评估退行性脊柱畸形患者等速躯干肌肉力量及其与健康相关生活质量的关系。
Assessment of isokinetic trunk muscle strength and its association with health-related quality of life in patients with degenerative spinal deformity.
机构信息
Department of Orthopaedics, Southwest Hospital, Third Military Medical University (Army Medical University), 30 Gaotanyan Street, Shapingba, Chongqing, 400038, China.
Department of Orthopaedics, The 83nd Group Army Hospital of the People's Liberation Army (PLA 371 Central Hospital), Xinxiang Medical College, 210 Wenhua Street, Hongqi district, Xinxiang, 453000, Henan, China.
出版信息
BMC Musculoskelet Disord. 2020 Dec 9;21(1):827. doi: 10.1186/s12891-020-03844-8.
BACKGROUND
A considerable portion of the elderly population are increasingly afflicted by degenerative spinal deformity (DSD), which seriously affects patient health-related quality of life (HRQoL). HRQoL index is used across many studies to show correlations between radio-graphical alignment, disability, and pain in patients with DSD. However, imaged structural deformity represents only one aspect for consideration, namely, the disability effect of DSD. We assessed the isokinetic strength of trunk muscle in patients with degenerative spinal deformity (DSD), and investigated its relationship with HRQoL.
METHODS
In total, 38 patients with DSD (DSD group) and 32 healthy individuals (control group) were recruited. Both groups were homogeneous for age, weight, height and body mass index (BMI). Assessments were performed using the isokinetic dynamometer IsoMed-2000; trunk extensor, flexor strength and flexion/extension (F/E) ratios were explored concentrically at speeds of 30°, 60° and 120° per second. The grip strength of both hands was measured using a hand-held dynamometer. Visual analogue scale (VAS) scores, the Oswestry Disability Index (ODI), a Roland-Morris disability questionnaire (RDQ), and a 36-item Short Form Health Survey (SF-36) evaluated patient HRQoL. Correlations between trunk strength and HRQoL were analyzed.
RESULTS
When compared with the control group, the DSD group showed lower trunk extensor strength at three velocity movements, and higher F/E ratios at 60° and 120°/s (p < 0.05). Both groups exhibited similar trunk flexor strength and grip strength (p > 0.05). In DSD group, trunk extensor strength at 60°/s was negatively associated with ODI and RDQ (p < 0.05). A negative relationship between trunk flexor strength at 120°/s and ODI was also recorded (p < 0.05). In addition, trunk extensor strength at 60°/s and trunk flexor strength at 120°/s were positively correlated with physical functioning and role-physical scores according to the SF-36 (p < 0.05).
CONCLUSIONS
We identified isolated trunk extensor myopathy in DSD, which causes an imbalance in trunk muscle strength. Isokinetic trunk extensor strength at 60°/s and trunk flexor strength at 120°/s can predict disability, and decrease physical HRQoL in DSD patients.
背景
相当一部分老年人患有退行性脊柱畸形（DSD），这严重影响了患者的健康相关生活质量（HRQoL）。HRQoL 指数在许多研究中被用于显示 DSD 患者的影像学排列、残疾和疼痛之间的相关性。然而，影像学结构畸形仅代表需要考虑的一个方面，即 DSD 的残疾影响。我们评估了退行性脊柱畸形（DSD）患者的躯干肌肉等速力量，并研究了其与 HRQoL 的关系。
方法
共纳入 38 例 DSD 患者（DSD 组）和 32 例健康个体（对照组）。两组在年龄、体重、身高和体重指数（BMI）方面均相似。使用等速测力计 IsoMed-2000 进行评估；以 30°、60°和 120°/秒的速度进行同心测试，探究躯干伸肌、屈肌力量和屈伸比（F/E）。使用手持测力计测量双手握力。视觉模拟量表（VAS）评分、Oswestry 残疾指数（ODI）、Roland-Morris 残疾问卷（RDQ）和 36 项简明健康调查问卷（SF-36）评估患者的 HRQoL。分析了躯干力量与 HRQoL 之间的相关性。
结果
与对照组相比，DSD 组在三种速度运动中表现出较低的躯干伸肌力量，在 60°和 120°/s 时表现出较高的 F/E 比值（p<0.05）。两组的躯干屈肌力量和握力相似（p>0.05）。在 DSD 组中，60°/s 时的躯干伸肌力量与 ODI 和 RDQ 呈负相关（p<0.05）。120°/s 时的躯干屈肌力量与 ODI 也呈负相关（p<0.05）。此外，60°/s 时的躯干伸肌力量和 120°/s 时的躯干屈肌力量与 SF-36 中的生理功能和躯体角色评分呈正相关（p<0.05）。
结论
我们发现 DSD 中存在孤立的躯干伸肌肌病，导致躯干肌肉力量失衡。60°/s 时的等速躯干伸肌力量和 120°/s 时的躯干屈肌力量可以预测残疾，并降低 DSD 患者的生理 HRQoL。
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