训练性下腰痛患者躯干肌生物力学及相关研究

BIOMECHANICAL STUDY OF TRUNK MUSCLE STRENGTH AND INTERRELATED STUDY IN PATIENTS WITH LOW BACK PAIN CAUSED BY MILITARY TRAINING

探讨训练性下腰痛患者的躯干肌力、腰椎曲度及骶棘肌横截面积的变化 ,应用CYBEX 6 0 0 0型等速测试训练系统测试腰痛组和正常组各 4 0名的躯干肌力指标 ,并在立位腰椎侧位X线片上测量腰椎曲度 ,应用彩超测量骶棘肌横截面积 ,两组间进行比较。结果显示 ,躯干屈肌PT/BW腰痛组与正常组无显著性差异 ,TAE则腰痛组低于正常组(P <0 0 5 ) ,而躯干伸肌PT/BW和TAE腰痛组均低于正常组 (P <0 0 5 ) ;腰痛组的F/E大于正常组 (P <0 0 5 ) ,腰椎曲度小于正常组 (P <0 0 5 ) ,骶棘肌横截面积与正常组无显著性差异。提示训练性下腰痛者存在着明显的腰背肌力下降 ,以及由此所致的躯干肌肌力失衡、腰椎生理曲度变直 。

To ascertain the change of trunk muscle strength and lumbar curvature and cross sectional area of M. sacrospinalis in low back pain caused by military training, the indexes of trunk muscle strength (PT/BW, TAE, F/E) were measured in patients with low back pain and healthy subjects with CYBEX 6000 isokinetic testing system. The lumbar curvature was measured in lumbar X ray films on the lateral projection in standing position, and the cross sectional area of sacrospinalis was measured by ultrasonography. All of the indexes were compared between the two groups.The results showed PT/BW of flexors was not significantly different between the patients and healthy subjects, TAE of flexors in patients was lower than that of healthy subjects ( P <0 05),PT/ BW and TAE of extensors in patients were lower than those of healthy subjects ( P <0 05), and F/E in patients was greater than that of healthy subjects ( P <0 05). Lumbar curvature in patients was smaller than that those of healthy subjects( P <0 05). Cross sectional area of M. sacrospinalis was not significantly different between the two groups. These results indicdte in patients with low back pain caused by military training, extensor strength declines significantly, as a result, the trunk muscle strength loses balance and the lumbar curvature decreases,but the atrophy of M.S acrospinalis does not change significantly.