Laboratory of Clinical Biomechanics, Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Laboratory of Biomechanics and Kinesiology, San José Hospital, Santiago, Chile.
Laboratory of Clinical Biomechanics, Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile; Service of Physical Therapy, Hospital Clínico La Florida, Santiago, Chile.
Arch Phys Med Rehabil. 2021 Mar;102(3):463-469. doi: 10.1016/j.apmr.2020.07.015. Epub 2020 Sep 2.
To determine the effect of dual tasking on trunk muscle endurance in patients after lumbar diskectomy.
Cross-sectional study.
Rehabilitation hospital setting.
Individuals (N=14) undergoing primary lumbar diskectomy.
Using a randomized design on 2 separate days, muscle endurance was evaluated during prone bridging and Biering-Sorensen tests. Each test was randomly performed under 2 cognitive conditions: single task without cognitive condition and self-regulated dual task (ie, mathematical task).
The primary outcomes were time to failure and pain assessed by the visual analog scale from 0 to 100 mm. The secondary outcomes were kinesiophobia assessed by the Tampa Scale and disability assessed by the Oswestry Disability Index. Associations were tested using a repeated measures analysis of variance with relevant interaction test.
A significant interaction between condition, endurance tests, and kinesiophobia (P=.005) was found. The post hoc comparison showed positive effects between cognitive conditions in both endurance tests (prone bridging test: mean difference, 15.7s; 95% confidence interval [CI], 7.5-24s; P=.001; Biering-Sorensen test: mean difference, 7.9s; 95% CI, 1.9-14s; P=.014). The linear regression analysis between the Tampa Scale for Kinesiophobia and the difference of time to failure between cognitive conditions showed a positive correlation only during the Biering-Sorensen test (r=0.80; P=.001).
A self-regulated dual task increases trunk muscle endurance in patients after lumbar diskectomy. The results suggest that the difference observed in time to failure between the single task and dual task is associated with fear avoidance, especially during back extension. This strategy seems especially relevant for patients with high levels of fear avoidance and may be used to improve trunk muscle endurance.
确定双重任务对腰椎间盘切除术后患者躯干肌肉耐力的影响。
横断面研究。
康复医院环境。
接受初次腰椎间盘切除术的个体（N=14）。
在 2 天内使用随机设计，在俯卧桥接和 Biering-Sorensen 测试中评估肌肉耐力。每项测试均在 2 种认知条件下随机进行：无认知条件的单一任务和自我调节的双重任务（即数学任务）。
主要结果是通过视觉模拟量表（0 至 100mm）评估的失败时间和疼痛。次要结果是通过坦帕量表评估的运动恐惧症和通过 Oswestry 残疾指数评估的残疾。使用重复测量方差分析和相关交互测试来测试关联。
发现条件、耐力测试和运动恐惧症之间存在显著的交互作用（P=.005）。事后比较显示，在两种耐力测试中，认知条件之间均存在积极影响（俯卧桥接测试：平均差异 15.7s；95%置信区间[CI]，7.5-24s；P=.001；Biering-Sorensen 测试：平均差异 7.9s；95%CI，1.9-14s；P=.014）。在坦帕运动恐惧症量表和认知条件之间的失败时间差异之间的线性回归分析仅显示在 Biering-Sorensen 测试中存在正相关（r=0.80；P=.001）。
自我调节的双重任务可增加腰椎间盘切除术后患者的躯干肌肉耐力。结果表明，在单一任务和双重任务之间观察到的失败时间差异与恐惧回避有关，尤其是在背伸时。这种策略似乎特别适用于恐惧回避程度较高的患者，并且可能用于提高躯干肌肉耐力。
