Individuals with recurrent low back pain exhibit further altered frontal plane trunk control in remission than when in pain.
Individuals with recurrent low back pain exhibit further altered frontal plane trunk control in remission than when in pain.
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DOI：
10.1016/j.clinbiomech.2021.105391
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发表时间：
2021-07
期刊：
影响因子：
--
通讯作者：
Kulig K
中科院分区：
文献类型：
--
作者：
Shih HS;Van Dillen LR;Kutch JJ;Kulig K
腰痛(LBP)引起的运动改变如果在症状缓解后不能解决，可能会导致长期的不良后果。这项研究的目的是确定躯干控制改变与复发性下腰痛是否持续超过症状持续时间。20名患有复发性LBP的年轻人在LBP发作期间和症状缓解期间分别进行了一次测试，20名匹配的健康志愿者作为对照。参与者在跑步机上以五种指定的步幅(0.33，0.67，1，1.33，1.67×首选步幅)行走。采用动作捕捉和表面肌电图仪记录躯干运动学和肌肉激活情况。用向量编码计算胸骨-骨盆协调性，并分析最长肌的激活和共激活。与对照组相比，患有复发性LBP的年轻人在步态过程中在额面显示出一种“更松散”的躯干控制策略，无论疼痛状态如何，这种策略都是持续的。与对照组相比，复发性LBP患者的躯干控制更松散，表现为更大的骨盆协调模式，更少的胸部协调模式，并减少了双侧最长肌的共同激活。当个体症状缓解时，更宽松的躯干控制策略被进一步放大，并表现出更大的躯干漂移，减少了额面上的同相协调。症状缓解期间异常运动的放大可能表明，在试验的疼痛发作之前存在的运动模式或解剖学因素，是反复发作的LBP患者躯干控制改变的基础。复发性LBP的症状缓解期可能是临床评估和治疗的重要窗口。
Movement alterations due to low back pain (LBP) could lead to long-term adverse consequences if they do not resolve after symptoms subside. This study aims to determine if altered trunk control associated with recurrent low back pain persists beyond symptom duration. Twenty young adults with recurrent LBP were tested once during an LBP episode and once in symptom remission, and twenty matched back-healthy participants served as controls. Participants walked on a treadmill with five prescribed step widths (0.33, 0.67, 1, 1.33, 1.67×preferred step width). Motion capture and surface electromyography were used to record trunk kinematics and muscle activation. Thorax-pelvis coordination was calculated using vector coding, and longissimus activation and co-activation were analyzed. Young adults with recurrent LBP exhibited a “looser” trunk control strategy in the frontal plane during gait that was persistent regardless of pain status across multiple step widths compared to controls. The looser trunk control was demonstrated by a greater pelvis-only, less thorax-only coordination pattern, and decreased bilateral longissimus co-activation in individuals with recurrent LBP compared to controls. The looser trunk control strategy was further amplified when individuals were in symptom remission and exhibited greater trunk excursion and reduced in-phase coordination in the frontal plane. The amplification of aberrant movement during symptom remission may suggest that movement patterns or anatomical factors existing prior to the tested painful episode underlie altered trunk control in individuals with recurrent LBP. The symptom remission period of recurrent LBP may be a critical window into clinical evaluation and treatment.
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影响因子：
6.1
作者：
da Silva, Tatiane;Mills, Kathryn;Hancock, Mark J.
通讯作者：
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影响因子：
4
作者：
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通讯作者：
Hodges, Paul W.
DOI：
10.1001/jama.2016.16885
发表时间：
2016-12-27
期刊：
JAMA
影响因子：
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作者：
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通讯作者：
Murray CJ
DOI：
10.1067/mmt.2001.118209
发表时间：
2001-10-01
影响因子：
1.3
作者：
Colloca, CJ;Keller, TS
通讯作者：
Keller, TS
DOI：
10.1249/mss.0000000000000594
发表时间：
2015-08-01
期刊：
MEDICINE AND SCIENCE IN SPORTS AND EXERCISE
影响因子：
--
作者：
Gildea, Jan E.;Van den Hoorn, Wolbert;Hodges, Paul W.
通讯作者：
Hodges, Paul W.