Neuromuscular neutral zones in humans: A new method to assess spinal stability

人类神经肌肉中性区：评估脊柱稳定性的新方法

• 批准号: 8146989
• 负责人: Bradley Davidson
• 金额: $ 22.98万
• 依托单位: UNIVERSITY OF DENVER (COLORADO SEMINARY)
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-09-30 至 2013-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8146989
• 关键词: Agreement; Award; Belief; Biomechanics; Clinical; Clinical Trials Design; Colorado; Diagnosis; Diagnostic; Doctor of Chiropractic; Ensure; Family Felidae; Female; Future; Goals; Human; Individual; Instruction; Investigation; Joint Laxity; Kinesiology; Laboratories; Lateral; Lesion; Ligaments; Low Back Pain; Manipulative Therapies; Measurement; Measures; Mechanoreceptors; Mediating; Mentors; Methodology; Methods; Metric; Modeling; Motion; Movement; Muscle; Nature; Pain; Participant; Patients; Phase; Physiological; Population; Positioning Attribute; Publications; Quadratus Lumborum Muscle; Radial; Reflex action; Relaxation; Research; Research Technics; Rotation; Sex Characteristics; Spinal; Stretching; Structure; Sum; Techniques; Testing; Therapeutic; Time; Tissues; Universities; Variant; Vertebral column; base; early onset; effective therapy; improved; in vivo; insight; kinematics; male; neuromuscular; patient population; public health relevance; sex; spine bone structure

DESCRIPTION (provided by applicant): The long-term goals of this research are to gain insight into mechanisms of spinal stability and develop measurement techniques that will be critical for assessing the effects of spinal manipulative therapy (SMT) on ligament-mediated reflexes in healthy individuals and patients with low back pain. The basis of this investigation is that neuromuscular mechanisms of spinal stability are inherently connected with the structure of the spine and surrounding tissues. Therefore, techniques of SMT likely have a direct effect on mechanoreceptors in the passive tissue that may alleviate pain during movement by improving timing of stabilizing reflexes in the lumbar spine as defined by neuromuscular neutral zones (NNZs). In order to investigate the effects of manipulative therapy on NNZs, the presence and reliability of measuring these in humans must first be established using a healthy population. The mentored phase (K99) of this award will last one year, and be used to demonstrate the presence of NNZs in humans, examine which muscle are involved, and scrutinize their interactions within this phenomenon. Three hypotheses will be tested that are relevant to this single specific aim. The independent phase (ROO) will last three years, and is centered on two specific aims. The first aim will be to develop a non-invasive technique to measure intervertebral kinematics. The second aim will be to establish reliable methodology to quantify NNZs, examine differences between three rotational paradigms, and investigate sex effects on these measures. Four hypotheses will be tested relevant to these aims. This research will be conducted in a movement science laboratory located at the University of Colorado Denver. Successful completion of this research will provide foundational methodology for future testing in patient populations and implementing clinical trials designed to gain insight into therapeutic mechanisms of SMT and physiological nature of functional spinal lesions. This research trajectory will provide quantitative and evaluative assistance to clinicians when diagnosing and treating the large population of patients who seek therapy for low back pain. PUBLIC HEALTH RELEVANCE: The goals of this project are to establish new methods for evaluating lumbar spine stability. In addition to providing insight into mechanisms of spine stability, these techniques may eventually provide diagnostics to Doctors of Chiropractic for efficiently treating patients with low back pain.

描述(申请人提供)：这项研究的长期目标是深入了解脊柱稳定性的机制，并开发测量技术，这对于评估脊柱手法疗法(SMT)对健康个体和下腰痛患者韧带介导的反射的影响至关重要。这项研究的基础是，脊柱稳定性的神经肌肉机制与脊柱和周围组织的结构内在地联系在一起。因此，SMT技术可能对被动组织中的机械感受器产生直接影响，这种感受器可能通过改善腰椎神经肌肉中性区(NNZ)定义的稳定反射的时间来减轻运动时的疼痛。为了调查手法治疗对NNZ的影响，必须首先使用健康人群来确定在人类中测量这些因素的存在和可靠性。该奖项的指导阶段(K99)将持续一年，用于证明人类中存在NNZ，检查涉及哪些肌肉，并仔细检查它们在这一现象中的相互作用。与这一具体目标相关的三个假设将得到检验。独立阶段(Roo)将持续三年，围绕两个具体目标。第一个目标将是开发一种非侵入性技术来测量椎间运动学。第二个目标将是建立可靠的方法来量化NNZ，检查三种轮换范式之间的差异，并调查性别对这些衡量标准的影响。与这些目标相关的四个假设将得到检验。这项研究将在科罗拉多大学丹佛分校的运动科学实验室进行。这项研究的成功完成将为未来在患者群体中进行测试和实施临床试验提供基础方法，这些试验旨在深入了解SMT的治疗机制和功能性脊柱病变的生理性质。这一研究轨迹将为临床医生在诊断和治疗大量寻求治疗下腰痛的患者时提供定量和评估帮助。 公共卫生相关性：该项目的目标是建立评估腰椎稳定性的新方法。除了提供对脊柱稳定机制的洞察外，这些技术最终可能为脊椎按摩医生提供诊断，以便有效地治疗下腰痛患者。