The relationship of transversus abdominis and lumbar multifidus clinical muscle tests in patients with chronic low back pain
The relationship of transversus abdominis and lumbar multifidus clinical muscle tests in patients with chronic low back pain
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DOI：
10.1016/j.math.2011.05.007
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发表时间：
2011-12-01
期刊：
影响因子：
--
通讯作者：
Sexton, Margot
中科院分区：
文献类型：
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作者：
Hides, Julie;Stanton, Warren;Sexton, Margot
前言：先前关于慢性下腰痛(LBP)患者的腹横肌(TRA)和多裂肌功能的研究已经孤立地对这些肌肉进行了研究。在临床实践中，人们假设这些肌肉之间存在某种关系，因此经常一起进行评估和康复。然而，还没有研究测试或记录这种联系。本研究旨在探讨临床肌肉测试与后诊临床评估过程中所采取的其他措施之间的关系。方法：对82例患者(男性40例，女性42例)进行临床肌肉收缩测试、多裂肌大小测量和其他临床测量，如疼痛和疼痛的分布。结果：收缩多裂肌的能力与收缩多裂肌的能力有关，收缩良好的多裂肌收缩的几率是正常收缩的4.5倍。收缩多裂的能力差与收缩差有关。单侧LBP患者多瓣肌不对称(11.6%)多于双侧/中枢性疼痛患者(0.01%)，且患侧多瓣肌收缩较差(P<；0.01)。没有发现其他显著的相关性。讨论与结论：本研究结果支持当前评估和康复慢性下腰痛患者横纹肌和多裂肌的临床实践。未来的研究可能会调查这些肌肉之间是否存在神经生理关系。(C)2011爱思唯尔有限公司。保留所有权利。
Introduction: Previous research of transversus abdominis (TrA) and multifidus muscle function in the presence of chronic low back pain (LBP) has investigated these muscles in isolation. In clinical practice, it is assumed that a relationship exists between these muscles and so they are often assessed and rehabilitated together. However, no studies have tested or documented this association. This study aimed to examine the relationships between clinical muscle testing and other measures taken in the course of a clinical assessment at a back clinic.Methods: This retrospective chart audit examined the files of 82 patients (40 Males, 42 Females) for results of clinical tests of TrA and multifidus muscle contraction, multifidus muscle size measurements and other clinical measures such as distribution of pain and pain on manual examination.Results: The ability to contract multifidus was related to the ability to contract TrA with the odds of a good contraction of multifidus being 4.5 times higher for patients who had a good contraction of TrA. A poor ability to contract multifidus was related to poor TrA contraction. Patients with unilateral LBP had more multifidus muscle asymmetry (11.6%) than those with bilateral/central pain (0.01%) and had a poor multifidus contraction on the affected side (p < 0.01). No other significant relationships were found.Discussion & conclusion: Current clinical practice of assessment and rehabilitation of both TrA and multifidus muscles in patients with chronic LBP is supported by the findings of this study. Future studies may investigate if a neurophysiological relationship exists between these muscles. (C) 2011 Elsevier Ltd. All rights reserved.