Bern University of Applied Sciences, School of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland; University of Basel, Faculty of Medicine, Basel, Switzerland.
Schulthess Klinik, Department of Rheumatology and Rehabilitation, Zurich, Switzerland.
J Biomech. 2024 Nov;176:112352. doi: 10.1016/j.jbiomech.2024.112352. Epub 2024 Sep 27.
Object lifting is often categorized into squat and stoop techniques, with the former believed to protect the back by maintaining a neutral spine, and the latter considered harmful due to spinal flexion. Despite the widespread promotion of these beliefs, there is no evidence to support such dichotomy, as spinal flexion is not conclusively linked to low back pain. This study aimed to investigate intervertebral disc deformation in the lower lumbar spine during squat and stoop lifting using indwelling bone pins. Five healthy males underwent insertion of Kirschner wires into the L3, L4, and L5 spinous processes, followed by biomechanical data collection using magnetic and optical tracking systems during upright standing, isolated flexion/extension, and object lifting with both squat and stoop techniques. Except for one subject, stoop lifting resulted in up to 90 % greater disc wedging compared to squat lifting, with a significant difference at L4/L5 (p = 0.042). The anterior annulus fibrosus experienced 10 % to 40 % more compression during stoop lifting, but no significant differences were found in posterior annulus fibrosus expansion between techniques. Lever arms were about 35 % longer during stoop compared to squat lifting. These results indicate that even though stoop lifting generally led to greater disc deformation, significant deformation was also observed during squat lifting, challenging the notion of maintaining a neutral spine with this technique. Moreover, the considerable variability observed among participants raises concerns about the suitability of current one-size-fits-all lifting guidelines.
物体举升通常分为深蹲和弯腰技术，前者被认为通过保持脊柱中立来保护背部，而后者则被认为是有害的，因为脊柱会弯曲。尽管这些观点被广泛宣传，但没有证据支持这种二分法，因为脊柱弯曲与腰痛没有明确的联系。本研究旨在使用留置骨钉研究深蹲和弯腰举升过程中腰椎下部椎间盘的变形。5 名健康男性在 L3、L4 和 L5 棘突插入克氏针，然后使用磁和光跟踪系统在直立站立、单独屈伸和深蹲、弯腰两种技术的物体举升时收集生物力学数据。除了一个对象，弯腰举升导致椎间盘楔变比深蹲举升高出 90%，在 L4/L5 处有显著差异（p=0.042）。前纤维环在弯腰举升时经历了 10%至 40%的更大压缩，但在技术之间，后纤维环扩张没有发现显著差异。与深蹲相比，在弯腰时杠杆臂长约长 35%。这些结果表明，尽管弯腰举升通常会导致更大的椎间盘变形，但在深蹲举升时也观察到了显著的变形，这对使用该技术保持脊柱中立的观点提出了挑战。此外，参与者之间存在相当大的可变性，这引起了对当前一刀切的举升指南的适用性的关注。
