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

描述（由申请人提供）：本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，这些技术对于评估脊柱操纵疗法（SMT）对健康个体和腰痛患者韧带介导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有着内在的联系。因此，SMT技术可能对被动组织中的机械感受器有直接影响，可以通过改善由神经肌肉中性区（NNZs）定义的腰椎稳定反射的时间来减轻运动时的疼痛。为了研究操纵疗法对NNZs的影响，必须首先在健康人群中确定在人体内测量NNZs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NNZs在人类中的存在，检查哪些肌肉参与其中，并仔细检查它们在这种现象中的相互作用。将测试与这一特定目标相关的三个假设。独立阶段（ROO）将持续三年，并以两个具体目标为中心。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NNZs，审查三种轮流模式之间的差异，并调查性别对这些措施的影响。将测试与这些目标相关的四个假设。这项研究将在科罗拉多大学丹佛分校的一个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的测试和实施临床试验提供基础方法，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腰痛治疗的患者时提供定量和评估性的帮助。

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.