Yasuda Toru, Jaotawipart Sirinda, Kuruma Hironobu
Zama General Hospital, Kanagawa, Japan.
Graduate School of Human Health Sciences, Tokyo Metropolitan University, Tokyo, Japan.
Prog Rehabil Med. 2023 Jul 22;8:20230022. doi: 10.2490/prm.20230022. eCollection 2023.
This study used magnetic resonance imaging (MRI) to investigate the effects of thoracic spine self-mobilization on patients with low back pain (LBP) and lumbar hypermobility.
Twenty-four patients (15 men, 9 women) with LBP were randomly allocated to a thoracic spine self-mobilization group or sham group. The thoracic spine self-mobilization group performed thoracic spine active flexion and extension activities using two tennis balls fixed with athletic tape. Outcome measures were collected pre-intervention and after 4 weeks and included the Visual Analog Scale (VAS) for pain, the Oswestry Disability Index, lumbar rotation angle measured using MRI taken in the lateral position with 45° of trunk rotation, thoracolumbar rotation range of motion (ROM) in the sitting position, and stiffness of the erector spinae muscles. The effects of the intervention were analyzed using two-way repeated-measures analysis of variance (ANOVA), followed by multiple comparisons. The significance level was set at 5%.
The results of the two-way repeated measures ANOVA indicated that the main effect of the group was significant (P<0.05) for VAS, the sum of the lumbar rotation angle, and the thoracolumbar rotation ROM. A significant group-by-time interaction was found for the sum of lumbar rotation angles. The results of the multiple comparison tests for VAS, sum of the lumbar rotation angle from L1 to S1, and thoracolumbar rotation ROM were significantly different after 4 weeks.
This study revealed a decrease in lumbar segmentation after thoracic spine mobilization. Thoracic spine mobilization may be effective in patients with LBP and hypermobility.
本研究采用磁共振成像（MRI）来探究胸椎自我松动术对下腰痛（LBP）和腰椎活动度过大患者的影响。
24例LBP患者（15例男性，9例女性）被随机分配到胸椎自我松动术组或假手术组。胸椎自我松动术组使用两根用运动胶带固定的网球进行胸椎主动屈伸活动。在干预前和4周后收集结果指标，包括疼痛视觉模拟量表（VAS）、Oswestry功能障碍指数、在躯干旋转45°的侧位MRI测量的腰椎旋转角度、坐位胸腰段旋转活动范围（ROM）以及竖脊肌的僵硬度。使用双向重复测量方差分析（ANOVA）分析干预效果，随后进行多重比较。显著性水平设定为5%。
双向重复测量ANOVA的结果表明，对于VAS、腰椎旋转角度总和以及胸腰段旋转ROM，组间主效应显著（P<0.05）。在腰椎旋转角度总和方面发现了显著的组×时间交互作用。4周后，VAS、L1至S1腰椎旋转角度总和以及胸腰段旋转ROM的多重比较测试结果存在显著差异。
本研究揭示了胸椎松动术后腰椎节段活动度降低。胸椎松动术可能对LBP和活动度过大的患者有效。
