Department of Rehabilitation Medicine, Iwate Medical University, Yahaba-cho Shiwa-gun, Iwate, 028-3695, Japan.
Rehabilitation Division, Iwate Medical University Hospital, Iwate, Japan.
BMC Neurol. 2022 May 23;22(1):189. doi: 10.1186/s12883-022-02719-w.
Postural abnormality is one of the main symptoms of Parkinson's disease (PD). The erector spinae muscles play an important role in maintaining an upright posture, but the fatigability of the erector spinae in patients with PD is unknown. The purpose of this study was to compare the trunk extension maximum voluntary contraction (MVC) and the fatigability of the erector spinae between female patients with PD and healthy volunteers.
Th participants of this cross-sectional pilot study comprised 19 patients with PD and nine healthy volunteers matched for sex, age, and physical characteristics as a control group. The MVC of all participants was measured, and after sufficient rest, the Sørensen back endurance test was conducted to the point of exhaustion. The muscle activity of the erector spinae during the Sørensen back endurance test was measured using surface electromyography. The median frequency (MF) slope, which is an index of fatigability, was calculated from the recorded surface muscle activity by means of power spectrum analysis using a Fast Fourier transformation.
Nine of the 19 patients with PD were unable to perform the Sørensen back endurance test, and a lower proportion of the PD group were able to perform it compared with the control group. The MVC of those patients with PD who were able to perform the Sørensen back endurance test was lower than that of the control group, and the time for which the pose could be maintained was shorter. There was no significant difference between the MF slope on the left and right side in the PD group, and it was higher on both sides than in the control group.
This is the first study to demonstrate a reduction of maximum muscle strength and great fatigability of the erector spinae in patients with PD. This discovery strongly underlines the need for paraspinal muscle training from an early stage with the aim of preventing the progression of postural abnormality in patients with PD.
姿势异常是帕金森病(PD)的主要症状之一。竖脊肌在维持直立姿势方面起着重要作用,但 PD 患者竖脊肌的疲劳性尚不清楚。本研究的目的是比较女性 PD 患者和健康志愿者的躯干伸展最大自主收缩(MVC)和竖脊肌疲劳性。
这项横断面初步研究的参与者包括 19 名 PD 患者和 9 名健康志愿者,他们在性别、年龄和身体特征方面与对照组相匹配。所有参与者的 MVC 均进行了测量,充分休息后,进行 Sørensen 腰背耐力测试直至力竭。使用表面肌电图测量 Sørensen 腰背耐力测试过程中竖脊肌的肌肉活动。通过快速傅里叶变换的功率谱分析,从记录的表面肌肉活动中计算出中位频率(MF)斜率,这是疲劳性的指标。
19 名 PD 患者中有 9 名无法进行 Sørensen 腰背耐力测试,与对照组相比,PD 组能够进行该测试的患者比例较低。能够进行 Sørensen 腰背耐力测试的 PD 患者的 MVC 低于对照组,维持姿势的时间更短。PD 组左侧和右侧的 MF 斜率没有显著差异,两侧均高于对照组。
这是第一项表明 PD 患者最大肌肉力量降低和竖脊肌疲劳性增加的研究。这一发现强烈强调了需要从早期开始进行竖脊肌训练,以防止 PD 患者的姿势异常进展。