Yu Geoffrey C W, Yeung Jessica C Y, Chan Matthew H M, Tong Kate C T, Poon Sara K W, Sun Eliza R, Tsang Sharon M H
Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China.
Sci Rep. 2025 May 13;15(1):16623. doi: 10.1038/s41598-025-01843-0.
This cross-sectional study aimed to compare the change in spinal posture, mechanical stiffness, and motor control of the thoracolumbar spine in individuals who were asymptomatic and those with chronic nonspecific low back pain (LBP) of flexion pattern (FP) or active extension pattern (AEP) during pushing and pulling tasks performed in standing. The real-time thoracolumbar posture, mechanical stiffness, electromyographic amplitude and synergy between specified trunk muscle pairs (Internal Oblique and Multifidus, Rectus Abdominis and Erector Spinae, Internal Oblique and Rectus Abdominis, Multifidus and Erector Spinae) were analysed during quiet standing, standing pushing and pulling tasks against a load standardized at 15% of the individual body weight in a total of 39 individuals (asymptomatic, n = 14; FP, n = 11; AEP, n = 14). Pulling task resulted in greater lumbar posterior translation (p = 0.009) and Rectus Abdominis activity (p = 0.006), but smaller lumbar lordosis (p < 0.001) when compared to pushing task. Pulling task also resulted smaller lumbar lordosis (p < 0.001) and thoracic kyphosis (p = 0.003) comparing to upright standing. AEP group showed a significantly greater amplitude of their Internal Oblique activity when compared to those who were asymptomatic across all tasks (p = 0.001). Findings suggested that pulling manoeuvre in standing produced greater shear at the lumbar spine than that of pushing manoeuvre. Individuals with low back pain executed the low-load push/pull tasks with the motor strategy largely comparable to asymptomatic group. Future studies investigating the cumulative effect of repetitive push/pull loadings on the movement and motor control of the spine are warranted to better understand the long-term impacts on spinal health.
这项横断面研究旨在比较无症状个体以及患有慢性非特异性下腰痛（LBP）且呈屈曲模式（FP）或主动伸展模式（AEP）的个体在站立位进行推和拉任务时胸腰椎的脊柱姿势、机械刚度和运动控制的变化。在39名个体（无症状者，n = 14；FP组，n = 11；AEP组，n = 14）安静站立、站立推和拉任务（对抗相当于个体体重15%的标准化负荷）过程中，分析了实时胸腰椎姿势、机械刚度、肌电图幅度以及特定躯干肌肉对（腹内斜肌和多裂肌、腹直肌和竖脊肌、腹内斜肌和腹直肌、多裂肌和竖脊肌）之间的协同作用。与推任务相比时，拉任务导致更大的腰椎后移（p = 0.009）和腹直肌活动（p = 0.006），但腰椎前凸减小（p < 0.001）。与直立站立相比，拉任务也导致更小的腰椎前凸（p < 0.001）和胸椎后凸（p = 0.003）。与所有任务中的无症状个体相比，AEP组的腹内斜肌活动幅度显著更大（p = 0.001）。研究结果表明，站立位的拉动作比推动作在腰椎产生更大的剪切力。下腰痛个体执行低负荷推/拉任务时的运动策略与无症状组基本相当。有必要开展进一步研究，调查重复性推/拉负荷对脊柱运动和运动控制的累积影响，以便更好地了解其对脊柱健康的长期影响。
