Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Belgium.
Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium.
J Electromyogr Kinesiol. 2019 Dec;49:102352. doi: 10.1016/j.jelekin.2019.102352. Epub 2019 Aug 22.
Clinically, sagittal spinal mobility is objectively assessed by forward bending range of motion (ROM) tests such as the modified-Schober test (m-Schober test). However, evidence comparing ROM during forward bending and daily activities is limited. In this study, a kinematic model including six spinal regions, pelvic/sacral and femur segment was used to characterize associations between m-Schober test and return from forward bending (RFB), and between RFB and lifting. No significant correlations were found between m-Schober test and lumbar ROM during RFB. Furthermore, we found significantly smaller ROM in all spinal regions during lifting compared to RFB, except in the upper thoracic spine, lumbosacral (L5/S1) and hip joints. However, we observed moderate to very strong correlations between the two movements tasks for all lumbar regions. Furthermore, cross-correlation between L5/S1 and lower lumbar spine regions showed no segmental redundancy of L5. These results suggest that an m-Schober test provides insufficient insight into lumbar mobility and that multi-segmental spine measurements should be introduced clinically. Furthermore, this study has demonstrated that RFB can be used as a reference for lumbar regions during lifting, with use of the current multi-segmental spine model and that the inclusion of L5/S1 provides more detailed information on lumbar kinematics.
临床上，通过前屈活动范围（ROM）测试（如改良 Schober 测试（m-Schober 测试））客观评估矢状位脊柱活动度。然而，比较前屈时 ROM 与日常活动的证据有限。在这项研究中，使用包括六个脊柱区域、骨盆/骶骨和股骨段的运动学模型来描述 m-Schober 测试与前屈后恢复（RFB）之间以及 RFB 与举重之间的关联。m-Schober 测试与 RFB 期间腰椎 ROM 之间没有发现显著相关性。此外，与 RFB 相比，在举重过程中所有脊柱区域的 ROM 均显著较小，除了在上胸椎、腰骶（L5/S1）和髋关节。然而，我们观察到对于所有腰椎区域，这两个运动任务之间存在中等至非常强的相关性。此外，L5/S1 和下腰椎区域之间的互相关显示 L5 没有节段冗余。这些结果表明，m-Schober 测试不能充分了解腰椎的活动度，临床上应引入多节段脊柱测量。此外，本研究表明，RFB 可作为举重过程中腰椎区域的参考，使用当前的多节段脊柱模型，并且包括 L5/S1 可以提供有关腰椎运动学的更详细信息。
