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慢性下腰痛对从坐到站和从站到坐过程中腰椎前凸的影响。

Effect of Chronic Low Back Pain on Lumbar Spine Lordosis During Sit-to-Stand and Stand-to-Sit.

作者信息

Pourahmadi Mohammadreza, Takamjani Ismail Ebrahimi, Sarrafzadeh Javad, Mohsenifar Holakoo, Fazeli Sayyed Hamed, Bagheri Rasool, Taghipour Morteza

机构信息

Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Tehran, Iran.

Neuromuscular Rehabilitation Research Center, Department of Physiotherapy, Semnan University of Medical Sciences, Semnan, Semnan, Iran.

出版信息

J Manipulative Physiol Ther. 2020 Feb;43(2):79-92. doi: 10.1016/j.jmpt.2018.11.028. Epub 2020 May 30.

Abstract

OBJECTIVE

This study aimed to evaluate lumbar lordosis during sit-to-stand (STS) and stand-to-sit (SIT) in individuals with and without chronic nonspecific low back pain (CNLBP). The second objective was to investigate sex-related differences in lumbar lordosis.

METHODS

Twenty-six patients with CNLBP and 26 controls were recruited. Controls were matched with cases using a frequency matching method. Reflective markers were placed over the spinous process of T, L, S, and the anterior and posterior superior iliac spines. The participants were instructed to stand up at a self-selected pace and maintain their normal upright standing posture for 3 seconds, and then sit down. Kinematic data were recorded at a sampling frequency of 100 Hz using a motion capture system. Lumbar lordosis angle was calculated from the intersection between the line joining T and L, and the line joining L to S.

RESULTS

Lumbar lordosis was decreased in patients with CNLBP during STS and SIT compared with the asymptomatic group (mean difference = 2.68°-9.32°; P ≤ .005). Furthermore, no differences were seen in lumbar lordosis at starting position between CNLBP and asymptomatic groups during STS and SIT (mean difference = 2.68°-3.75°; P ≥ .099). Interestingly, the magnitude of the effect size suggested that the difference in lumbar lordosis values between female and male participants was relatively large (Cohen's d = -1.81 to 0.20).

CONCLUSION

Decreased lumbar lordosis in patients with CNLBP during STS and SIT could be considered as an important point during rehabilitation. Moreover, the present study showed that there is a sex-related difference among women and men in lumbar lordosis during STS and SIT tasks.

摘要

目的

本研究旨在评估慢性非特异性下腰痛(CNLBP)患者与非患者在从坐到站(STS)和从站到坐(SIT)过程中的腰椎前凸情况。第二个目的是调查腰椎前凸的性别差异。

方法

招募了26例CNLBP患者和26名对照者。采用频率匹配法使对照者与病例相匹配。在T、L、S棘突以及髂前上棘和髂后上棘放置反光标记物。参与者被要求以自选速度站起来,保持正常直立姿势3秒,然后坐下。使用运动捕捉系统以100Hz的采样频率记录运动学数据。腰椎前凸角度由连接T和L的线与连接L和S的线的交点计算得出。

结果

与无症状组相比,CNLBP患者在STS和SIT过程中的腰椎前凸减小(平均差异=2.68°-9.32°;P≤0.005)。此外,在STS和SIT过程中,CNLBP组与无症状组起始位置的腰椎前凸无差异(平均差异=2.68°-3.75°;P≥0.099)。有趣的是,效应量大小表明女性和男性参与者之间腰椎前凸值的差异相对较大(科恩d=-1.81至0.20)。

结论

CNLBP患者在STS和SIT过程中腰椎前凸减小可被视为康复过程中的一个重要要点。此外,本研究表明在STS和SIT任务中,男性和女性在腰椎前凸方面存在性别差异。

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