Department of Orthopaedic Surgery, University of California, 95 Kirkham St., San Francisco, CA, 94122, USA.
Albany Medical College, Albany, NY, USA.
Eur Spine J. 2022 Jul;31(7):1889-1896. doi: 10.1007/s00586-022-07253-4. Epub 2022 May 20.
This study explores the biomechanics underlying the sit-to-stand (STS) functional maneuver in chronic LBP patients to understand how different spinal disorders and levels of pain severity relate to unique compensatory biomechanical behaviors. This work stands to further our understanding of the relationship between spinal loading and symptoms in LBP patients.
We collected in-clinic motion data from 44 non-specific LBP (NS-LBP) and 42 spinal deformity LBP (SD-LBP) patients during routine clinical visits. An RGB-depth camera tracked 3D joint positions from the frontal view during unassisted, repeated STS maneuvers. Patient-reported outcomes (PROs) for back pain (VAS) and low back disability (ODI) were collected during the same clinical visit.
Between patient groups, SD-LBP patients had 14.3% greater dynamic sagittal vertical alignment (dSVA) and 10.1% greater peak spine torque compared to NS-LBP patients (p < 0.001). SD-LBP patients also had 11.8% greater hip torque (p < 0.001) and 86.7% greater knee torque (p = 0.04) compared to NS-LBP patients. There were no significant differences between patient groups in regard to anterior or vertical torso velocities, but anterior and vertical torso velocities correlated with both VAS (r = - 0.38, p < 0.001) and ODI (r = - 0.29, p = 0.01). PROs did not correlate with other variables.
Patients with LBP differ in movement biomechanics during an STS transfer as severity of symptoms may relate to different compensatory strategies that affect spinal loading. Further research aims to establish relationships between movement and PROs and to inform targeted rehabilitation approaches.
本研究旨在探讨慢性下腰痛（LBP）患者坐站（STS）功能动作的生物力学基础，以了解不同的脊柱疾病和疼痛严重程度如何与独特的代偿生物力学行为相关。这项工作有助于进一步了解脊柱负荷与 LBP 患者症状之间的关系。
我们在常规临床就诊期间从 44 名非特异性下腰痛（NS-LBP）和 42 名脊柱畸形下腰痛（SD-LBP）患者中收集了门诊运动数据。在无辅助的情况下，使用 RGB-深度摄像机从正面视图跟踪 3D 关节位置，重复 STS 动作。在同一临床就诊期间收集患者报告的结果（PRO），包括背部疼痛（VAS）和下腰痛残疾（ODI）。
在患者组之间，SD-LBP 患者的动态矢状垂直平衡（dSVA）比 NS-LBP 患者大 14.3%，峰值脊柱扭矩大 10.1%（p<0.001）。SD-LBP 患者的髋部扭矩比 NS-LBP 患者大 11.8%（p<0.001），膝关节扭矩大 86.7%（p=0.04）。在向前或垂直躯干速度方面，患者组之间没有显著差异，但向前和垂直躯干速度与 VAS（r=-0.38，p<0.001）和 ODI（r=-0.29，p=0.01）均呈显著相关。PRO 与其他变量无相关性。
在 STS 转移过程中，患有 LBP 的患者的运动生物力学存在差异，因为症状的严重程度可能与影响脊柱负荷的不同代偿策略有关。进一步的研究旨在建立运动与 PRO 之间的关系，并为有针对性的康复方法提供信息。
