摘要
目的研究腰椎间盘突出症(lumbar disc herniation,LDH)患者在坐立过程中疼痛对腰椎和髋关节力矩的影响。方法应用AMTI测力台采集20例健康对照与20例LDH受试者的动力学数据,通过统计参数映射(statistical parametric mapping,SPM)分析两组受试者坐立任务中腰椎与髋关节在矢状面和冠状面的力矩差异。结果与健康对照组相比,LDH受试者从站立回到坐位过程中腰椎最大屈曲力矩与髋关节最大内收力矩明显增高(P<0.05)。SPM分析显示,在站立初期阶段(37%~42%),LDH组髋关节外展力矩大于健康对照组,存在统计学差异(P=0.007)。结论LDH受试者在坐立过程中腰椎骨盆不够稳定,尤其站立静止阶段,难以使身体达到平衡状态,需增加髋关节外展力矩来维持骨盆稳定。在临床评估治疗中应重点关注脊柱与骨盆的稳定功能。
Objective To study the effect of pain on the lumbar and hip joint moments in patients with lumbar disc herniation(LDH)while sitting and standing.Methods Dynamic data from 20 healthy controls and 20 patients with LDH were collected using an AMTI dynamometer.The differences in moments between the lumbar spine and hip joints in the sagittal and coronal planes for the two groups of subjects performing sitting-standing tasks were analyzed using statistical parameter mapping(SPM).Results Compared to the healthy control group,the LDH group showed a significant increase in the maximum lumbar flexion moment and the maximum hip adduction moment from standing to sitting(P<0.05).SPM analysis showed that during the initial phase of standing(37%-42%),the hip abduction moment of the LDH group was significantly greater than that of the healthy control group(P=0.007).Conclusions Subjects with LDH have an unstable lumbar spine and pelvis during sitting and standing,especially at the stationary stage,which makes it difficult to achieve balance in their body.Therefore,increasing the hip abduction moment is necessary to maintain pelvic stability.During clinical evaluation and treatment,emphasis should be placed on the stable function of the spine and pelvis.
作者
周鑫
赵雄
曹奔
孔令军
吴志伟
朱清广
房敏
ZHOU Xin;ZHAO Xiong;CAO Ben;KONG Lingjun;WU Zhiwei;ZHU Qingguang;FANG Min(Tuina Department,Yueyang Integrated Traditional Chinese and Western Medicine Hospital Affiliated with Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Institute of Traditional Chinese Medicine Tuina,Shanghai Academy of Traditional Chinese Medicine,Shanghai 200437,China;University of Ottawa,Ontario K1N6N5,Canada;Tuina Department,Shuguang Hospital Affiliated with Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China)
出处
《医用生物力学》
CAS
CSCD
北大核心
2024年第2期258-264,共7页
Journal of Medical Biomechanics
基金
国家自然科学基金项目(82205304,82030121)
上海市“科技创新行动计划”启明星培育扬帆专项(22YF1449900),上海市“科技创新行动计划”医学创新研究专项项目(21Y21920300)。
关键词
腰椎间盘突出症
腰椎
髋关节
统计参数映射
力矩
lumbar disc herniation(LDH)
lumbar spine
hip joint
statistical parameter mapping(SPM)
moment