Pilot--Breath Control during Lifting Tasks

每年有2%的美国劳动力有可补偿的腰痛（LBP）损伤，估计总数为 每年花费超过200亿美元。大约40%的报告在工作中发生LBP的人 举东西时用力过猛造成的伤害非常需要加强对 提升任务的机制，以改善减少伤害的方案。 当机械应力超过相关组织的耐受极限时，发生下背部的提升损伤 从而在脊柱节段之间产生过度运动。充分稳定节段的能力 通过协调肌肉控制来防止这种过度运动是下背部锻炼的共同目标 程序.随着腹腔的肌肉组织围绕腹腔内容物收缩，腹腔内 压力（IAP）增加，并将腹部转化为“刚性圆柱体”， 多节的韧带棘。一些研究表明，增加IAP增加腰椎稳定性。为 由于横膈膜形成腹腔的顶部，呼吸控制可以有助于呼吸和IAP的产生。 呼吸控制已被证明与IAP产生直接相关，以及与腰椎间盘突出症的直接体内测量直接相关。 稳定呼吸和运动系统的协调的重要性，在起重任务，以实现充分的 尽管几乎没有关于自然呼吸的研究，但多位作者都提出了腰椎稳定性 在提升任务期间控制探索这个问题。增加对正常协调模式的理解， 呼吸和运动系统可以允许在锻炼计划中改进训练方法以获得腰部稳定性， 有助于预防和康复腰椎不稳引起的腰痛。 具体目标1：开发数据收集和分析举重任务期间呼吸控制模式的新方法 可用于确定这些模式的时机、幅度和方向是否具有理论支持 在机械挑战的关键时刻保持腰椎稳定性。 具体目标2：确定不同水平的挑战对腰椎稳定性的影响（例如，载荷，垂直高度， 水平距离）对健康正常人呼吸控制模式的影响。 具体目标3：确定不同水平的挑战对腰椎稳定性的影响（例如，载荷，垂直高度， 水平距离）对间歇性机械性下背部患者呼吸控制模式的影响 痛苦 具体目标4：确定间歇性呼吸困难患者在举重任务期间使用的呼吸控制模式是否 当与正常受试者的呼吸模式相比时，机械性下背痛不同。 我们提出的研究将提供第一个完整的描述呼吸控制在起重任务， 第一个确定呼吸和运动系统协调是否存在显着差异的受试者之间， 而且没有腰痛。该试点项目数据将提供可用于设计的效应量估计值， 更大的相关研究这项研究有可能在提升任务领域提供有意义的新信息 和下背痛，并直接应用于腰部稳定性训练领域，以预防或减轻下背痛。

Two percent of the US workforce has a compensable low back pain (LBP) injury each year with an estimated total annual cost exceeding $20 billion. Approximately 40% of those who report an occurrence of LBP on the job associate that injury with overexertion while lifting objects. There is a significant need for increased understanding of the mechanisms of lifting tasks in order to improve programs for injury reduction. Lifting injuries to the low back occur when mechanical stress exceeds the tolerance limits of the involved tissues thereby producing excessive motion between spinal segments. The ability to adequately stabilize the segments of the lumbar spine to prevent this excessive motion via coordinated muscular control is a common goal in low back exercise programs. As the musculature of the abdominal cavity contracts around the abdominal contents, intra-abdominal pressure (IAP) increases and converts the abdomen into a "rigid cylinder" that has an increased stability compared to the multi-segmented ligamentous spine. Several studies suggest that increases in IAP increase lumbar stability. As the diaphragm forms the roof of the abdominal cavity, breath control can contribute to both respiration and IAP production. Breath control has been shown to be directly related to IAP production as well as to direct in-vivo measures of lumbar stability. The importance of coordination of the respiratory and motor systems during lifting tasks to achieve sufficient lumbar stability has been suggested by multiple authors, although there has been almost no study of natural breath control during lifting tasks exploring this issue. Increased understanding of the normal coordinative patterns of respiratory and motor systems may allow improved training methods in exercise programs for lumbar stability and contribute to both prevention and rehabilitation of low back pain due to lumbar instability. Specific Aim 1: Develop novel methods of data collection and analysis of breath control patterns during lifting tasks that can be used to determine if the timing, magnitude and direction of these patterns demonstrate theoretical support for lumbar stability at critical moments of mechanical challenge. Specific Aim 2: Determine the effects of different levels of challenge to lumbar stability (e.g., load, vertical height, horizontal distance) during lifting tasks on the breath control patterns in healthy normal subjects. Specific Aims 3: Determine the effects of different levels of challenge to lumbar stability (e.g., load, vertical height, horizontal distance) during lifting tasks on the breath control patterns in patients with intermittent mechanical low back pain. Specific Aim 4: Determine if the patterns of breath control during lifting tasks used by patients with intermittent mechanical low back pain differs when compared to breath patterns of normal subjects. The research we propose will provide the first complete descriptions of breath control during lifting tasks and will be the first to determine if significant differences in respiratory and motor system coordination exist between subjects with and without low back pain. This pilot project data will provide estimates of effect size that can be used in the design of larger related studies. This research has the potential to provide meaningful new information in the area of lifting tasks and low back pain and have direct applications in the area of lumbar stability training to prevent or reduce low back pain.