Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Québec, H3A 3C2, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada.
School of Physical & Occupational Therapy, McGill University, Montréal, Québec, H3G 1Y5, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM), Centre intégré universitaire de santé et de services sociaux du Centre-Sud-de-l'Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada.
Musculoskelet Sci Pract. 2021 Oct;55:102421. doi: 10.1016/j.msksp.2021.102421. Epub 2021 Jul 4.
Wearing a lumbosacral orthosis (LSO) is known to influence spine mechanics, but less is known about how LSOs affect motor control. Whether the use of a LSO can negatively affect motor control of the lumbar spine is still under debate.
The current study examined the immediate effects of two flexible LSOs (extensible and non-extensible) on the anticipatory postural adjustments that prepare the spine for a predictable perturbation.
A comparative study using a repeated measures design in a laboratory setting.
Healthy controls (n = 20) and participants with low back pain (n = 40) performed a rapid arm flexion/extension cycle with and without these LSOs. The latency between the activations of the shoulder and different back (iliocostalis lumborum) and abdominal (rectus abdominis, internal and external obliques) muscles, as measured with surface electromyography, was used as the outcome.
The effects, which were comparable between groups and between LSOs, were mixed, with some muscles showing significantly (p ˂ 0.05) earlier activation and others showing delayed activation with the use of a LSO, relative to the control condition. The corresponding effect sizes were low to average (Hedges's g range: 0.17-0.48).
These findings suggest a change in the motor program before task initiation, which might be generalizable to other activities of daily living or work. However, none of the effects were large, making it difficult to provide clear conclusions with regard to their clinical relevance. It remains to be tested whether these immediate adaptations in motor planning can induce long term detrimental effects to the control of lumbar stability.
佩戴腰骶矫形器（LSO）已知会影响脊柱力学，但对于 LSO 如何影响运动控制知之甚少。LSO 的使用是否会对腰椎的运动控制产生负面影响仍存在争议。
本研究旨在检测两种柔性 LSO（可伸缩和不可伸缩）对预期姿势调整的即时影响，这些调整可使脊柱为可预测的干扰做好准备。
在实验室环境中使用重复测量设计的比较研究。
健康对照组（n=20）和腰痛组（n=40）在使用和不使用这些 LSO 的情况下进行快速手臂屈伸/伸展循环。通过表面肌电图测量肩部和不同背部（多裂肌）和腹部（腹直肌、内/外斜肌）肌肉的激活之间的潜伏期，作为结果。
这些影响在组间和 LSO 间是混合的，具有可比性，一些肌肉的激活明显（p ˂ 0.05）更早，而其他肌肉的激活则延迟，与对照条件相比。相应的效应大小为低至中等（Hedges's g 范围：0.17-0.48）。
这些发现表明在任务开始前运动程序发生了变化，这可能适用于其他日常生活活动或工作。然而，没有一个影响是大的，因此很难对其临床相关性得出明确的结论。尚待测试这些运动规划的即时适应是否会对腰椎稳定性的控制产生长期的不利影响。
