Motor Control and Neural Plasticity Lab, Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom 73170, Thailand.
Physical Therapy Clinic, Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom 73170, Thailand..
Clin Biomech (Bristol). 2020 May;75:104996. doi: 10.1016/j.clinbiomech.2020.104996. Epub 2020 Apr 20.
Theoretically, lumbopelvic stabilization techniques during hamstring muscle stretching could increase lumbar stiffness relative to hamstring muscle in individuals with a history of low back pain and suspected clinical lumbar instability. However, evidence to support this theory is limited. This study aimed to 1) determine changes in lumbopelvic, lumbar, and hip motions, and hamstring muscle length after stretching exercises with lumbopelvic stiffening or relaxing techniques, and 2) compare those changes between techniques.
This study used a randomized crossover design. Thirty-two participants with a history of low back pain and bilateral hamstring muscle tightness were recruited. The order of the first technique was randomly assigned. After a 2-day washout, participants were crossed over to the second technique. Motion data during active forward trunk bending and bilateral hamstring muscle length during passive knee extension were collected pre- and post-intervention.
Significant increases (P < 0.05) were found in bilateral hamstring muscle length for both techniques. However, stiffening technique demonstrated a significant decrease in lumbar motion (P < 0.05) and increase in hip motion (P < 0.05), while relaxing technique demonstrated trends showing increases in lumbar and hip motions (P = 0.134 and 0.115, respectively). The findings showed significantly greater improvement (P < 0.05) in lumbar and hip motions with stiffening technique.
The findings suggest increased relative stiffness of the lumbar spine during hamstring muscle stretching can specifically lengthen bilateral hamstring muscle and decrease excessive lumbar motion. This stiffening technique may prevent excessive movement of the lumbar spine, thereby reducing the risk of recurrent low back pain.
理论上，在有腰痛病史和疑似临床腰椎不稳定的个体进行腘绳肌拉伸时，采用腰骶部稳定技术可以使腰椎相对于腘绳肌的刚度增加。但是，支持这一理论的证据有限。本研究旨在：1）确定腰骶部僵硬或放松技术拉伸运动后腰骶部、腰椎和髋关节运动以及腘绳肌长度的变化；2）比较两种技术之间的这些变化。
本研究采用随机交叉设计。招募了 32 名有腰痛病史和双侧腘绳肌紧张的参与者。首先随机分配技术的顺序。经过 2 天的洗脱期后，参与者交叉到第二种技术。在干预前后，收集主动前屈和双侧被动膝关节伸展时的运动数据。
两种技术的双侧腘绳肌长度均有显著增加（P<0.05）。然而，僵硬技术的腰椎运动明显减少（P<0.05），髋关节运动增加（P<0.05），而放松技术则显示出腰椎和髋关节运动增加的趋势（P=0.134 和 0.115）。结果表明，僵硬技术在腰椎和髋关节运动方面的改善程度显著更大（P<0.05）。
研究结果表明，在腘绳肌拉伸过程中，腰椎的相对刚度增加可以专门拉长双侧腘绳肌并减少腰椎过度运动。这种僵硬技术可以防止腰椎过度运动，从而降低腰痛复发的风险。
