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非特异性慢性下腰痛患者腰大肌疲劳的不对称性。

Asymmetry of lumbar muscles fatigability with non-specific chronic low back pain patients.

机构信息

Willy Taillard Laboratory of Kinesiology, Geneva University Hospitals and Geneva University, 4 Rue Gabrielle-Perret-Gentil, 1205, Geneva 14, Switzerland.

Univ. Grenoble Alpes, AGEIS, Grenoble, France.

出版信息

Eur Spine J. 2019 Nov;28(11):2526-2534. doi: 10.1007/s00586-019-06140-9. Epub 2019 Sep 13.

Abstract

PURPOSE

Non-specific chronic low back pain (NSCLBP) patients present with reduced back extensor muscle endurance which could be explained by the higher fatigability of their lumbar muscles. However, studies investigating lumbar muscle fatigability have shown contradictory findings. Furthermore, none investigated potential asymmetry in lumbar muscle fatigability, despite neuromuscular asymmetry being reported as a risk factor for NSCLBP. The present study's primary purpose was to determine whether NSCLBP patients presented with higher lumbar muscle fatigability and fatigability asymmetry than asymptomatic participants.

METHODS

Thirty NSCLBP patients and 23 asymptomatic participants performed the Sorensen test. The median frequencies from the electromyographs of the right and left erector spinae longissimus (ESL) and lumbar multifidus (LMF) were measured during the test. A linear regression was performed on the median frequencies on each muscle. Slope and initial median frequency were extracted to characterize fatigability. Asymmetry was quantified by the absolute differences between right-side and left-side muscle pairs.

RESULTS

NSCLBP patients presented significantly poorer back extensor muscle endurance than asymptomatic participants. No differences were found between NSCLBP patients and asymptomatic participants in terms of fatigability or fatigability asymmetry for either the ESL or LMF. The initial median frequency in both muscles was significantly lower among NSCLBP patients.

CONCLUSIONS

The present study showed that NSCLBP patients did not present higher fatigability or higher fatigability asymmetry in lumbar muscles than asymptomatic participants. The heterogeneity of the NSCLBP population, due to the absence of any specific etiology, may explain these findings. These slides can be retrieved under Electronic Supplementary Material.

摘要

目的

非特异性慢性下背痛(NSCLBP)患者的腰背伸肌耐力降低,这可以用其腰椎肌肉的疲劳性更高来解释。然而,研究腰椎肌肉疲劳性的研究结果却存在矛盾。此外,尽管神经肌肉不对称被报道为 NSCLBP 的一个危险因素,但没有研究潜在的腰椎肌肉疲劳性不对称。本研究的主要目的是确定 NSCLBP 患者是否比无症状参与者表现出更高的腰椎肌肉疲劳性和疲劳性不对称。

方法

30 名 NSCLBP 患者和 23 名无症状参与者进行了 Sorensen 测试。在测试过程中,测量了右侧和左侧竖脊肌(ESL)和多裂肌(LMF)的肌电图的中值频率。对每个肌肉的中值频率进行线性回归。提取斜率和初始中值频率来描述疲劳性。通过右侧和左侧肌肉对之间的绝对差异来量化不对称性。

结果

NSCLBP 患者的腰背伸肌耐力明显比无症状参与者差。NSCLBP 患者和无症状参与者在 ESL 或 LMF 的疲劳性或疲劳性不对称方面均无差异。在这两个肌肉中,初始中值频率在 NSCLBP 患者中明显较低。

结论

本研究表明,与无症状参与者相比,NSCLBP 患者的腰椎肌肉疲劳性或疲劳性不对称性并没有更高。由于缺乏特定病因,NSCLBP 患者群体的异质性可能解释了这些发现。这些幻灯片可以在电子补充材料中检索到。

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