非特异性慢性下腰痛男性在直立坐姿和前屈位时的腰椎轴向旋转运动学。
Lumbar Axial Rotation Kinematics in an Upright Sitting and With Forward Bending Positions in Men With Nonspecific Chronic Low Back Pain.
机构信息
Department of Physical Therapy, The Spinal Research Laboratory, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
Department of Physical Therapy, Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel.
出版信息
Spine (Phila Pa 1976). 2020 Mar 1;45(5):E244-E251. doi: 10.1097/BRS.0000000000003265.
STUDY DESIGN
A controlled cross-sectional study.
OBJECTIVE
The aim of this study was to compare the kinematics of lumbar axial rotation while sitting in an upright and forward bending position in men suffering with and without nonspecific chronic low back pain (NSCLBP).
SUMMARY OF BACKGROUND DATA
Lumbar rotation while sitting is an important factor in the mechanism of low back pain. Nevertheless, its kinematics has scarcely been investigated.
METHODS
Range of motion (ROM in), average velocity (AV), maximum velocity (MV), and maximal acceleration (MA) of lumbar rotation while sitting in an upright (UP-sitting) and full forward bending position (FFB-sitting) were examined using an industrial lumbar motion monitor in 50 men (25 with NSCLBP and 25 controls). Pain level and the Rolland Morris questionnaire (RMQ) were also included.
RESULTS
All examined kinematical parameters were significantly lower in men with NSCLBP compared with the controls (↓ROM = 16%-29%; ↓AV = 35%-53%; ↓MV = 3%-46%; ↓MA = 7%-44%) and significantly decreased when moving from UP-sitting to FFB-sitting. In the UP-sitting, the ROM and AV in both groups and the right rotation-MV in the NSCLBP group were always greater during the right rotation compared to the left (NSCLBP = ROM: Δ3.92°, AV: Δ2.74°, MV:Δ3.61°; controls = ROM: Δ3.46°, AV: Δ1.72°). The left rotation-MV was significantly greater compared to the right only in FFB-sitting in the controls (Δ3.03°). In all kinematical parameters in the NSCLBP group, no correlations were found in the visual analogue scale (VAS) levels (4.43 ± 1.47) or RMQ total score (12.32 ± 5.44).
CONCLUSION
The kinematic parameters of lumbar rotation were reduced in men with NSCLBP compared with controls both in an UP-sitting and FFB-sitting. In both groups, NSCLBP and controls, asymmetry in lumbar rotation kinematics was indicated as well as a decrease when moving from UP-sitting to FFB-sitting.
LEVEL OF EVIDENCE
研究设计
对照性的横截面研究。
目的
本研究旨在比较患有和不患有非特异性慢性下腰痛（NSCLBP）的男性在直坐和前屈位时腰椎轴向旋转的运动学。
背景资料概要
坐时腰椎旋转是腰痛机制中的一个重要因素。然而，其运动学尚未得到充分研究。
方法
使用工业腰椎运动监测仪，对 50 名男性（25 名患有 NSCLBP，25 名对照组）在直坐（UP 坐姿）和完全前屈位（FFB 坐姿）时的腰椎旋转活动范围（ROM in）、平均速度（AV）、最大速度（MV）和最大加速度（MA）进行了检测。还包括疼痛程度和 Rolando Morris 问卷（RMQ）。
结果
与对照组相比，患有 NSCLBP 的男性所有检查的运动学参数均显著降低（↓ROM=16%-29%；↓AV=35%-53%；↓MV=3%-46%；↓MA=7%-44%），且从 UP 坐姿移动到 FFB 坐姿时，这些参数显著下降。在 UP 坐姿中，ROM 和 AV 在两组中以及 NSCLBP 组的右侧旋转-MV 总是大于左侧（NSCLBP=ROM：Δ3.92°，AV：Δ2.74°，MV：Δ3.61°；对照组=ROM：Δ3.46°，AV：Δ1.72°）。仅在对照组中，FFB 坐姿时左侧旋转-MV 明显大于右侧（Δ3.03°）。在 NSCLBP 组的所有运动学参数中，VAS 水平（4.43±1.47）或 RMQ 总分（12.32±5.44）均无相关性。
结论
与对照组相比，患有 NSCLBP 的男性在直坐和 FFB 坐姿时腰椎旋转的运动学参数均降低。在两组中，NSCLBP 和对照组都表现出腰椎旋转运动学的不对称性，并且从直坐移动到 FFB 坐姿时会减少。
证据等级
3 级
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