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本体感觉加权变化对慢性下腰痛患者姿势控制的影响:一项横断面研究。

The effects of proprioceptive weighting changes on posture control in patients with chronic low back pain: a cross-sectional study.

作者信息

Cheng Xue, Yang Jiajia, Hao Zengming, Li Yan, Fu Ruochen, Zu Yao, Ma Jinjin, Lo Wai Leung Ambrose, Yu Qiuhua, Zhang Guifang, Wang Chuhuai

机构信息

Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

Guangdong Engineering and Technology Research Center for Rehabilitation Medicine and Translation, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.

出版信息

Front Neurol. 2023 May 19;14:1144900. doi: 10.3389/fneur.2023.1144900. eCollection 2023.

Abstract

INTRODUCTION

Patients with chronic low back pain (CLBP) exhibit changes in proprioceptive weighting and impaired postural control. This study aimed to investigate proprioceptive weighting changes in patients with CLBP and their influence on posture control.

METHODS

Sixteen patients with CLBP and 16 healthy controls were recruited. All participants completed the joint reposition test sense (JRS) and threshold to detect passive motion test (TTDPM). The absolute errors (AE) of the reposition and perception angles were recorded. Proprioceptive postural control was tested by applying vibrations to the triceps surae or lumbar paravertebral muscles while standing on a stable or unstable force plate. Sway length and sway velocity along the anteroposterior (AP) and mediolateral (ML) directions were assessed. Relative proprioceptive weighting (RPW) was used to evaluate the proprioception reweighting ability. Higher values indicated increased reliance on calf proprioception.

RESULTS

There was no significant difference in age, gender, and BMI between subjects with and without CLBP. The AE and motion perception angle in the CLBP group were significantly higher than those in the control group (JRS of 15°: 2.50 (2.50) vs. 1.50 (1.42), JRS of 35°: 3.83 (3.75) vs. 1.67 (2.00), < 0.01; 1.92 (1.18) vs. 0.68 (0.52), < 0.001). The CLBP group demonstrated a significantly higher RPW value than the healthy controls on an unstable surface (0.58 ± 0.21 vs. 0.41 ± 0.26, < 0.05). Under the condition of triceps surae vibration, the sway length ( < 0.05; < 0.001), AP velocity ( < 0.01; < 0.001) and ML velocity ( < 0.05) had significant group main effects. Moreover, when the triceps surae vibrated under the unstable surface, the differences during vibration and post vibration in sway length and AP velocity between the groups were significantly higher in the CLBP group than in the healthy group ( < 0.05). However, under the condition of lumbar paravertebral muscle vibration, no significant group main effect was observed.

CONCLUSION

The patients with CLBP exhibited impaired dynamic postural control in response to disturbances, potentially linked to changes in proprioceptive weighting.

摘要

引言

慢性下腰痛(CLBP)患者表现出本体感觉权重变化和姿势控制受损。本研究旨在调查CLBP患者的本体感觉权重变化及其对姿势控制的影响。

方法

招募了16名CLBP患者和16名健康对照者。所有参与者均完成了关节复位测试感觉(JRS)和被动运动检测阈值测试(TTDPM)。记录复位和感知角度的绝对误差(AE)。通过在稳定或不稳定的测力平台上站立时对腓肠肌或腰旁肌施加振动来测试本体感觉姿势控制。评估沿前后(AP)和内外侧(ML)方向的摆动长度和摆动速度。使用相对本体感觉权重(RPW)来评估本体感觉重新加权能力。较高的值表明对小腿本体感觉的依赖增加。

结果

有CLBP和无CLBP的受试者在年龄、性别和BMI方面无显著差异。CLBP组的AE和运动感知角度显著高于对照组(15°的JRS:2.50(2.50)对1.50(1.42),35°的JRS:3.83(3.75)对1.67(2.00),<0.01;1.92(1.18)对0.68(0.52),<0.001)。在不稳定表面上,CLBP组的RPW值显著高于健康对照组(0.58±0.21对0.41±0.26,<0.05)。在腓肠肌振动的情况下,摆动长度(<0.05;<0.001)、AP速度(<0.01;<0.001)和ML速度(<0.05)有显著的组主效应。此外,当在不稳定表面下腓肠肌振动时,CLBP组在振动期间和振动后的摆动长度和AP速度的组间差异显著高于健康组(<0.05)。然而,在腰旁肌振动的情况下,未观察到显著的组主效应。

结论

CLBP患者在受到干扰时表现出动态姿势控制受损,这可能与本体感觉权重的变化有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7dd5/10235490/fde5315fd4a3/fneur-14-1144900-g0001.jpg

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