The Mechanism and Function of Lumbosacral Orthoses

腰骶矫形器的机理和功能

• 批准号: 6914887
• 负责人: Jacek Cholewicki
• 金额: $ 28.5万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2007-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6914887
• 关键词: adult human (21+); assistive device /technology; backache; bioenergetics; biomechanics; clinical research; electromyography; ergonomics; functional ability; gait; human subject; human therapy evaluation; lumbosacral region; medical rehabilitation related tag; muscle contraction; patient oriented research; proprioception /kinesthesia; questionnaires; rehabilitation

DESCRIPTION (provided by applicant): New mechanisms and function of lumbosacral orthoses (LSOs) in the management of low back pain (LBP) are explored in this application by testing four hypotheses. These hypotheses are based on the rationale of LSO-enhanced spine stability, which has not been considered in this context before. The LSO provides additional stability to the lumbar spine and, therefore, patients with LBP will (i) exhibit less trunk antagonistic muscle co-contraction when wearing the LSO as compared to the "No LSO" condition, (ii) respond with a smaller number of muscles and longer latency to sudden trunk loading when wearing the LSO as compared to the "No LSO" condition, (iii) walk with gait closer resembling a normal pattern when wearing the LSO as compared to walking without the LSO, and (iv) exhibit enhanced proprioception in the lumbar spine when wearing the LSO as compared to the "No LSO" condition. Twenty LBP subjects for the experimental group and 20 control LBP subjects will be recruited from the Yale Spine Service clinics to test each hypothesis. The subjects in the experimental group will wear the LSO for 4-6 weeks. All subjects will be tested every two weeks with and without the LSO in 3 separate experiments to address each hypothesis. These experiments will consist of (1) the EMG Experiment to address hypotheses (i) and (ii), (2) the Gait Experiment to address hypothesis (iii), and (3) the Proprioception Experiment to address hypothesis (iv). New research developments will allow us to overcome several methodological and conceptual difficulties to make the proposed research now feasible. Therefore, the application of the following features will distinguish the proposed research from past studies: (i) the concept and quantification of spine stability, (ii) an experimental design tuned to detect very small LSO effects in EMG activity, (iii) a novel, submaximal exertion procedure for normalizing EMG data for patients with LBP, who are reluctant or unable to exert maximum effort, and (iv) a long-term (4-6 weeks) study, which may be necessary for acclimatization to the LSO. The results from these studies could be used in formulating rational guidelines for the prescription of LSOs as well as for improving their designs. In addition, data generated from the proposed research will also carry-over into advancing our understanding of the mechanisms and function of ergonomic lumbar supports.

描述（由申请人提供）：通过测试四个假设，探索了腰骨矫形器（LSO）在腰痛管理（LBP）中的新机制和功能。这些假设是基于LSO增强脊柱稳定性的基本原理，在这种情况下尚未考虑。 The LSO provides additional stability to the lumbar spine and, therefore, patients with LBP will (i) exhibit less trunk antagonistic muscle co-contraction when wearing the LSO as compared to the "No LSO" condition, (ii) respond with a smaller number of muscles and longer latency to sudden trunk loading when wearing the LSO as compared to the "No LSO" condition, (iii) walk with gait closer resembling a normal pattern when wearing the LSO as与没有LSO的行走相比，（IV）与“ NO LO”条件相比，（IV）佩戴LSO时表现出增强的本体感受。实验组的20个LBP受试者和20名对照LBP受试者将从耶鲁脊柱服务诊所招募，以检验每个假设。实验组中的受试者将穿LSO 4-6周。在3个单独的实验中，将在有和没有LSO的情况下每两周测试所有受试者，以解决每个假设。这些实验将包括（1）EMG实验，以解决假设（i）和（ii），（2）步态实验以解决假设（III），以及（3）针对假设（IV）的前置实验。 新的研究发展将使我们能够克服一些方法论和概念上的困难，以使拟议的研究现在可行。因此，以下特征的应用将区分拟议的研究与过去的研究区分开：（i）脊柱稳定性的概念和量化，（ii）一种实验设计，用于检测在EMG活性中检测到非常小的LSO效应，（iii）一种新颖的，次最大的施加过程，用于对LBP的患者进行EMG数据的正常数据，可能是在LBP中进行的最大努力，并且可能是劳动和努力（4）（4）（IV）（IV）（IV）（IV），（IV）（IV）（IV）（IV）（IV）（IV）适应LSO。这些研究的结果可用于制定LSO处方的合理指南以及改善其设计。此外，拟议的研究产生的数据还将随身携带，以促进我们对人体工程学腰椎支持的机制和功能的理解。