Delayed trunk muscle reflex responses increase the risk of low back injuries
Delayed trunk muscle reflex responses increase the risk of low back injuries
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DOI：
10.1097/01.brs.0000188273.27463.bc
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发表时间：
2005-12-01
期刊：
影响因子：
3
通讯作者：
Goldberg, B
中科院分区：
文献类型：
--
作者：
Cholewicki, J;Silfies, SP;Goldberg, B
研究设计。前瞻性观察研究，随访2- 3年。确定对躯干突然负荷的延迟肌肉反射反应是腰背损伤（LBI）的结果还是一个危险因素。背景资料摘要。与对照组相比，慢性腰痛患者和有LBI病史的运动员在运动控制方面存在差异。然而，目前尚不清楚这些变化是lbi的风险还是结果。本文测量了303名大学生运动员在躯干屈曲、伸展和侧屈中快速释放力时的肌肉反射潜伏期。还获得了他们的个人资料、运动经历和LBI病史的信息。将数据输入二元逻辑回归模型，以确定未来lbi的预测因素。共有292名运动员参与最终分析，其中女148名，男144名。在随访期间，31名（11%）运动员持续发生LBI。该回归模型包括LBI病史、体重以及在屈曲和侧弯负荷释放期间肌肉关闭的潜伏期，正确预测了74%的LBI结果。当存在LBI病史时，维持LBI的几率增加2.8倍，并且腹肌关闭延迟每毫秒增加3%。平均而言，持续LBI的运动员比没有持续LBI的运动员的延迟时间长14毫秒（77 bb1比63 bb1）。损伤后再测肌肉反应潜伏期无明显变化。延迟的肌肉反射反应显著增加持续LBI的几率。这些延迟似乎是预先存在的风险因素，而不是LBI的影响。
Study Design. Prospective observational study with a 2- to 3-year follow-up.Objectives. To determine whether delayed muscle reflex response to sudden trunk loading is a result of or a risk factor for sustaining a low back injury (LBI).Summary of Background Data. Differences in motor control have been identified in individuals with chronic low back pain and in athletes with a history of LBI when compared with controls. However, it is not known whether these changes are a risk for or a result of LBI.Methods. Muscle reflex latencies in response to a quick force release in trunk flexion, extension, and lateral bending were measured in 303 college athletes. Information was also obtained regarding their personal data, athletic experience, and history of LBI. The data were entered into a binary logistic regression model to identify the predictors of future LBI.Results. A total of 292 athletes were used for the final analysis (148 females and 144 males). During the follow-up period, 31 (11%) athletes sustained an LBI. The regression model, consisting of history of LBI, body weight, and the latency of muscles shutting off during flexion and lateral bending load releases, predicted correctly 74% of LBI outcomes. The odds of sustaining LBI increased 2.8-fold when a history of LBI was present and increased by 3% with each millisecond of abdominal muscle shut-off latency. On average, this latency was 14 milliseconds longer for athletes who sustained LBI in comparison to athletes who did not sustain LBI ( 77 [36] vs. 63 [31]). There were no significant changes in any of the muscle response latencies on retest following the injury.Conclusions. The delayed muscle reflex response significantly increases the odds of sustaining an LBI. These delayed latencies appear to be a preexisting risk factor and not the effect of an LBI.