Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, United States.
Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri, United States.
Musculoskelet Sci Pract. 2021 Apr;52:102336. doi: 10.1016/j.msksp.2021.102336. Epub 2021 Jan 26.
Subgroups of people with low back pain display differences in their lumbar alignment during tests from a clinical examination. However, it is unknown if subgroups display the same patterns during a functional activity test and if gender influences subgroup-related differences.
Test if differences in lumbar alignment between two LBP subgroups are 1) present during a functional activity test of preferred sitting and 2) independent of gender.
Cross-sectional.
154 participants with chronic low back pain were classified based on the Movement System Impairment Classification System by a physical therapist. Participants performed a functional activity test of preferred sitting and clinical tests of maximum flexed and extended sitting. 3D marker co-ordinate data were collected. Sagittal plane lumbar alignment, indexed by lumbar curvature angle, was calculated. A three-way mixed effect analysis of variance was used to examine effects of test, subgroup, gender, subgroup × test, gender × test and subgroup × gender.
RESULTS/FINDINGS: The lumbar rotation with extension subgroup [LCA = -8.0° (-9.5,-6.5)] displayed a more extended lumbar alignment than lumbar rotation [LCA = -5.9° (-7.4,-4.4)]. Women [LCA = -10.7° (-12.3,-9.2)] displayed a more extended lumbar alignment than men [LCA = -3.2° (-4.7,-1.7)]. There was a significant gender × test interaction (p = 0.01). The subgroup × test (p = 0.99) and subgroup × gender (p = 0.76) interactions were not significant.
LBP subgroup differences in lumbar alignment are present during preferred sitting. Gender-related differences in lumbar alignment are not driving subgroup differences. These findings highlight the need to use patient-specific clinical characteristics to guide treatment of a functional activity of preferred sitting limited due to low back pain.
在临床检查的测试中，腰痛患者亚组的腰椎排列存在差异。然而，尚不清楚这些亚组在功能活动测试中是否表现出相同的模式，以及性别是否会影响与亚组相关的差异。
检验 2 个 LBP 亚组之间的腰椎排列差异 1）是否存在于功能活动的首选坐姿测试中，以及 2）是否独立于性别。
横断面研究。
154 名慢性腰痛患者由物理治疗师根据运动系统障碍分类系统进行分类。参与者进行了首选坐姿的功能活动测试和最大屈曲及伸展坐姿的临床测试。收集 3D 标记坐标数据。通过腰椎曲率角计算矢状面腰椎排列，即腰椎曲度角。采用三因素混合效应方差分析检验测试、亚组、性别、亚组×测试、性别×测试和亚组×性别之间的影响。
结果/发现：伸展性腰椎旋转亚组[LCA=-8.0°（-9.5，-6.5）]的腰椎排列比腰椎旋转亚组更伸展[LCA=-5.9°（-7.4，-4.4）]。女性[LCA=-10.7°（-12.3，-9.2）]的腰椎排列比男性更伸展[LCA=-3.2°（-4.7，-1.7）]。性别与测试之间存在显著的交互作用（p=0.01）。亚组与测试（p=0.99）和亚组与性别（p=0.76）之间的交互作用不显著。
在首选坐姿中，腰痛患者亚组的腰椎排列存在差异。腰椎排列的性别差异并不是导致亚组差异的原因。这些发现强调需要使用患者特定的临床特征来指导因腰痛而受限的首选坐姿的功能活动治疗。
