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竖脊肌和多裂肌的不同特性对慢性阻塞性肺疾病患者身体机能的影响

Different Properties of the Erector Spinae and Multifidus Muscles on Physical Performance in Patients With Chronic Obstructive Pulmonary Disease.

作者信息

Imashiro Kyosuke, Nakanishi Masanori, Minoshima Yuta, Kouda Ken, Sasaki Seigo, Takahashi Koichiro, Asai Kazuhisa, Hirano Tsunahiko, Matsunaga Kazuto, Minakata Yoshiaki

机构信息

Division of Rehabilitation, Wakayama Medical University Hospital, Wakayama, 641-8510, Japan.

Department of Rehabilitation Medicine, Wakayama Medical University, Wakayama, 641-8509, Japan.

出版信息

Int J Chron Obstruct Pulmon Dis. 2025 Apr 29;20:1299-1308. doi: 10.2147/COPD.S513153. eCollection 2025.

Abstract

BACKGROUND

Muscle atrophy in the dorsal muscle group (DMG) is associated with physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD). However, no studies have separately evaluated the erector spinae muscle (ESM) and the multifidus muscle (MM) within the DMG, leaving the distinct impact of each muscle on PA unclear.

PURPOSE

This study evaluated the differences in muscle characteristics between ESM and MM in stable patients with COPD.

PATIENTS AND METHODS

In Study 1, we evaluated the relationship between the cross-sectional area of ESM (ESM) and MM (MM) on chest computed tomography and PA parameters. In Study 2, as a pilot study, we analyzed the muscle fatigue characteristics of ESM and MM using a trunk holding test and electromyographic (EMG) power spectrum analysis to evaluate the median frequency (MF) slope. We then evaluated the differences in the MF slopes of both muscles in patients with COPD compared with healthy subjects.

RESULTS

Of 77 patients with COPD, the MM was positively associated with the duration of PA at ≥3.0 metabolic equivalents (METs) (r=0.279, p=0.014), whereas the ESM was negatively associated with the duration of behavior at 1.0-1.5 METs (r=-0.429, p<0.001). The MF slopes of the MM were significantly lower in COPD patients (n=7) than in healthy subjects (n=28) (p<0.01), indicating greater fatigue, with no significant differences in MF slopes for ESM or trunk extension holding time.

CONCLUSION

These results indicate that the functional characteristics of the ESM and MM differ in COPD patients. MM was mainly associated with moderate-to-vigorous PA and involved greater fatigue in COPD patients compared to healthy subjects, while the ESM was mainly associated with sedentary behavior.

摘要

背景

慢性阻塞性肺疾病(COPD)患者背侧肌群(DMG)的肌肉萎缩与体力活动(PA)相关。然而,尚无研究分别评估DMG中的竖脊肌(ESM)和多裂肌(MM),因此各肌肉对PA的独特影响尚不清楚。

目的

本研究评估稳定期COPD患者ESM和MM之间的肌肉特征差异。

患者与方法

在研究1中,我们评估了胸部计算机断层扫描上ESM和MM的横截面积与PA参数之间的关系。在研究2中,作为一项初步研究,我们使用躯干支撑试验和肌电图(EMG)功率谱分析来评估中位频率(MF)斜率,分析ESM和MM的肌肉疲劳特征。然后,我们评估了COPD患者与健康受试者相比,这两块肌肉MF斜率的差异。

结果

在77例COPD患者中,MM与≥3.0代谢当量(METs)时的PA持续时间呈正相关(r = 0.279,p = 0.014),而ESM与1.0 - 1.5 METs时的行为持续时间呈负相关(r = -0.429,p < 0.001)。COPD患者(n = 7)的MM的MF斜率显著低于健康受试者(n = 28)(p < 0.01),表明疲劳程度更高,ESM的MF斜率或躯干伸展支撑时间无显著差异。

结论

这些结果表明,COPD患者中ESM和MM的功能特征不同。MM主要与中度至剧烈PA相关,与健康受试者相比,COPD患者的MM疲劳程度更高,而ESM主要与久坐行为相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b72a/12049135/15fdabc99d3f/COPD-20-1299-g0001.jpg

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