慢性下背痛患者躯干运动的精度。
Precision of trunk movement in people with chronic low back pain.
机构信息
HU University of Applied Sciences, Institute for Human Movement Studies, Postbus 12011, 3501 AA, Utrecht, the Netherlands; Department of Human Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 1081 BT, Amsterdam, the Netherlands.
HU University of Applied Sciences, Institute for Human Movement Studies, Postbus 12011, 3501 AA, Utrecht, the Netherlands; Research and Development, Military Rehabilitation Centre 'Aardenburg', Doorn, the Netherlands.
出版信息
Musculoskelet Sci Pract. 2024 Oct;73:103165. doi: 10.1016/j.msksp.2024.103165. Epub 2024 Aug 12.
BACKGROUND
Motor control exercise is commonly applied in people with chronic low back pain (CLBP), but possibly not all people with CLBP have motor control impairments. We suggest movement precision as measure to identify motor control impairments. Movement precision has been operationalized as trunk movement variability (TMV) and as trunk tracking error(s) (TTE).
OBJECTIVES
To compare the known-group validity and the responsiveness of TMV and TTE.
DESIGN
We used a case-control comparison (Healthy controls (n = 30) vs CLBP (n = 60)) to assess the known-group validity. A cohort study, (measurements in week 3 and week 12 of treatment), was used to assess responsiveness.
METHODS
TMV (temporal (CyclSD) and spatial (MeanSD)) was analyzed during standing, repetitive flexion and rotation tasks (35x). TTE was measured during movement target tracking tasks, again in flexion and rotation. Participants with CLBP followed a multidisciplinary intervention and both measures were assessed in week 3 and week 12 of treatment. 2-way MANOVA and 2-way ANOVA were used to assess the effect of Group (CLBP vs healthy controls) and direction (flexion vs rotation) on TMV and TTE. For responsiveness, 2-way MANOVA and 2-way ANOVA were used to assess the effect of treatment and direction on both measures.
FINDINGS
At baseline, TMV was not different between groups, while TTE was higher in the people with CLBP (p = 0.005, n = 0.09). Treatment strongly decreased temporal TMV (p = 0.025, n = 0.33) and TTE (p < 0.001, n = 0.844).
CONCLUSIONS
These results demonstrate that TTE is more sensitive to CLBP and more responsive to treatment than TMV.
背景
运动控制训练常用于慢性下背痛（CLBP）患者，但并非所有 CLBP 患者都存在运动控制障碍。我们建议运动精度作为识别运动控制障碍的指标。运动精度已经通过躯干运动可变性（TMV）和躯干跟踪误差（TTE）来操作化。
目的
比较 TMV 和 TTE 的已知组有效性和反应性。
设计
我们使用病例对照比较（健康对照组（n=30）与 CLBP 组（n=60））来评估已知组有效性。使用队列研究（治疗第 3 周和第 12 周的测量）来评估反应性。
方法
在站立、重复屈伸和旋转任务（35 次）期间分析 TMV（时间（CyclSD）和空间（MeanSD））。在屈伸和旋转运动目标跟踪任务中测量 TTE。CLBP 患者接受多学科干预，在治疗第 3 周和第 12 周评估这两种测量方法。使用双向 MANOVA 和双向 ANOVA 评估组（CLBP 与健康对照组）和方向（屈伸与旋转）对 TMV 和 TTE 的影响。为了评估反应性，使用双向 MANOVA 和双向 ANOVA 评估治疗和方向对这两种测量方法的影响。
发现
在基线时，组间 TMV 没有差异，而 CLBP 患者的 TTE 较高（p=0.005，n=0.09）。治疗强烈降低了时间 TMV（p=0.025，n=0.33）和 TTE（p<0.001，n=0.844）。
结论
这些结果表明，TTE 比 TMV 更敏感于 CLBP，并且对治疗更有反应。
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