腰椎稳定性对NLBP患者躯干肌群形态机能特性的影响

Effects of the Lumbar Spine Stability on the Morphology and Functional Characteristics of Trunk Muscles in People with NLBP

目的:探索非特异性腰痛(NLBP)患者腰椎稳定性与躯干肌群形态、张力及力量等各方面特性的关系以及相关因素对这种关系的影响。方法:招募青年男性参与者,包括不同腰椎稳定性NLBP亚组(LSI组10人,Non-LSI组9人)以及正常对照组(10人)。测试采集脊柱肌群CSA、张力等数据以及最大等长屈伸力量。通过多元方差分析(MANOVA)比较各指标在各组别以及各种因素间的差异。结果:1)参与者组别因素与测试部位、发力位置等因素均无交互作用。2)腰多裂肌的大小和物理特性在各组别间均不具有显著性差异。3)脊柱肌群最大屈伸力矩表现出2个NLBP亚组比对照组屈肌力量更大、伸肌力量更小的趋势,LSI组更甚(P>0.05);LSI组屈伸力矩比值大于对照组(P<0.05)。结论:腰痛以及腰椎稳定性因素与躯干肌群的形态和物理学特性并无直接关联;力量这一机能特性中F/E比值是反映不同腰椎稳定性LBP患者与正常人机能差异的敏感指标。NLBP不是一个同质性群体,采用腰椎稳定性进行亚组划分具有一定可行性。

Objective： This article aimed at exploring the relationship between lumbar spinal stability of NLBP patients and trunk muscle characteristics in morphology,myotonometric and strength aspects,and the influencing factors of this relationship. Methods： The young male participants were recruited in this research,and divided into different lumbar spinal stability NLBP subgroups（ 10 of LSI group,9 of Non-LSI group） and normal control group（ 10 people）. The CSA,tension and maximum isometric force of spinal muscles were tested. The differences of these indexes in different groups were analyzed by MANOVA. Results： 1） There is no interaction between group and test location and force position. 2） There is no difference of multifidu＇s size and physical features in different groups. 3） Two NLBP subgroups＇ flexor strength is larger than control group＇s,but extensor strength is lower,and these differences of LSI group are more obvious（ P〈 0. 05）. The ratio of flexion and extension torques in LSI group is higher than that in control group（ P〈 0. 05）. Conclusions： There are no direct links between low back pain,lumbar spinal stability and morphology and physical characteristics of trunk muscles. F / E ratio in strength feature is a sensitive index to reflect the physical function difference between LBP patients and normal people.NLBP is not a homogeneous group,and there is a certain feasibility to classify the subgroups by lumbar spinal stability.