Motor Control Deficit in Low Back Pain: Cause or Effect?

描述：(逐字摘自申请表)修订申请表：因为 下腰痛的具体原因尚未确定，它 仍然是一个重大的公共卫生问题。其中的许多因素 与腰背痛相关的是机械性的。流行病学和 生物力学研究表明，突发性和突发性之间存在联系。 意想不到的负荷，如滑倒和摔倒，以及腰部受伤。在这些下面 在这种情况下，运动控制腰椎的机械稳定性是 在确定躯干对突然载荷的运动学响应和 随后受伤的可能性。然而，与健康对照组相比，LBP 患者表现出运动控制缺陷，如躯干肌肉反射延迟 反应差，躯干定位感觉差，姿势控制受损。这些 缺陷可能构成持续受伤的易感风险因素， 补偿/痛苦避免机制，或者它们可能是损害的后果 由腰椎组织支撑。拟议研究的目的 是为了提高我们对被测马达之间关系的理解 控制赤字和LBP。两项实验研究和一项事后分析 整个数据集形成了三个具体的目标。第一个前瞻性设计 研究将包括初步测试和为期两年的校队随访 运动员。目的是确定腰椎运动控制不良是否 脊柱增加了腰部受伤的风险。第二 将进行随机前瞻性研究，以记录运动的变化 腰椎病患者标准和治疗前后腰椎的控制 修改康复计划，强调运动控制训练。几个 在初步研究中开发的测试将量化发动机中的缺陷 LBP患者的控制力：躯干肌肉对突然的反应， 多向负荷释放和腰椎的稳定性，以及 坐姿不稳时躯干的姿势控制。它们之间的相互关系 在LBP人群中，上述运动控制和其他变量的措施将 在第三个具体目标中确定。这些额外的变量将 包括：躯干位置和运动本体感觉，客观和主观 测量身体功能、诊断和症状持续时间，以及个人 年龄和性别等特征。拟议研究的结果 将对设计更有效的方案具有重要的临床意义 LBP的预防、诊断和康复策略。

DESCRIPTION: (Verbatim from application) Revised Application: Because the specific causes underlying low back pain LBP have not yet been identified, it continues to be a significant public health problem. Many of the factors associated with low-back pain are mechanical in nature. Epidemiological and biomechanical studies have suggested that there is a link between sudden and unexpected loading, such as slips and falls, and low-back injuries. Under these circumstances, motor control of the mechanical stability of the lumbar spine is crucial in determining trunk kinematic response to sudden loading and the subsequent likelihood of injury. Compared to healthy controls, however, LBP patients exhibit deficits in motor control such as delayed trunk muscle reflex response, poor trunk positioning sense, and impaired postural control. These deficits may constitute predisposing risk factors for sustaining an injury, a compensation/pain avoidance mechanism, or they may be the consequence of damage sustained by the lumbar spine tissues. The objective of the proposed research is to improve our understanding of the relationship between the measured motor control deficit and LBP. Two experimental studies and a post-hoc analysis of the entire data set form the 3 specific aims. The first prospective design study will consist of the initial testing and a 2-year follow-up of varsity athletes. The goal is to determine whether poor motor control of the lumbar spine increases the risk for sustaining a low-back injury. The second randomized prospective study will be conducted to document the changes in motor control of the lumbar spine in LBP patients before and after standard and modified rehabilitation programs that emphasize motor control training. Several tests, developed in preliminary studies, will quantify the deficit in the motor control in LBP individuals: response of trunk muscles to a sudden, multi-directional load release and the stability of the lumbar spine, and postural control of the trunk in unstable sitting. Correlations between the above measures of motor control and other variables in the LBP population will be determined in the third specific aim. These additional variables will include: trunk position and motion proprioception, objective and subjective measures of physical function, diagnosis and duration of symptoms, and personal characteristics such as age and gender. The results of the proposed research will have a significant clinical relevance for designing more effective prevention, diagnosis, and rehabilitation strategies for LBP.