Why do some patients keep hurting their back? Evidence of ongoing back muscle dysfunction during remission from recurrent back pain
Why do some patients keep hurting their back? Evidence of ongoing back muscle dysfunction during remission from recurrent back pain
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DOI：
10.1016/j.pain.2008.12.002
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发表时间：
2009-04-01
期刊：
影响因子：
7.4
通讯作者：
Hodges, Paul W.
中科院分区：
文献类型：
--
作者：
MacDonald, David;Moseley, G. Lorimer;Hodges, Paul W.
大约34%的急性腰痛（LBP）患者会反复发作。目前还不清楚为什么有些人会复发，而有些人不会，但一个可能的原因是背部肌肉失去了正常的控制。我们调查了复发性单侧腰痛患者与健康参与者对深背部肌肉短纤维和长纤维的控制是否不同。在测试期间无症状的复发性单侧腰痛患者和一组健康志愿者参加了这项研究。肌内和表面电极记录了腰多裂肌和三角肌的短纤维和长纤维在快速手臂运动时的肌电活动（EMG）。相对于三角肌，我们比较了各组肌肉中短纤维和长纤维的肌电图。和侧面。与体位扰动相关，复发性单侧腰痛参与者的短纤维肌电图发作时间比健康参与者晚（p = 0.022）。健康参与者的两侧短纤维比长纤维更早活跃（p < 0.001）， LBP组的非疼痛侧短纤维比长纤维更早活跃（p = 0.045），但LBP组的疼痛侧短纤维比长纤维更早活跃。尽管症状得到缓解，但复发性单侧腰痛患者的深背部肌肉活动是不同的。由于深背部肌肉活动对正常的脊柱控制至关重要，目前的研究结果为复发性发作的候选机制提供了第一个证据。(C) 2008年国际疼痛研究协会。Elsevier B.V.版权所有。
Approximately thirty-four percent of people who experience acute low back pain (LBP) will have recurrent episodes. It remains unclear why some people experience recurrences and others do not, but one possible Cause is a loss of normal control of the back Muscles. We investigated whether the control of the short and long fibres of the deep back muscles was different in people with recurrent unilateral LBP from healthy participants. Recurrent unilateral LBP patients, who were symptom free during testing, and a group of healthy volunteers, participated. Intramuscular and surface electrodes recorded the electromyographic activity (EMG) of the short and long fibres of the lumbar multifidus and the shoulder muscle, deltoid, during a postural perturbation associated with a rapid arm movement. EMG onsets of the short and long fibres, relative to that of deltoid, were compared between groups, muscles. and sides. In association with a Postural perturbation, short fibre EMG onset occurred later in participants with recurrent unilateral LBP than in healthy participants (p = 0.022). The short fibres were active earlier than long fibres on both sides in the healthy participants (p < 0.001) and on the non-painful side in the LBP group (p = 0.045), but not on the previously painful side in the LBP group. Activity of deep back muscles is different in people with a recurrent unilateral LBP, despite the resolution of symptoms. Because deep back Muscle activity is critical for normal spinal control, the current results provide the first evidence of a candidate mechanism for recurrent episodes. (C) 2008 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.