Yang Qi-Hao, Wang Xue-Qiang
Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China.
Department of Rehabilitation Medicine, Shanghai Shangti Orthopaedic Hospital, Shanghai, China.
EFORT Open Rev. 2023 Aug 1;8(8):639-650. doi: 10.1530/EOR-23-0077.
Lumbar position sense can be assessed by measurement instruments including the goniometer, isokinetic dynamometry, and electronic motion monitoring equipment, which have demonstrated relatively high reliability. This literature provides a comprehensive overview of influencing factors of lumbar position sense measurement, including repositioning method, fatigue degree, and posture during the reposition. It highlights the significant role of muscle proprioception, which contributes to greater accuracy in active reposition compared to passive reposition. The differences in lumbar position sense with different measurement positions may be explained by the presence of mechanoreceptors in the load-bearing structures of the lumbar spine, especially in the facet joint capsules. These mechanoreceptors play a crucial role in providing sensory feedback and proprioceptive information pertaining to the position and movement of the lumbar spine. Individuals with low back pain (LBP) demonstrate alterations in lumbar position sense compared to those without LBP. The auto motor sensory feedback transmission mechanism of patients with non-specific LBP was more unstable than that of healthy people. These findings suggest that lumbar position sense may play a potential role in the development and perpetuation of LBP. At present, the commonly used clinical assessment methods for determining position sense include both active and passive repositioning. However, neither method exhibits high sensitivity and specificity, leading to the poor comparability of relevant studies and posing challenges for clinical application.
腰椎位置觉可通过包括角度计、等速测力法和电子运动监测设备在内的测量仪器进行评估，这些仪器已显示出相对较高的可靠性。该文献全面概述了腰椎位置觉测量的影响因素，包括重新定位方法、疲劳程度和重新定位期间的姿势。它强调了肌肉本体感觉的重要作用，与被动重新定位相比，肌肉本体感觉有助于主动重新定位时更高的准确性。不同测量位置的腰椎位置觉差异可能由腰椎承重结构中机械感受器的存在来解释，尤其是在小关节囊中。这些机械感受器在提供与腰椎位置和运动相关的感觉反馈和本体感觉信息方面起着关键作用。与无下腰痛（LBP）的个体相比，下腰痛患者的腰椎位置觉存在改变。非特异性LBP患者的自动运动感觉反馈传递机制比健康人更不稳定。这些发现表明，腰椎位置觉可能在LBP的发生和持续存在中发挥潜在作用。目前，用于确定位置觉的常用临床评估方法包括主动和被动重新定位。然而，这两种方法都没有表现出高敏感性和特异性，导致相关研究的可比性较差，并给临床应用带来挑战。
