Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, 1st, Abivardi Avenue, Chamran Blvd, Shiraz, Iran.
Int Urogynecol J. 2024 Jan;35(1):109-117. doi: 10.1007/s00192-023-05673-4. Epub 2023 Nov 22.
Patients with chronic functional constipation have some problems such as weakness of pelvic floor muscles, and a lack of coordination of pelvic floor and abdominal muscles has been seen. The goal of this study was to investigate the lumbar proprioception and the core muscle recruitment pattern.
The study type is a cross-sectional case-control study. There were 30 participants (case, n = 15, and control, n = 15). Electromyography of the core muscles was recorded while the subjects were getting up from the chair accompanied by lifting a weight, to check the pattern of muscle recruitment. Moreover, the lumbar proprioception was evaluated by an isokinetic device in both groups. The study was analyzed using independent t test and Mann-Whitney U test, and a nonparametric Friedman test was performed followed by Bonferroni pairwise comparison.
The comparison of muscle activity delay between the two groups showed that there was a significant difference between the two groups regarding the abdominal muscles, anal sphincter, and erector spinae (p < 0.05). However, there was no significant difference in the rectus femoris and gluteal muscles between the two groups (p > 0.05). Moreover, the proprioception of the lumbar region showed a significant difference (p < 0.05) between the two groups.
The results of this study demonstrated that the lumbar proprioception sense was reduced in the case group. This result can be justified, based on the problems in constipation (lack of coordination of muscles, weakness of pelvic floor muscles). The coordination of core muscles changed in patients with chronic functional constipation during a functional task.
慢性功能性便秘患者存在一些问题，如盆底肌无力，并且已经观察到盆底肌和腹肌的协调性不足。本研究的目的是研究腰椎本体感觉和核心肌肉募集模式。
研究类型为横断面病例对照研究。共有 30 名参与者（病例组，n=15；对照组，n=15）。在受试者起身时，通过抬起重物来记录核心肌肉的肌电图，以检查肌肉募集模式。此外，两组均通过等速装置评估腰椎本体感觉。使用独立 t 检验和 Mann-Whitney U 检验对研究进行分析，并进行非参数 Friedman 检验，然后进行 Bonferroni 两两比较。
两组肌肉活动延迟的比较显示，两组之间在腹部肌肉、肛门括约肌和竖脊肌方面存在显著差异（p<0.05）。然而，两组之间股直肌和臀肌之间没有显著差异（p>0.05）。此外，两组之间的腰椎区域本体感觉存在显著差异（p<0.05）。
本研究结果表明，病例组的腰椎本体感觉降低。基于便秘的问题（肌肉协调性不足、盆底肌无力）可以解释这一结果。慢性功能性便秘患者在执行功能任务时，核心肌肉的协调性发生了变化。
