Physical progress and residual impairment quantification after functional restoration. Part I: Lumbar mobility.
Physical progress and residual impairment quantification after functional restoration. Part I: Lumbar mobility.
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功能恢复后的身体进展和残余损伤量化。
DOI：
10.1097/00007632-199402001-00001
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发表时间：
1994
期刊：
影响因子：
3
通讯作者：
R. Gatchel
中科院分区：
文献类型：
--
作者：
T. Mayer;J. Tabor;E. Bovasso;R. Gatchel
量化慢性下腰痛(CLBP)患者的人类表现对于启动有效的治疗和指导以残疾为导向的功能恢复计划的进展以及在最大限度地改善医学时客观地评估损伤和功能限制至关重要。衡量体能的一个重要指标就是运动范围。患有慢性阻塞性肺疾病的患者几乎总是有一些活动障碍。本研究的主要目标是：1)建立一个具有代表性的CLBP患者样本中不同时间点的预期活动范围的数据库；2)在样本内，确定任何性别或脊柱手术引起的差异；3)评估参与综合功能恢复治疗计划所产生的活动范围的变化；以及4)确定区域活动范围的残余损害。评估了四组不同的CLBP患者：组1(n=92)，未手术男性；组2(n=26)，椎间盘摘除后男性；组3(n=59)，未手术女性；和组4(n=17)。对每组患者在三个时间点的脊柱活动范围、矢状/冠状运动和有效性(利用骨盆运动和仰卧腿抬高之间的关系)进行评估。结果显示，从最初的转诊到程序完成，患者的活动范围有了显著的改善。最显著的进步是骨盆运动，恢复到接近正常的水平，这表明绝大多数克服了疼痛或对受伤的恐惧造成的低努力或运动抑制。
Quantification of human performance in chronic low back pain (CLBP) patients is essential to initiate effective treatment and guide progress in a disability-oriented functional restoration program, as well as to objectively evaluate impairment and functional limitations at the time of maximum medical improvement. One such important measure of physical ability is range of motion. Patients who suffer from CLBP almost invariably have some disturbance of mobility. The major goals of the present study were to: 1) develop a database of anticipated range of motion levels at different points in time in a representative sample of CLBP patients; 2) within the sample, determine any gender or spinal surgery-induced differences; 3) evaluate change in range of motion produced by participation in a comprehensive functional restoration treatment program; and 4) identify residual impairment of regional range of motion. Four separate groups of CLBP patients were evaluated: Group 1 (n = 92), unoperated men; Group 2 (n = 26), postdiscectomy men; Group 3 (n = 59), unoperated women; and Group 4 (n = 17) postdiscectomy women. Patients in each group were assessed for spinal range of motion measures at three points in time, for sagittal/coronal motion and validity (employing the relationship between pelvic motion and supine leg raising). Results demonstrated dramatic patient improvements in range of motion from initial referral to program completion. The most significant gains were made in pelvic motion, which returned to near normal levels, indicating that the vast majority overcame low effort or movement inhibition produced by pain or fear of injury.(ABSTRACT TRUNCATED AT 250 WORDS)