| 冯 能,李跃红,缪 芸,吴德升.慢性腰痛患者站立位躯干屈伸运动时腰背肌的功能变化研究[J].中国康复医学杂志,2012,27(7):600~604 |
| 慢性腰痛患者站立位躯干屈伸运动时腰背肌的功能变化研究 点此下载全文 |
| 冯 能 李跃红 缪 芸 吴德升 |
| 上海市同济大学附属东方医院骨科，上海，200120 |
| 基金项目： |
| DOI： |
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| 摘要： |
| 摘要
目的：研究慢性腰痛（CLBP）患者在站立位矢状面屈伸运动时腰背肌功能状况的变化，揭示其改变的可能机制及临床意义。
方法：慢性非特异性腰痛患者25例和健康人25例，在站立位进行躯干的屈曲伸展运动，运用表面肌电图（sEMG）仪和摄像系统同步采集记录双侧L2/3、L4/5水平最长肌、多裂肌在站立位、前屈运动、完全屈曲及回到直立位不同运动时相的sEMG值。
结果：两组受试对象站立位时，最长肌及多裂肌均方根（RMS）值差异无显著性意义（P＞0.05）；前屈运动时，最长肌及多裂肌RMS值增大，完全屈曲时，最长肌及多裂肌RMS值减小，腰痛组在前屈运动和完全屈曲时，最长肌和多裂肌RMS值较健康对照组增大，差异具有显著性意义（P＜0.05）；由屈曲位回至直立位时，腰痛组最长肌和多裂肌的RMS值明显小于健康对照组，差异具有显著性意义（P＜0.05）；腰痛组最长肌和多裂肌的屈曲-放松比较健康对照组降低，差异具有显著性意义（P＜0.05）；运动时相对两组受试对象的最长肌和多裂肌RMS值影响均有显著性意义（P＜0.05）。
结论：在躯干屈伸运动中，健康人腰背肌存在屈曲-放松现象（FRP），腰痛患者腰背肌功能发生疼痛适应性改变，表现为屈曲-放松反应缺如和主动活动机能不足。 |
| 关键词：慢性腰痛 腰背肌 表面肌电图 屈曲-放松现象 |
| A study on the function of lumbar paraspinal muscles in patients with chronic low back pain during trunk flexion-extention Download Fulltext |
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| Dept. of Orthopedics, Shanghai East Hospital Affiliated of Shanghai Tongji University, 200120 |
| Fund Project: |
| Abstract: |
| Abstract
Objective: To assess the changes of lumbar paraspinal muscle function in patients with chronic low back pain (CLBP) during trunk flexion-extention, to interpret the changes in trunk muscle activity in CLBP patients and clinical implications.
Method: During twenty-five CLBP patients and 25 healthy subjects performed flexion-extention, surface electromyographic(sEMG) activities of multifidus and longissimus were evaluated with surface electrodes, root mean square(RMS) of these paraspinal muscles in upright standing, bend forward, full flexion and re-extention as well as flexion-relaxation ratio were calculated.
Result: During upright standing, RMS of multifidus and longissimus were similar in both group (P＞0.05). During trunk flexion with straight knees, RMS of sEMG activities initially increased in the initial phase of flexion, and then decreased with increments of flexion angle; relaxation of muscles occured in the outmost range of flexion; during bend forward, full flexion, RMS of multifidus and longissimus in CLBP patients were greater than that in control group (P＜0.05), and flexion-relaxation ratio was lower than that in healthy control group (P＜0.05); during flexion-upright RMS of multifidus and longissimus in CLBP patients were less than that in control group significantly(P＜0.05); motion phase had apparent impact on RMS of lumbar paraspinal muscles in both groups (P＜0.05).
Conclusion: The flexion-relaxation phenomenon (FRP) is presented in healthy control during trunk flexion； in CLBP patients the recruitment changes of lumbar paraspinal muscles are pain-adaptation, no FRP, activation of muscles reduce and active motion function deficiency. |
| Keywords:chronic low back pain lumbar paraspinal muscle surface electromyography flexion-relaxation phenomenon |
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