Differences in sitting postures are associated with nonspecific chronic low back pain disorders when patients are subclassified
Differences in sitting postures are associated with nonspecific chronic low back pain disorders when patients are subclassified
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DOI：
10.1097/01.brs.0000202532.76925.d2
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发表时间：
2006-03-15
期刊：
影响因子：
3
通讯作者：
Straker, LM
中科院分区：
文献类型：
--
作者：
Dankaerts, W;O'Sullivan, P;Straker, LM
研究设计。比较研究。目标。调查无症状个体和非特异性慢性腰痛 (NS-CLBP) 患者的坐姿（汇总和细分）并评估细分的重要性。背景摘要。目前，几乎没有证据支持 CLBP 患者与无痛对照组坐姿不同的假设。尽管先前已强调将 NS-CLBP 患者分为同质亚组，但在检查坐姿时尚未尝试考虑此类分组。方法。使用电磁测量装置测量 33 名 NS-CLBP 患者和 34 名无症状受试者在“正常”和“倾斜”坐姿期间的三个角度（骶骨倾斜、下腰椎和上腰椎）。在测试之前，两位盲法临床医生对 NS-CLBP 患者进行了细分。 20 名患者被归类为屈曲运动控制障碍，13 名患者被归类为主动伸展运动控制障碍。结果。在正常坐姿期间，对照组和 NS-CLBP（合并）患者之间没有发现差异。相比之下，基于子分类的分析显示，与健康对照相比，主动伸展模式的患者在有症状的下腰椎处坐姿更加前凸，而屈曲模式的患者坐姿更加后凸（F = 19.7；df(1) = 2，df(2) = 63，P < 0.001）。此外，当要求 NS-CLBP 患者从平常的坐姿弯腰时，他们改变姿势的能力较差（t = 4.2，df = 65；P < 0.001）。结论。仅当 NS-CLBP 患者进行亚分类时，通常坐姿的差异才会显现出来。这凸显了对 NS-CLBP 患者进行细分的重要性。
Study Design. A comparative study.Objectives. To investigate sitting postures of asymptomatic individuals and nonspecific chronic low back pain (NS-CLBP) patients (pooled and subclassified) and evaluate the importance of subclassification.Summary of Background. Currently, little evidence exists to support the hypothesis that CLBP patients sit differently from pain-free controls. Although classifying NS-CLBP patients into homogeneous subgroups has been previously emphasized, no attempts have been made to consider such groupings when examining seated posture.Methods. Three angles ( sacral tilt, lower lumbar, and upper lumbar) were measured during "usual" and "slumped" sitting in 33 NS-CLBP patients and 34 asymptomatic subjects using an electromagnetic measurement device. Before testing, NS-CLBP patients were subclassified by two blinded clinicians. Twenty patients were classified with a flexion motor control impairment and 13 with an active extension motor control impairment.Results. No differences were found between control and NS-CLBP ( pooled) patients during usual sitting. In contrast, analyses based on subclassification revealed that patients classified with an active extension pattern sat more lordotic at the symptomatic lower lumbar spine, whereas patients with a flexion pattern sat more kyphotic, when compared with healthy controls (F = 19.7; df(1) = 2, df(2) = 63, P < 0.001). Further, NS-CLBP patients had less ability to change their posture when asked to slump from usual sitting (t = 4.2, df = 65; P < 0.001).Conclusions. Differences in usual sitting posture were only revealed when NS-CLBP patients were subclassified. This highlights the importance of subclassifying NS-CLBP patients.