The Effects of Vibration and Muscle Fatigue on Trunk Sensorimotor Control in Low Back Pain Patients.
The Effects of Vibration and Muscle Fatigue on Trunk Sensorimotor Control in Low Back Pain Patients.
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DOI：
10.1371/journal.pone.0135838
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Descarreaux M
中科院分区：
文献类型：
--
作者：
Boucher JA;Abboud J;Nougarou F;Normand MC;Descarreaux M
慢性下腰痛(CLBP)患者感觉运动功能的改变和躯干肌肉疲劳性的增加已被证实。这项研究评估了在有和没有局部竖脊肌振动的情况下躯干力产生的控制，并评估了肌肉疲劳对躯干感觉运动控制的影响。20名非特异性cLBP患者和20名健康受试者被要求在躯干伸肌疲劳方案之前和之后，在有和没有局部振动刺激的情况下进行亚最大等长躯干伸展扭矩。计算并比较了恒定误差(CE)、可变误差(VE)和峰值扭矩绝对误差(AE)。躯干伸肌在等长收缩和疲劳过程中的激活使用表面肌电信号(SEMG)进行测量。患者组躯干的强迫复制精度(CE=9.81±2.23 Nm；AE=18.16±3.97 Nm)显著低于健康受试者(CE=4.44±1.68 Nm；AE=12.23±2.44 Nm)。局部竖脊振动导致患者组CE(4.33±2.14 Nm)和AE(13.71±3.45 Nm)平均得分显著降低。相反，健康受试者在振动条件下CE(8.17±2.10 Nm)和AE(16.29±2.82 Nm)的平均得分显著增加。疲劳方案导致竖脊肌疲劳，如sEMG中值时间频率斜率显着降低所示。根据疲劳方案，cLBP患者在L4-5水平的sEMG均方根活动显著降低，在CE平均分方面，在振动刺激和不振动刺激下的反应方式相似。慢性下腰痛患者的强迫生殖感觉不如健康受试者准确。局部肌肉振动导致cLBP患者在肌肉疲劳方案前后的躯干神经肌肉控制显著改善。运动控制训练中的肌肉振动刺激可能会影响运动适应，可考虑用于cLBP的治疗。还需要进一步的工作来清楚地确定在感觉运动系统的哪些水平上可以实现这些收益。
Changes in sensorimotor function and increased trunk muscle fatigability have been identified in patients with chronic low back pain (cLBP). This study assessed the control of trunk force production in conditions with and without local erector spinae muscle vibration and evaluated the influence of muscle fatigue on trunk sensorimotor control. Twenty non-specific cLBP patients and 20 healthy participants were asked to perform submaximal isometric trunk extension torque with and without local vibration stimulation, before and after a trunk extensor muscle fatigue protocol. Constant error (CE), variable error (VE) as well as absolute error (AE) in peak torque were computed and compared across conditions. Trunk extensor muscle activation during isometric contractions and during the fatigue protocol was measured using surface electromyography (sEMG). Force reproduction accuracy of the trunk was significantly lower in the patient group (CE = 9.81 ± 2.23 Nm; AE = 18.16 ± 3.97 Nm) than in healthy participants (CE = 4.44 ± 1.68 Nm; AE = 12.23 ± 2.44 Nm). Local erector spinae vibration induced a significant reduction in CE (4.33 ± 2.14 Nm) and AE (13.71 ± 3.45 Nm) mean scores in the patient group. Healthy participants conversely showed a significant increase in CE (8.17 ± 2.10 Nm) and AE (16.29 ± 2.82 Nm) mean scores under vibration conditions. The fatigue protocol induced erector spinae muscle fatigue as illustrated by a significant decrease in sEMG median time-frequency slopes. Following the fatigue protocol, patients with cLBP showed significant decrease in sEMG root mean square activity at L4-5 level and responded in similar manner with and without vibration stimulation in regard to CE mean scores. Patients with cLBP have a less accurate force reproduction sense than healthy participants. Local muscle vibration led to significant trunk neuromuscular control improvements in the cLBP patients before and after a muscle fatigue protocol. Muscle vibration stimulation during motor control exercises is likely to influence motor adaptation and could be considered in the treatment of cLBP. Further work is needed to clearly identify at what levels of the sensorimotor system these gains are achievable.