Pelvis-Thorax Coordination in the Transverse Plane During Walking in Persons With Nonspecific Low Back Pain
Pelvis-Thorax Coordination in the Transverse Plane During Walking in Persons With Nonspecific Low Back Pain
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DOI：
10.1097/00007632-200202150-00016
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发表时间：
2002-02-15
期刊：
影响因子：
3
通讯作者：
Beek, Peter J.
中科院分区：
文献类型：
--
作者：
Lamoth, Claudine J. C.;Meijer, Onno G.;Beek, Peter J.
研究设计。研究了 39 名非特异性腰痛患者和 19 名健康参与者在行走过程中骨盆和胸部的横向旋转。 目标。深入了解腰痛对步态的影响，并确定临床上有用的措施来表征腰痛患者的行走质量。背景数据摘要。对腰痛患者的步态研究报告显示步行速度下降。在正常步态中，随着步行速度的增加，同相骨盆-胸部协调（同步性）向反相协调（反向旋转）发展。本研究探讨了步行速度对腰痛患者骨盆和胸部旋转的影响。方法。计算骨盆和胸部旋转的幅度，并进行光谱分析。骨盆-胸部协调性以相对傅里叶相位为特征，耦合强度通过交叉谱分析进行评估。结果。与健康参与者相比，当步行速度为 3.8 km/h 或更高时，腰痛患者的相对傅立叶相位显着更小，而当步行速度为 1.4 至 3.0 km/h 时，耦合强度显着更高。个体骨盆和胸部旋转的幅度或频谱内容没有发现显着的组间差异。结论。与健康参与者相比，腰痛患者的步态特点是骨盆-胸部协调更加僵硬、灵活性较差，而各部件旋转的运动学没有显着差异。这一结果表明，协调性措施比与各个节段旋转相关的运动学措施更能充分评估腰痛患者的步行质量，并且保守治疗应使用旨在改善节段间协调性的方法。
Study Design. Transverse pelvis and thorax rotations were studied during walking in 39 patients with nonspecific low back pain and 19 healthy participants.Objectives. To gain insight into the consequences of low back pain for gait and to identify clinically useful measures for characterizing the quality of walking in patients with low back pain.Summary of Background Data. Gait studies in patients with low back pain have reported a decrease in walking velocity. In normal gait, in-phase pelvis-thorax coordination (synchronicity) evolves toward antiphase coordination (counterrotation) as walking velocity increases. This study examined the effect of walking velocity on pelvis and thorax rotations in patients with low back pain.Methods. Amplitudes of pelvis and thorax rotations were calculated, and spectral analyses were performed. Pelvis-thorax coordination was characterized in terms of relative Fourier phase, and coupling strength was assessed by means of cross-spectral analysis.Results. In comparison with healthy participants, relative Fourier phase was significantly smaller in low back pain patients for walking velocities of 3.8 km/h and higher, whereas coupling strength was significantly higher for velocities from 1.4 to 3.0 km/h. No significant group differences were found in amplitude or spectral content of individual pelvis and thorax rotations.Conclusion. In comparison with healthy participants, the gait of patients with low back pain was characterized by a more rigid, less flexible pelvis-thorax coordination in the absence of significant differences in the kinematics of the component rotations. This result suggests that coordination measures are more adequate in assessing quality of walking in patients with low back pain than are kinematic measures pertaining to the individual segment rotations, and that conservative therapy should use methods aimed at improving intersegmental coordination.