Saito Hiroki, Yokoyama Hikaru, Sasaki Atsushi, Nakazawa Kimitaka
Department of Physical Therapy, Tokyo University of Technology, Tokyo, JPN.
Division of Advanced Health Science, Institute of Engineering, Tokyo University of Agriculture and Technology, Tokyo, JPN.
Cureus. 2024 Feb 21;16(2):e54649. doi: 10.7759/cureus.54649. eCollection 2024 Feb.
Background Identifying altered trunk control is critical for treating extension-related low back pain (ERLBP), a common subgroup classified by clinical manifestations. The changed coordination of trunk muscles within this group during particular trunk tasks is still not clearly understood. Objectives The objective of this study is to investigate trunk muscle coordination during 11 trunk movement and stability tasks in individuals with ERLBP compared to non-low back pain (LBP) participants. Methods Thirteen individuals with ERLBP and non-LBP performed 11 trunk movement and stability tasks. We recorded the electromyographic activities of six back and abdominal muscles bilaterally. Trunk muscle coordination was assessed using the non-negative matrix factorization (NMF) method to identify trunk muscle synergies. Results The number of synergies in the ERLBP group during the cross-extension and backward bend tasks was significantly higher than in the non-LBP group (p<0.05). The cluster analysis identified the two trunk synergies for each task with strikingly similar muscle activation patterns between groups. In contrast, the ERLBP group exhibited additional trunk muscle synergies that were not identified in the non-LBP group. The number of synergies in the other tasks did not differ between groups (p>0.05). Conclusion Individuals with ERLBP presented directionally specific alterations in trunk muscle synergies that were considered as increased coactivations of multiple trunk muscles. These altered patterns may contribute to the excessive stabilization of and the high frequency of hyperextension in the spine associated with the development and persistence of ERLBP.
识别躯干控制改变对于治疗与伸展相关的下腰痛（ERLBP）至关重要，ERLBP是一种根据临床表现分类的常见亚组。该组患者在特定躯干任务中躯干肌肉协调性的变化仍不清楚。目的：本研究的目的是调查与无下腰痛（LBP）参与者相比，ERLBP患者在11项躯干运动和稳定性任务中的躯干肌肉协调性。方法：13名ERLBP患者和非LBP患者进行了11项躯干运动和稳定性任务。我们双侧记录了六块背部和腹部肌肉的肌电活动。使用非负矩阵分解（NMF）方法评估躯干肌肉协调性，以识别躯干肌肉协同作用。结果：ERLBP组在交叉伸展和后弯任务中的协同作用数量显著高于非LBP组（p<0.05）。聚类分析确定了每项任务的两种躯干协同作用，两组之间的肌肉激活模式极为相似。相比之下，ERLBP组表现出非LBP组未识别出的额外躯干肌肉协同作用。其他任务中的协同作用数量在两组之间没有差异（p>0.05）。结论：ERLBP患者在躯干肌肉协同作用方面表现出方向特异性改变，这些改变被认为是多块躯干肌肉的共同激活增加。这些改变的模式可能导致与ERLBP的发生和持续相关的脊柱过度稳定和过度伸展的高频率。
