌和多裂肌的表面肌电图。计算每个肌肉的 FR 比值。指尖到大腿测试用于评估躯干侧向 ROM。每个参数的不对称性计算为右侧和左侧之间的绝对差异。
结果
NSCLBP 患者的躯干侧向 ROM 明显低于 AP。NSCLBP 患者的竖脊肌 FR 比值不对称性明显大于 AP（P<0.05）。多裂肌和躯干侧向 ROM 不对称性在两组之间无显著差异。仅在 NSCLBP 患者中观察到竖脊肌 FR 比值不对称性与躯干侧向 ROM 不对称性之间存在显著相关性（r=0.49）。
结论
本研究结果表明，竖脊肌长肌的 FR 比值不对称与躯干侧向 ROM 不对称具有中等相关性。此外，结果证实 NSCLBP 患者的躯干侧向 ROM 降低，与躯干旋转相关的竖脊肌 FR 比值不对称。这些发现表明脊柱负荷不平衡，这可能导致疼痛持续存在。
证据水平
3 级。
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