Pilot--Breath Control during Lifting Tasks

每年有2%的美国劳动力遭受可补偿的腰背痛(LBP)伤害，据估计 年成本超过200亿美元。报告在工作伙伴中发生LBP的人中约有40% 举起物体时过度用力所造成的伤害。我们很有必要加深对 提升任务的机制，以改进减少伤害的方案。 当机械应力超过受累组织的耐受极限时，就会发生腰背部的提举损伤。 从而在脊柱节段之间产生过度运动。充分稳定关节节段的能力 腰椎通过协调肌肉控制来防止这种过度运动是腰背部锻炼的共同目标。 程序。由于腹部的肌肉组织围绕着腹部内容物收缩，腹内 压力(IAP)增加并将腹部转化为具有更高稳定性的“刚性圆柱体” 多节段韧带脊椎。一些研究表明，IAP的增加可以提高腰椎的稳定性。作为 横隔膜形成腹膜，呼吸控制可以促进呼吸和IAP的产生。 呼吸控制已被证明与IAP的产生以及腰椎的直接体内测量直接相关。 稳定性。举重任务中呼吸系统和运动系统协调的重要性 多位作者提出了腰椎稳定性的建议，尽管几乎没有关于自然呼吸的研究。 在研究这一问题的起重任务期间进行控制。增加对正常的协调模式的理解 呼吸和运动系统可以在锻炼计划中改进训练方法，以保持腰椎的稳定性和 有助于预防和康复因腰椎不稳引起的腰背痛。 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 这可以用来确定这些模式的时间、大小和方向是否证明了理论支持 用于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，负荷、垂直高度、 水平距离)对健康正常受试者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，负荷、垂直高度、 水平距离)对间歇性机械性腰背痛患者呼吸控制模式的影响 疼痛。 具体目标4：确定间歇性心脏病患者在举重任务过程中的呼吸控制模式 与正常受试者的呼吸模式相比，机械性下腰痛有所不同。 我们提出的研究将提供第一个关于举重任务中呼吸控制的完整描述，并将 第一个确定呼吸和运动系统协调性是否存在显著差异的受试者 而且没有腰痛。该试点项目数据将提供可用于设计的影响大小的估计 更大规模的相关研究。这项研究有可能为起重任务领域提供有意义的新信息 和腰背痛，并在腰椎稳定训练领域有直接应用，以预防或减轻下腰痛。

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.