Fitze Daniel P, Franchi Martino V, Ellenberger Lynn, Peterhans Loris, Fröhlich Stefan, Frey Walter O, Spörri Jörg
Sports Medical Research Group, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Switzerland.
University Centre for Prevention and Sports Medicine, Department of Orthopedics, Balgrist University Hospital, University of Zurich, Switzerland.
Sports Health. 2023 Nov-Dec;15(6):886-894. doi: 10.1177/19417381221136129. Epub 2022 Dec 14.
The lumbar multifidus (LMF), as a dynamic stabilizer of the lumbar spine, may play an important role in the prevention of overuse-related back complaints.
LMF morphology is associated with trunk stability and differs between symptomatic and asymptomatic skiers.
Cohort study.
Level 3.
A total of 85 youth skiers (28 females, mean age, 14.7 ± 0.7 years; 57 males, mean age, 14.9 ± 0.5 years) underwent anthropometric assessments, an estimation of biological maturation, a magnetic resonance imaging- and ultrasound-based examination of LMF morphology, and a biomechanical quantification of deadbug bridging stabilization performance. Athletes were categorized as symptomatic if they had registered at least 1 significant overuse-related back complaint episode in the 12 months before the main examination.
Male skiers showed a greater LMF size (ie, anatomical cross-sectional area [ACSA]) than female skiers, except for vertebral body L5, where no difference was found (8.8 ± 1.8 cm vs 8.3 ± 1.4 cm, = 0.18). Conversely, female skiers displayed longer fascicles than male skiers (5.8 ± 0.8 cm vs 5.4 ± 0.8 cm, = 0.03). Skiers aged under 16 years (U16) skiers had greater values for LMF size and fascicle length than U15 skiers. Maturity offset was associated with L5 LMF size ( = 0.060, = 0.01), fascicle length ( = 0.038, = 0.04), and muscle thickness ( = 0.064, = 0.02). L5 LMF size was associated with trunk stability ( = 0.068, = 0.01). Asymptomatic skiers showed on average a 12.8% greater value for L5 LMF size compared with symptomatic skiers ( = 0.04).
There are sex- and age-related differences in LMF morphology in youth competitive alpine skiers. Moreover, the ACSA at the level of the lumbar vertebral body L5 undergoes changes during biological maturation, shows a small, but significant association with trunk stability, and differs between symptomatic and asymptomatic skiers with back complaints.
The observed association of muscle structure (ie, L5 LMF ACSA) with functional aspects (ie, trunk stabilization capacity) and clinical representation (ie, overuse-related back complaints) further highlights the important role of the multifidus muscle for training and injury prevention in youth competitive alpine skiers around the growth spurt.
腰椎多裂肌（LMF）作为腰椎的动态稳定器，可能在预防与过度使用相关的背部不适方面发挥重要作用。
LMF形态与躯干稳定性相关，且有症状和无症状的滑雪者之间存在差异。
队列研究。
3级。
共有85名青年滑雪者（28名女性，平均年龄14.7±0.7岁；57名男性，平均年龄14.9±0.5岁）接受了人体测量评估、生物成熟度估计、基于磁共振成像和超声的LMF形态检查以及死虫桥接稳定性能的生物力学量化。如果运动员在主要检查前12个月内至少记录了1次与过度使用相关的严重背部不适发作，则将其归类为有症状。
男性滑雪者的LMF尺寸（即解剖横截面积[ACSA]）大于女性滑雪者，但在第5腰椎椎体处未发现差异（8.8±1.8平方厘米对8.3±1.4平方厘米，P=0.18）。相反，女性滑雪者的肌束比男性滑雪者长（5.8±0.8厘米对5.4±0.8厘米，P=0.03）。16岁以下（U16）的滑雪者的LMF尺寸和肌束长度值大于15岁以下（U15）的滑雪者。成熟度偏移与第5腰椎LMF尺寸（P=0.060，r=0.01）、肌束长度（P=0.038，r=0.04）和肌肉厚度（P=0.064，r=0.02）相关。第5腰椎LMF尺寸与躯干稳定性相关（P=0.068，r=0.01）。与有症状的滑雪者相比，无症状的滑雪者第5腰椎LMF尺寸平均大12.8%（P=0.04）。
青年竞技高山滑雪者的LMF形态存在性别和年龄相关差异。此外，第5腰椎椎体水平的ACSA在生物成熟过程中会发生变化，与躯干稳定性存在小但显著的关联，并且在有背部不适的有症状和无症状滑雪者之间存在差异。
观察到的肌肉结构（即第5腰椎LMF ACSA）与功能方面（即躯干稳定能力）和临床表现（即与过度使用相关的背部不适）之间的关联进一步凸显了多裂肌在青春期前后青年竞技高山滑雪者训练和预防损伤中的重要作用。
