Inefficient muscular stabilization of the lumbar spine associated with low back pain - A motor control evaluation of transversus abdominis
Inefficient muscular stabilization of the lumbar spine associated with low back pain - A motor control evaluation of transversus abdominis
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DOI：
10.1097/00007632-199611150-00014
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发表时间：
1996-11-15
期刊：
影响因子：
3
通讯作者：
Richardson, CA
中科院分区：
文献类型：
--
作者：
Hodges, PW;Richardson, CA
研究设计。在有或没有腰痛的人群中，通过实验模型来确定躯干肌肉对手臂运动引起的脊柱干扰的协调，间接评估了腹横肌对脊柱稳定的贡献。评估与手臂运动相关的躯干肌肉活动的时间序列，并确定腰痛患者是否存在该参数的功能障碍。背景资料摘要。很少有研究评估腰痛患者躯干肌肉的运动控制或该系统功能障碍的可能性，评估躯干肌肉对肢体运动的反应提供了一个合适的模型来评估该系统，最近的证据表明，该评估应包括腹横肌。15例腰痛患者和15例步行对照者在站立状态下对视觉刺激进行快速的肩部屈曲、外展和伸展，使用细丝和表面电极评估腹肌、腰椎多裂肌和对侧三角肌的肌电活动。在对照组中，每个方向的运动导致躯干肌肉在三角肌之前或之后不久收缩。腹横肌总是第一个活跃的肌肉，不受运动方向的影响，支持了该肌肉在脊柱僵硬产生中的假设作用。腰痛患者所有动作均明显延迟腹横肌收缩。在其他肌肉中发现了孤立的差异。腹横肌收缩的延迟发作表明运动控制的缺陷，并可能导致脊柱肌肉稳定的效率低下。
Study Design. The contribution of transversus abdominis to spinal stabilization was evaluated indirectly in people with and without low back pain using an experimental model identifying the coordination of trunk muscles in response to a disturbance to the spine produced by arm movement.Objectives. To evaluate the temporal sequence of trunk muscle activity associated with arm movement, and to determine if dysfunction of this parameter was present in patients with low back pain.Summary of Background Data. Few studies have evaluated the motor control of trunk muscles or the potential for dysfunction of this system in patients with low back pain, Evaluation of the response of trunk muscles to limb movement provides a suitable model ca evaluate this system, Recent evidence indicates that this evaluation should include transversus abdominis.Methods. While standing, 15 patients with tow back pain and 15 marched control subjects performed rapid shoulder flexion, abduction, and extension in response to a visual stimulus, Electromyographic activity of the abdominal muscles, lumbar multifidus, and the contralateral deltoid was evaluated using fine-wire and surface electrodes.Results. Movement in each direction resulted in contraction of trunk muscles before or shortly after the deltoid in control subjects. The transversus abdominis was invariably the first muscle active and was not influenced by movement direction, supporting the hypothesized role of this muscle in spinal stiffness generation. Contraction of transversus abdominis was significantly delayed in patients with low back pain with all movements. Isolated differences were noted in the other muscles.Conclusions. The delayed onset of contraction of transversus abdominis indicates a deficit of motor control and is hypothesized to result in inefficient muscular stabilization of the spine.