青少年特发性脊柱侧凸患者进行上肢功能任务时,胸椎伸肌肌肉疲劳对神经肌肉控制的影响。

Effect of muscle fatigue of the thoracic erector spinae on neuromuscular control when performing the upper extremity functional tasks in people with adolescent idiopathic scoliosis.

机构信息

Department of Rehabilitation Science, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.

School of Health Sciences, University of Sydney, Sydney, Australia.

出版信息

PLoS One. 2023 Jan 27;18(1):e0281001. doi: 10.1371/journal.pone.0281001. eCollection 2023.

Abstract

Adolescent idiopathic scoliosis (AIS) disrupts spinal alignment and increases the intrinsic demand for active stabilization to maintain postural stability. Understanding the paraspinal muscle fatigability and its effects on spinal alignment and kinematics informs the importance of paraspinal muscle endurance for postural stability. This study aims to investigate the effects of fatigue of thoracic erector spinae on the spinal muscle activity and spinal kinematics in individuals with scoliosis. Spinal muscle activity, posture and mobility measured by electromyography and surface tomography were compared between 15 participants with scoliosis and 15 age- and gender-matched healthy controls during unilateral shoulder flexion and abduction with and without holding a 2-kg weight and performed before and after a fatigue task (prone isometric chest raise). No between-groups difference was found for the spinal extensor endurance. Erector spinae activity at the convex side of AIS group was significantly higher than that at their concave side and than that of healthy controls during shoulder elevations, regardless of the fatigue status. Significant decreases in translational and rotational mobility were found at convex side of AIS group during weighted abduction tasks after fatigue. In contrast, a significant increase in rotational mobility was demonstrated at convex side of AIS participants during weighted flexion tasks after fatigue. Our results revealed a comparable level of spinal extensor endurance between individuals with or without AIS. The increase in muscle activation post-fatigue provides no additional active postural stability but may increase the risk of back pain over the convex side in individuals with scoliosis. Findings highlight imbalances in muscles and the potential implications in optimising neuromuscular activation and endurance capacity in the rehabilitation for AIS patients. Future research is needed to investigate if endurance training of the convex-sided back extensors could optimize the impaired neuromuscular control in the AIS patients.

摘要

青少年特发性脊柱侧凸(AIS)会破坏脊柱的排列,并增加主动稳定的内在需求,以维持姿势稳定。了解竖脊肌的疲劳特性及其对脊柱排列和运动学的影响,有助于认识竖脊肌耐力对姿势稳定的重要性。本研究旨在探讨脊柱侧凸患者胸段竖脊肌疲劳对脊柱肌肉活动和脊柱运动学的影响。在进行单侧肩前屈和外展时,通过肌电图和表面断层摄影术测量脊柱肌肉活动、姿势和活动度,并与 15 名脊柱侧凸患者和 15 名年龄和性别匹配的健康对照组进行比较,同时还比较了有无持 2kg 重物以及疲劳任务(俯卧等长胸部抬高)前后的情况。脊柱伸肌耐力在两组间无差异。在进行肩抬高时,AIS 组凸侧的竖脊肌活动明显高于凹侧和健康对照组,无论疲劳状态如何。疲劳后,AIS 组凸侧在进行负重外展时,平移和旋转活动度显著下降。相比之下,在疲劳后进行负重前屈时,AIS 组凸侧的旋转活动度显著增加。我们的结果表明,脊柱侧凸患者与无脊柱侧凸患者的脊柱伸肌耐力相当。疲劳后肌肉激活增加并不能提供额外的主动姿势稳定性,但可能会增加脊柱侧凸患者凸侧背部疼痛的风险。研究结果强调了肌肉的不平衡以及在优化脊柱侧凸患者神经肌肉激活和耐力能力的康复治疗中的潜在影响。需要进一步的研究来探讨凸侧腰背伸肌耐力训练是否可以优化脊柱侧凸患者受损的神经肌肉控制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb31/9882757/5fd511daf1ec/pone.0281001.g001.jpg

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