Low back skin sensitivity has minimal impact on active lumbar spine proprioception and stability in healthy adults
Low back skin sensitivity has minimal impact on active lumbar spine proprioception and stability in healthy adults
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DOI：
10.1007/s00221-016-4625-5
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发表时间：
2016-08-01
影响因子：
2
通讯作者：
Brown, Stephen H. M.
中科院分区：
文献类型：
--
作者：
Beaudette, Shawn M.;Larson, Katelyn J.;Brown, Stephen H. M.
本研究的目的是（1）确定是否可以通过使用局部利多卡因-丙胺卡因麻醉剂（EMLA（A（R）））降低下背部皮肤敏感性，以反映慢性下背部疼痛（CLBP）患者报告的降低，以及（2）确定皮肤敏感性降低是否导致腰椎本体感觉、神经肌肉控制和动态稳定性降低。28名健康受试者被平均分为EMLA和安慰剂治疗组。各组完成皮肤最小单丝和两点辨别（TPD）阈值测试，以及矢状和轴向腰椎主动复位错误，坐位平衡和重复提升动态稳定性测试。这些测试在EMLA或安慰剂治疗应用之前和之后进行。结果表明，在EMLA组中，下背部最小单丝和TPD阈值显著增加。安慰剂组的皮肤敏感性保持不变。在EMLA组中，下背部皮肤敏感性的降低对下背部本体感觉（主动矢状和轴向复位）和动态稳定性（坐位平衡和重复提升）的影响极小。这些结果表明，用EMLA麻醉剂处理下背部皮肤可以有效地降低下背部皮肤的敏感性。此外，这些外周皮肤敏感性的降低幅度与CLBP患者中报告的相似。在这一健康人群中，下背部皮肤敏感性降低对主动腰椎本体感觉、神经肌肉控制和动态稳定性的影响极小。
The purpose of the current work was to (1) determine whether low back cutaneous sensitivity could be reduced through the use of a topical lidocaine-prilocaine anesthetic (EMLA(A (R))) to mirror reductions reported in chronic lower back pain (CLBP) patients, as well as to (2) identify whether reductions in cutaneous sensitivity resulted in decreased lumbar spine proprioception, neuromuscular control and dynamic stability. Twenty-eight healthy participants were divided equally into matched EMLA and PLACEBO treatment groups. Groups completed cutaneous minimum monofilament and two-point discrimination (TPD) threshold tests, as well as tests of sagittal and axial lumbar spine active repositioning error, seated balance and repeated lifting dynamic stability. These tests were administered both before and after the application of an EMLA or PLACEBO treatment. Results show that low back minimum monofilament and TPD thresholds were significantly increased within the EMLA group. Skin sensitivity remained unchanged in the PLACEBO group. In the EMLA group, decreases in low back cutaneous sensitivity had minimal effect on low back proprioception (active sagittal and axial repositioning) and dynamic stability (seated balance and repeated lifting). These findings demonstrate that treating the skin of the low back with an EMLA anesthetic can effectively decrease the cutaneous sensitivity of low back region. Further, these decreases in peripheral cutaneous sensitivity are similar in magnitude to those reported in CLBP patients. Within this healthy population, decreased cutaneous sensitivity of the low back region has minimal influence on active lumbar spine proprioception, neuromuscular control and dynamic stability.