颈、腰肌训练的效果研究

Effects of muscle training on improving neck/lumbar functions

目的 通过一项持续6周的颈、腰肌专项训练,观察颈、腰肌等长训练配合徒手康复性训练对于增强颈、腰功能的效果,为飞行员颈、腰损伤防治提供有效的措施. 方法 6名男性健康志愿者,利用自行研制的颈、腰肌等长综合训练器进行每周2次、持续6周的专项颈、腰肌等长肌力训练.训练过程中受试者采用与歼击机飞行员飞行时相同的坐姿,保持脊柱正直位,以60％最大肌肉力量为单次训练负荷进行颈后伸和腰后伸.每次训练各完成2组颈后伸和腰后伸,每组重复10次.每次在训练器设备上专项训练前有组织地进行徒手训练作为辅助,并要求其他时间自行完成训练,确保每周不少于2次.徒手训练包括俯卧放松、俯卧位伸展、俯卧挺身、仰卧起坐、站立伸展5个基本动作.训练前、后测量脊柱正直位时颈肌后伸和左、右侧屈最大肌力,腰后伸最大肌力,颈、腰后伸10s最大肌力冲量和90 s最大肌力总冲量;在测量冲量的过程中记录体表肌电图;测量颈、腰前屈后伸、左右旋转、左右屈曲的最大主动活动范围.利用SPSS 18.0统计软件对训练前、后的数据进行配对t检验. 结果 与训练前相比,训练后受试者颈部正直位后伸肌力、左侧屈肌力显著增加（t=4.140、3.125,P＜0.05）;受试者的腰后伸肌力平均值增长了10％.训练后受试者颈后伸和腰后伸10 s肌力冲量、90 s肌力总冲量均显著增加（t=2.631～3.202,P＜0.05）;颈后伸、腰前屈,腰左转方向主动活动范围显著增加（t=4.011～6.343,P＜0.01）.训练后受试者90 s颈后伸肌电中位频率、10 s腰后伸肌电均方根值显著降低（t=3.402、2.944,P＜0.05）,其他肌电指标差异无统计学意义.结论 以歼击机飞行员飞行时的坐姿为训练体态,采用颈、腰肌等长训练配合徒手康复性训练,可有效提升飞行员颈、腰肌后伸的力量和耐力,增强脊柱稳定性,保持颈、腰运动功能.训练计划对于改善颈、腰损伤的效果还需进一步研究.

Objective To provide measure for preventing and rehabilitating neck and lumbar injury in fighter pilots by 6-wk program of neck and psoas muscle isometric training cooperated with healing setting-up exercises.Methods Six male healthy volunteers were trained in isometric contractions twice a week for 6 weeks by using self-designed Neck and Psoas Muscle Isometric Training Cooperated Equipment.During training,subjects seated and kept the same posture as in flight.They performed 2 sets of neck and lumbar extension exercises with 60% maximal voluntary contraction （MVC） strength for 10 times.Subjects also completed healing setting-up exercises before equipment training.They were also asked to perform additional healing setting-up exercises by themselves at least twice a week.The setting-up exercises included：relax in prone posture,prone posture stretching,prostrate straight on back,sit-up,and standing stretching.The pre-and posttraining tests consisted of the isometric MVC strength in neck extension,neck left lateral flexion （Ltflx） and right lateral flexion （Rtflx）,lumbar extension,10 s maximal strength impulse and 90 s maximal strength total impulse in neck/lumbar extension test,electromyography in impulse test,spine active range-of-motion （ROM） in flexion and extension,Ltflx and Rtflx,left and right rotation.The software package SPSS 18.0 was applied for paired t-test.Results Compared with those before training,post-training neck isometric MVC in extension and Ltflx improved significantly （t=4.140,3.125,P〈0.05）.Lumbar extension isometric MVC mean value increased 10%.10 s maximal strength impulse and 90 s maximal strength total impulse in neck and lumbar extension increased significantly （t=2.631-3.202,P〈0.05）.ROM in neck extension,lumbar flexion and left rotation improved significantly （t=4.011-6.343,P〈0.01）.In SEMG,median frequency in 90 s neck extension and root-mean-square in 10 s lumbar extension decreased significantly （t =3.402,2.944,P〈0.05）.The others did not significantly change.Conclusions Neck and lumbar muscle isometric exercise at the same sitting posture as pilot in flight cooperated with healing setting-up exercises shows a positive trend toward improving pilot extension strength and endurance,enhancing stabilizers of spine and activity functions.Further research should be directed to the effect of training on promoting neck and lumbar healing.