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

描述：（逐字从应用程序）修订的应用程序：因为 下腰痛的具体原因尚未确定， 仍然是一个严重的公共卫生问题。的许多因素 与腰痛相关的疼痛本质上是机械性的。流行病学和 生物力学研究表明，突然和 意外负载，如滑倒和福尔斯，以及腰部受伤。根据这些 在这种情况下，腰椎的机械稳定性的电机控制是 决定躯干对突然负荷的运动学反应的关键， 随后的伤害可能性。与健康对照组相比，LBP 患者表现出运动控制缺陷， 反应，躯干定位感差，姿势控制受损。这些 缺陷可能构成持续损伤的诱发风险因素， 补偿/疼痛避免机制，或者它们可能是损害的后果 由腰椎组织支撑。拟议研究的目标 是为了提高我们对被测电动机 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目标。第一次前瞻性设计 研究将包括初步测试和2年的后续行动的大学 运动员目的是确定腰椎运动控制不良 脊柱增加了风险，为持续下背部受伤。第二 将进行随机前瞻性研究，以记录运动功能的变化 LBP患者标准治疗前后的腰椎控制， 改进的康复计划，强调运动控制训练。几 在初步研究中开发的测试将量化运动中的缺陷， LBP个体的控制：躯干肌肉对突然， 多方向载荷释放和腰椎稳定性，以及 在不稳定坐姿中躯干的姿势控制。之间的相关性 LBP人群中上述运动控制和其他变量的测量将 第三个具体目标。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 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 将具有显著的临床相关性， 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.