不同体位下腰背伸肌力量对退行性脊柱畸形患者健康相关生活质量的影响。

The effects of back extensor strength in different body positions on health-related quality of life in patients with degenerative spinal deformity.

机构信息

Department of Orthopaedics, Southwest Hospital, Army Medical University, Chongqing, China.

Department of Medical Research, Army Medical Center (Daping Hospital), Army Medical University, Chongqing, China.

出版信息

J Back Musculoskelet Rehabil. 2024;37(2):503-511. doi: 10.3233/BMR-230206.

DOI:10.3233/BMR-230206

PMID:38143335

Abstract

BACKGROUND

Degenerative spinal deformity (DSD) is believed to originate from degeneration of the discs and facet joints and vertebral wedging. Currently, the nosogeny of DSD is not yet fully clarified and there has been no systematic study on the impact of their lower back muscle strength on quality of life.

OBJECTIVE

To determine the characteristics of back extensor strength (BES) in different body positions and examine their correlations with health-related quality of life (HQOL) in degenerative spinal deformity (DSD) patients.

METHODS

Participants comprised 60 DSD patients and 40 healthy volunteers. Maximal isometric BES was evaluated by dynamometers with the subject in three different positions (standing, prone, sitting). The visual analogue scale (VAS) score, Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMQ), and 36-item Short Form Health Survey (SF-36) score were used to evaluate patient HQOL. Correlations between the BES in different body positions and HQOL were analysed.

RESULTS

The BES values in three body positions were significantly smaller in DSD patients than healthy subjects (P< 0.05). The standing BES was found to be negatively associated with ODI and RMQ (R= 0.313, p< 0.05 and R= 0.422, p< 0.01, respectively). A negative relationship between sitting BES and RMQ was also seen (R= 0.271, p< 0.05). In addition, the standing and prone BES were positively correlated with the physical functioning score of the SF-36 (R= 0.471, p< 0.01 and R= 0.289, p< 0.05, respectively), and the sitting BES was positively correlated with the role-physical score of the SF-36 (R= 0.436, p< 0.01).

CONCLUSION

The results indicate that the back extensor muscle is compromised in DSD patients and there are differences in predicting the severity of disability and physical HQOL scores with BES in different positions. Standing BES was the most reliable contributor to HQOL among three body positions.

摘要

背景

退行性脊柱畸形（DSD）被认为源于椎间盘和小关节的退化以及椎体楔形。目前，DSD 的发病机制尚未完全阐明，也没有对其腰背肌力量对生活质量的影响进行系统研究。

目的

确定不同体位下腰背伸肌力量（BES）的特征，并探讨其与退行性脊柱畸形（DSD）患者健康相关生活质量（HQOL）的相关性。

方法

参与者包括 60 例 DSD 患者和 40 例健康志愿者。使用测力计在三种不同体位（站立、俯卧、坐位）下评估最大等长 BES。采用视觉模拟评分（VAS）、Oswestry 功能障碍指数（ODI）、Roland-Morris 残疾问卷（RMQ）和 36 项简明健康调查量表（SF-36）评分评估患者 HQOL。分析不同体位下 BES 与 HQOL 的相关性。

结果

DSD 患者三种体位的 BES 值均明显小于健康受试者（P<0.05）。站立位 BES 与 ODI 和 RMQ 呈负相关（R=0.313，p<0.05 和 R=0.422，p<0.01）。坐位 BES 与 RMQ 也呈负相关（R=0.271，p<0.05）。此外，站立位和俯卧位 BES 与 SF-36 的躯体功能评分呈正相关（R=0.471，p<0.01 和 R=0.289，p<0.05），而坐位 BES 与 SF-36 的躯体角色功能评分呈正相关（R=0.436，p<0.01）。