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考虑胸骨位置的针对性运动控制可改善有早产风险且伴有腰痛的孕妇的脊柱排列。

Targeted Motor Control Considering Sternal Position Improves Spinal Alignment in Pregnant Women at Risk for Preterm Birth with Low Back Pain.

作者信息

Żurawski Arkadiusz Łukasz, Ha Sun Young, Świercz Grzegorz, Adamczyk Gruszka Olga, Kiebzak Wojciech Piotr

机构信息

Collegium Medicum, Jan Kochanowski University in Kielce, al. IX Wieków Kielc 19a, 25-516 Kielce, Poland.

Health & Wellness Research Institute, Kyungnam University, 7 Kyungnamdaehak-ro, Masanhappo-gu, Changwon-si 51767, Gyeongsangnam-do, Republic of Korea.

出版信息

J Clin Med. 2024 Dec 16;13(24):7661. doi: 10.3390/jcm13247661.

Abstract

Lumbopelvic pain (LBP) is a prevalent condition during pregnancy, affecting a significant proportion of pregnant women. It arises from hormonal, biomechanical, and postural changes, often exacerbating discomfort and impairing quality of life. This study aimed to evaluate the effects of targeted motor control interventions focusing on sternal alignment on spinal alignment, pain, and muscle activity in pregnant women at risk of preterm birth. This pre-post quasi-experimental study included 32 pregnant women at 28-32 weeks of gestation, who were hospitalized due to the risk of preterm birth. Inclusion criteria required participants to have LBP lasting at least two weeks and the ability to walk and stand for 40 min. The intervention involved targeted motor control exercises designed to optimize sternal and sacral alignment. Spinal alignment, pain intensity, and muscle activity were measured pre- and post-intervention using the DIERS formetric system, numerical rating scale (NRS), and electromyography (EMG), respectively. Data were analyzed using Wilcoxon signed-rank tests. Significant improvements were observed in spinal alignment parameters, including reductions in the sternal angle, sacral angle, cervical and lumbar lordosis depths, thoracic kyphosis angle, and pelvic tilt ( < 0.05). Pain intensity decreased significantly from a mean NRS score of 5.77 ± 1.42 in the relaxed posture to 2.54 ± 0.71 in the corrected posture ( < 0.05). Muscle activity of the rhomboid muscles increased in the corrected posture, correlating with improved thoracic kyphosis, while activity of the serratus anterior muscle showed reductions ( < 0.05). Targeted motor control focusing on sternal alignment effectively improved spinal alignment and reduced pain in pregnant women at risk of preterm birth with LBP. The intervention offers a safe, non-invasive, and practical approach to managing pregnancy-related musculoskeletal challenges. Future research should validate these findings in diverse populations and explore long-term effects and broader clinical applications.

摘要

腰骶部疼痛(LBP)是孕期常见的病症,影响着相当一部分孕妇。它源于激素、生物力学和姿势的变化,常常加剧不适并损害生活质量。本研究旨在评估针对胸骨对齐的针对性运动控制干预对有早产风险的孕妇脊柱排列、疼痛和肌肉活动的影响。这项前后对照的准实验研究纳入了32名妊娠28 - 32周因早产风险而住院的孕妇。纳入标准要求参与者有持续至少两周的腰骶部疼痛,并且能够行走和站立40分钟。干预措施包括旨在优化胸骨和骶骨对齐的针对性运动控制练习。分别在干预前后使用DIERS人体测量系统、数字评分量表(NRS)和肌电图(EMG)测量脊柱排列、疼痛强度和肌肉活动。数据采用Wilcoxon符号秩检验进行分析。观察到脊柱排列参数有显著改善,包括胸骨角、骶骨角、颈椎和腰椎前凸深度、胸椎后凸角和骨盆倾斜度的减小(P < 0.05)。疼痛强度从放松姿势下平均NRS评分为5.77 ± 1.42显著降低至纠正姿势下的2.54 ± 0.71(P < 0.05)。菱形肌的肌肉活动在纠正姿势下增加,与胸椎后凸改善相关,而前锯肌的活动则减少(P < 0.05)。针对胸骨对齐的针对性运动控制有效改善了有早产风险且患有腰骶部疼痛的孕妇的脊柱排列并减轻了疼痛。该干预措施为管理与妊娠相关的肌肉骨骼问题提供了一种安全、无创且实用的方法。未来的研究应在不同人群中验证这些发现,并探索其长期影响和更广泛的临床应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d553/11676327/043ec229028b/jcm-13-07661-g001.jpg

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