The Relationship Between Hip-Abductor Strength and the Magnitude of Pelvic Drop in Patients With Low Back Pain
The Relationship Between Hip-Abductor Strength and the Magnitude of Pelvic Drop in Patients With Low Back Pain
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DOI：
10.1123/jsr.19.4.422
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发表时间：
2010-11-01
影响因子：
1.7
通讯作者：
Ferber, Reed
中科院分区：
文献类型：
--
作者：
Kendall, Karen D.;Schmidt, Christie;Ferber, Reed
内容：理论上，特伦德伦伯氏试验（TT）阳性表明站立位髋外展肌（HABD）肌肉组织无力，导致对侧骨盆下垂，并代表负荷转移受损，这可能导致腰痛。很少有研究测试HABDs的弱点是否与骨盆下降（MPD）的幅度直接相关。目的：研究非特异性下腰痛（NSLBP）患者和健康对照（CON）在静态TT和步行期间HABD强度和MPD之间的关系。第二个目的是检查3周HABD强化计划后NSLBP的这种关系。设计：准实验。单位：临床研究实验室。参与者：20人（10名NSLBP和10名CON）。干预措施：加强人类可持续发展。主要观察指标：标准化HABD强度、TT时的MPD和行走时的最大骨盆额面偏移。结果如下：在基线时，NSLBP受试者明显弱于CON（31%; P = 0.03）。两组之间的最大骨盆前平面偏移（P = 0.72）、右侧MPD（P = 1.00）或左侧MPD（P = 0.40）无差异。在静态TT期间，NSLBP（r =-.32，P =.36）和CON（r =-.24，P =.48）的左侧HABD强度与右侧MPD之间以及NSLBP（r =-.24，P =.50）和CON（r =-.41，P =.22）的右侧HABD强度与左侧MPD之间无显著相关性。HABD强度与NSLBP（r =-.04，P =.90）和CON（r =-.14，P =.68）的最大骨盆额面偏移之间无显著相关性。强化后，NSLBP显示HABD强度显著增加（12%; P = 0.02），疼痛减轻48%，静态TT和最大骨盆前平面偏移期间的MPD与基线相比无差异。结论：在CON和NSLBP的静态TT和步行过程中，HABD强度与MPD相关性较差。结果表明，HABD强度可能不是控制骨盆稳定性的唯一影响因素，静态TT作为HABD功能的测量方法使用有限。
Context: It has been theorized that a positive Trendelenburg test (TT) indicates weakness of the stance hip-abductor (HABD) musculature, results in contralateral pelvic drop, and represents impaired load transfer, which may contribute to low back pain. Few studies have tested whether weakness of the HABDs is directly related to the magnitude of pelvic drop (MPD). Objective: To examine the relationship between HABD strength and MPD during the static TT and during walking for patients with nonspecific low back pain (NSLBP) and healthy controls (CON). A secondary purpose was to examine this relationship in NSLBP after a 3-wk HABD-strengthening program. Design: Quasi-experimental. Setting: Clinical research laboratory. Participants: 20 (10 NSLBP and 10 CON). Intervention: HABD strengthening. Main Outcome Measures: Normalized HABD strength, MPD during TT, and maximal pelvic frontal-plane excursion during walking. Results: At baseline, the NSLBP subjects were significantly weaker (31%; P = .03) than CON. No differences in maximal pelvic frontal-plane excursion (P = .72), right MPD (P = 1.00), or left MPD (P = .40) were measured between groups. During the static TT, nonsignificant correlations were found between left HABD strength and right MPD for NSLBP (r = -.32, P = .36) and CON (r = -.24, P = .48) and between right HABD strength and left MPD for NSLBP (r = -.24, P = .50) and CON (r = -.41, P = .22). Nonsignificant correlations were found between HABD strength and maximal pelvic frontal-plane excursion for NSLBP (r = -.04, P = .90) and CON (r = -.14, P = .68). After strengthening, NSLBP demonstrated significant increases in HABD strength (12%; P = .02), 48% reduction in pain, and no differences in MPD during static TT and maximal pelvic frontal-plane excursion compared with baseline. Conclusions: HABD strength was poorly correlated to MPD during the static TT and during walking in CON and NSLBP. The results suggest that HABD strength may not be the only contributing factor in controlling pelvic stability, and the static TT has limited use as a measure of HABD function.