Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510080, China.
Neural Plast. 2021 Jul 27;2021:9975862. doi: 10.1155/2021/9975862. eCollection 2021.
This study is aimed at exploring the effects of virtual reality (VR) training on postural control, measured by anticipatory and compensatory postural adjustments (APAs and CPAs, respectively), in patients with chronic nonspecific low back pain (CNLBP) and the potential neuromuscular mechanism of VR training.
Thirty-four patients were recruited and randomly assigned to the VR group ( = 11), the motor control exercise group (MCE, = 12) and the control group (CG, = 11). The VR group received VR training using Kinect Xbox 360 systems and magnetic therapy. Besides magnetic therapy, the participants in the MCE group performed real-time ultrasound-guided abdominal drawing-in maneuver (ADIM) and four-point kneeling exercise. The CG only received magnetic therapy. Surface muscle electromyography (sEMG) was used to record the muscle activities of transverse abdominis (TrA), multifidus (MF), lateral gastrocnemius (LG), and tibialis anterior (TA) during ball-hitting tasks. The muscle activation time and integrals of the electromyography activities (IEMGs) during the APA and CPA stages were calculated and used in the data analysis. The visual analogue scale (VAS) and Oswestry dysfunction index (ODI) scores were also recorded.
A significant interaction effect of time × group was observed on the activation time of TrA ( = 0.018) and MF ( = 0.037). The post-intervention activation time of the TrA was earlier in the VR group ( = 0.029). In contrast, the post-intervention activation time of the MF was significantly delayed in the VR group ( = 0.001). The IEMGs of TrA ( = 0.002) and TA ( = 0.007) during CPA1 significantly decreased only in the VR group after the intervention. The VAS scores of three group participants showed significant decreases after intervention ( < 0.001).
Patients with CNLBP showed reciprocal muscle activation patterns of the TrA and MF muscles after VR training. VR training may be a potential intervention for enhancing the APAs of the patients with CNLBP.
本研究旨在探讨虚拟现实（VR）训练对慢性非特异性下腰痛（CNLBP）患者姿势控制的影响，分别以预期性和代偿性姿势调整（APAs 和 CPAs）来衡量，并探讨 VR 训练的潜在神经肌肉机制。
共招募 34 名患者，并随机分为 VR 组（n=11）、运动控制训练组（MCE，n=12）和对照组（CG，n=11）。VR 组使用 Kinect Xbox 360 系统和磁疗进行 VR 训练。除磁疗外，MCE 组的参与者还进行实时超声引导腹部收缩（ADIM）和四点跪地运动。CG 组仅接受磁疗。在击球任务中，使用表面肌电图（sEMG）记录横腹肌（TrA）、多裂肌（MF）、腓肠肌外侧（LG）和胫骨前肌（TA）的肌肉活动。计算 APA 和 CPA 阶段的肌电活动的肌肉激活时间和积分（IEMG），并用于数据分析。还记录了视觉模拟评分（VAS）和 Oswestry 功能障碍指数（ODI）评分。
时间×组的交互作用在 TrA（ = 0.018）和 MF（ = 0.037）的激活时间上有显著差异。VR 组干预后的 TrA 激活时间更早（ = 0.029）。相反，VR 组干预后 MF 的激活时间明显延迟（ = 0.001）。仅在 VR 组中，干预后 CPA1 期间的 TrA（ = 0.002）和 TA（ = 0.007）的 IEMG 显著降低。三组参与者的 VAS 评分在干预后均显著降低（ < 0.001）。
CNLBP 患者在 VR 训练后表现出 TrA 和 MF 肌肉的反向肌肉激活模式。VR 训练可能是增强 CNLBP 患者 APA 的潜在干预措施。
