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基于磁共振成像的定量观察:马拉松跑步对腰椎、椎旁肌肉和腰椎间盘各部分的影响。

Quantitative observation based on magnetic resonance imaging: the effects of marathon running on lumbar vertebrae, paraspinal muscles, and lumbar disc components.

作者信息

Li Jiahui, Deng Xiaolong, Li Boyi, Song Yi, Tian Tian, Pan Jiawei, Miao Haitao, Liu Jie, Chen Yong

机构信息

Department of Radiology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.

Hangzhou Institute of Sports Medicine for Marathon, Hangzhou, China.

出版信息

Quant Imaging Med Surg. 2024 Dec 5;14(12):8811-8823. doi: 10.21037/qims-24-1053. Epub 2024 Nov 13.

Abstract

BACKGROUND

Lumbar spine injuries and lumbar disc degeneration are common spinal health problems that seriously affect people's quality of life and efficiency at work. Marathon running enhances skeletal muscle strength and endurance, and promotes increased bone mineral density. This study aimed to investigate the effects of marathon running on the lumbar spine and surrounding tissue components.

METHODS

In total, 54 amateur marathon runners (age: 41.7±7.2 years), who were randomly recruited from an amateur marathon runners club in Hangzhou, and 30 healthy volunteer participants (age: 37.7±5.3 years) were enrolled in this prospective cross-sectional study. The Dixon-volumetric interpolated breath-hold examination (VIBE), T2* mapping, and conventional T2 sequences were used to evaluate the proton density fat fraction (PDFF) and cross-sectional area (CSA) of the vertebral bodies, and bilateral paraspinal muscles (PMs), as well as the T2 relaxation times of the intervertebral discs (IVDs).

RESULTS

There were significant differences in the fat fraction (FF) of each vertebral segment between the marathon runners and healthy participants (P<0.05). There were also significant differences between the healthy participants and marathon runners in terms of the T2 relaxation times of the anterior nucleus pulposus (ANP) (41.28±14.36 . 38.04±13.12 ms; P=0.008), central nucleus pulposus (54.67±17.85 . 50.24±17.46 ms; P=0.003), and posterior annulus fibrosus (PAF) (25.80±7.67 . 22.63±6.88 ms; P<0.001). The CSA of the psoas major at the L3 (8.25±2.17 . 9.70±1.81 cm, P=0.002), L4 (11.82±2.65 . 13.62±1.97 cm, P<0.001), and L5 (12.59±2.47 . 14.25±2.38 cm, P<0.001) levels and that of the erector spinae at the L2 (16.59±4.87 . 20.13±3.71 cm, P<0.001), and L3 (18.04±4.63 . 21.65±3.38 cm, P<0.001) levels were lower in the marathon runner group than the control group. The PDFF of the psoas major at all levels was significantly lower in the marathon runner group than the control group (P<0.001). Annulus fibrosus (AF) at the L4/5 (r=-0.342, P=0.011) and L5/S1 (r=-0.304, P=0.026) levels were negatively correlated with the monthly running distance. Additionally, the PDFF of the psoas major was weakly and negatively correlated with the monthly running distance at the L3 level (r=-0.396, P=0.003).

CONCLUSIONS

Marathon running may benefit the structure of the lumbar spine in a number of ways, including by reducing the lumbar vertebral body and psoas major muscle FFs and by reducing lumbar disc degeneration. However, in terms of building muscle strength, marathon running should be combined with some intensity of resistance training to minimize muscle loss due to excessive aerobic exercise.

摘要

背景

腰椎损伤和腰椎间盘退变是常见的脊柱健康问题,严重影响人们的生活质量和工作效率。马拉松跑步可增强骨骼肌力量和耐力,并促进骨矿物质密度增加。本研究旨在探讨马拉松跑步对腰椎及其周围组织成分的影响。

方法

本前瞻性横断面研究共纳入54名从杭州一个业余马拉松跑步者俱乐部随机招募的业余马拉松跑步者(年龄:41.7±7.2岁)和30名健康志愿者参与者(年龄:37.7±5.3岁)。采用 Dixon 容积内插屏气检查(VIBE)、T2* 成像及常规T2序列评估椎体、双侧椎旁肌(PM)的质子密度脂肪分数(PDFF)和横截面积(CSA),以及椎间盘(IVD)的T2弛豫时间。

结果

马拉松跑步者与健康参与者各椎体节段的脂肪分数(FF)存在显著差异(P<0.05)。健康参与者与马拉松跑步者在前侧髓核(ANP)的T2弛豫时间(41.28±14.36对38.04±13.12 ms;P=0.008)、中央髓核(54.67±17.85对50.24±17.46 ms;P=0.003)和后侧纤维环(PAF)(25.80±7.67对22.63±6.88 ms;P<0.001)方面也存在显著差异。马拉松跑步者组L3(8.25±2.17对9.70±1.81 cm,P=0.002)、L4(11.82±2.65对13.62±1.97 cm,P<0.001)和L5(12.59±2.47对14.25±2.38 cm,P<0.001)水平腰大肌的CSA以及L2(16.59±4.87对20.13±3.71 cm,P<0.001)和L3(18.04±4.63对21.65±3.38 cm,P<0.001)水平竖脊肌的CSA均低于对照组。马拉松跑步者组各水平腰大肌的PDFF均显著低于对照组(P<0.001)。L4/5(r=-0.342,P=0.011)和L5/S1(r=-0.304,P=0.026)水平的纤维环(AF)与每月跑步距离呈负相关。此外,L3水平腰大肌的PDFF与每月跑步距离呈弱负相关(r=-0.396,P=0.003)。

结论

马拉松跑步可能在多个方面有益于腰椎结构,包括降低腰椎椎体和腰大肌的FF以及减轻腰椎间盘退变。然而,在增强肌肉力量方面,马拉松跑步应与一定强度的抗阻训练相结合,以尽量减少因过度有氧运动导致的肌肉流失。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e360/11651937/4eb6f864785a/qims-14-12-8811-f1.jpg

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