Liechti Melanie, von Arx Michael, Eichelberger Patric, Bangerter Christian, Meier Michael L, Schmid Stefan
Spinal Movement Biomechanics Group, Division of Physiotherapy, School of Health Professions, Bern University of Applied Sciences, Bern, Switzerland.
Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; University of Zurich, Zurich, Switzerland.
J Electromyogr Kinesiol. 2022 Aug;65:102678. doi: 10.1016/j.jelekin.2022.102678. Epub 2022 Jun 3.
Fear-avoidance beliefs, particularly the fear of lifting with a flexed spine, are associated with reduced spinal motion during object lifting. Low back pain patients thereby also showed potentially clinically relevant changes in the spatial distribution of back muscle activity, but it remains unknown whether such associations are also present in pain-free individuals. This cross-sectional observational study investigated the relationship between fear-avoidance beliefs and the spatial distribution of lumbar paraspinal muscle activity in pain-free individuals during a repetitive lifting task. Thirty participants completed two pain-related fear questionnaires and performed 25 repetitions of lifting a 5 kg-box from a lower to an upper shelf and back, while multi-channel electromyographic signals were recorded bilaterally from the lumbar erector spinae muscles. Changes in spatial distribution were defined as the differences in vertical position of the weighted centroids of muscle activity (centroid shift) between the first and last few repetitions. Linear regression analyses were performed to examine the relationships between centroid shift and fear-avoidance belief scores. Fear of lifting an object with a flexed spine was negatively associated with erector spinae activity centroid shift (R adj. = 0.1832; p = 0.045), which might be an expression of behavioral alterations to prevent the back from possible harm.
恐惧回避信念，尤其是对脊柱弯曲时提起重物的恐惧，与物体提起过程中脊柱活动度降低有关。腰痛患者的背部肌肉活动空间分布也出现了潜在的临床相关变化，但尚不清楚这种关联在无疼痛个体中是否也存在。这项横断面观察性研究调查了无疼痛个体在重复提起任务期间恐惧回避信念与腰旁肌活动空间分布之间的关系。30名参与者完成了两份与疼痛相关的恐惧问卷，并进行了25次将一个5公斤重的盒子从较低架子举到较高架子再放回的动作，同时从双侧腰竖脊肌记录多通道肌电信号。空间分布的变化定义为最初几次和最后几次重复动作之间肌肉活动加权质心垂直位置的差异（质心偏移）。进行线性回归分析以检验质心偏移与恐惧回避信念得分之间的关系。对脊柱弯曲时提起物体的恐惧与竖脊肌活动质心偏移呈负相关（调整后R = 0.1832；p = 0.045），这可能是为防止背部受到可能伤害而出现的行为改变的一种表现。
