Trunk motor variability in patients with non-specific chronic low back pain
Trunk motor variability in patients with non-specific chronic low back pain
复制标题
DOI：
10.1007/s00421-014-2985-8
复制
发表时间：
2014-12-01
影响因子：
3
通讯作者：
Descarreaux, Martin
中科院分区：
文献类型：
--
作者：
Abboud, Jacques;Nougarou, Francois;Descarreaux, Martin
识别和表征慢性腰痛（LBP）患者和健康参与者肌肉疲劳期间的躯干神经肌肉适应。46名非特异性慢性腰痛患者和23名健康对照者被要求执行躯干肌肉疲劳方案。采用双侧64个电极的粘接基质在竖脊上记录表面肌电图。通过不同问卷对疼痛评分、运动恐惧症和肢体残疾进行分析。为了描述运动变异性，计算了肌肉活动重心的离散度。采用重复测量方差分析比较各组之间的运动变异性。LBP患者的残疾和运动恐惧症得分明显高于LBP患者。结果显示，通过整个疲劳任务，健康组的左侧（p = 0.003）和右侧（p = 0.048）的运动变异性增加，这是显著的组效应。有趣的是，肌肉疲劳的增加导致两组的运动变异性增加（双方（p < 0.001）），但健康组的增加更大。慢性腰痛患者出现肌肉疲劳时，肌肉募集发生改变。因此，这些患者在持续等距收缩期间表现出肌肉收缩模式和强度的变化（运动变异性水平较低），这可能归因于肌肉内部和肌肉之间运动单元控制的变化。然而，随着时间的推移，LBP患者能够增加他们的运动变异性，但与健康参与者相比，增加的幅度较小。
To identify and characterize trunk neuromuscular adaptations during muscle fatigue in patients with chronic low back pain (LBP) and healthy participants.Forty-six patients with non-specific chronic LBP and 23 healthy controls were asked to perform a trunk muscles fatigue protocol. Surface electromyography was recorded using two adhesive matrix of 64 electrodes applied bilaterally over the erector spinae. Pain score, kinesiophobia and physical disability were analyzed through different questionnaires. To characterize motor variability, dispersion of muscular activity center of gravity was computed. Motor variability between groups was compared using repeated-measures analyses of variance.Score of disability and kinesiophobia were significantly higher in patients with LBP. Results indicated a significant group effect characterized by an increased motor variability in the healthy group through the entire fatigue task on the left (p = 0.003) and right side (p = 0.048). Interestingly, increasing muscle fatigue led to increased motor variability in both groups (on both sides (p < 0.001) but with a greater increase in the healthy group.Muscle recruitment is altered in patients with chronic LBP in the presence of muscle fatigue. Consequently, these patients exhibit changes in muscle recruitment pattern and intensity (lower levels of motor variability) during sustained isometric contraction that may be attributed to variation in the control of motor units within and between muscles. However, patients with LBP are able to increase their motor variability over time but with a lower increase compared to healthy participants.