非特异性腰痛患者腰背肌群延迟激活的研究

doi:10.3969/j.issn.1006-9771.2019.10.013

《中国康复理论与实践》 ›› 2019, Vol. 25 ›› Issue (10): 1187-1192.doi: 10.3969/j.issn.1006-9771.2019.10.013

非特异性腰痛患者腰背肌群延迟激活的研究

郑依莉¹, 胡浩宇¹, 刘晓晨¹, 董煜琳², 张娟¹, 龚迪¹, 宋歌¹, 王雪强^1,3

1.上海体育学院运动医学康复中心，上海市 200438;
2.上海市第二康复医院治疗部，上海市 200438;
3.上海上体伤骨科医院康复科，上海市 200438

出版日期:2019-10-25 发布日期:2019-10-30
通讯作者: 王雪强，E-mail: qiang897@163.com E-mail:qiang897@163.com
作者简介:郑依莉(1994-)，女，汉族，浙江乐清市人，硕士研究生，主要研究方向：腰痛。
基金资助:
1.国家自然科学基金项目(No. 81501956; No. 81871844)；2.教育部霍英东教育基金会资助项目(No. 161092)；3.上海市卫生和计划生育委员会临床专项项目(No. 201840346)；4.上海市人类运动能力开发与保障重点实验室项目(No. 11DZ2261100)；5.上海市教育委员会和上海市教育发展基金会“曙光计划”资助项目(No. 18SG48)

Activation of Multifidus and Erector Spinae Muscles during Upper Limb Flexion and Abduction in Patients with Nonspecific Low Back Pain

ZHENG Yi-li¹, HU Hao-yu¹, LIU Xiao-chen¹, DONG Yu-lin², ZHANG Juan¹, GONG Di¹, SONG Ge¹, WANG Xue-qiang^1,3

1.Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai 200438, China;
2.Department of Treatment, the Second Rehabilitation Hospital of Shanghai, Shanghai 200438, China;
3.Department of Rehabilitation Medicine, Shanghai Shangti Orthopedic Hospital, Shanghai 200438, China

Published:2019-10-25 Online:2019-10-30
Contact: WANG Xue-qiang, E-mail: qiang897@163.com E-mail:qiang897@163.com
Supported by:
Supported by Foundation:National Natural Science Foundation of China (No. 81501956; No. 81871844), Ministry of Education Fok?Ying-Tong Education Foundation (No. 161092), Shanghai Municipal Health Commission Clinical Special Subject (No. 201840346), the Shanghai Key Laboratory of Development and Protection of Human Athletic Ability (No. 11DZ2261100) and Shanghai Education Committee and Shanghai Education Development Foundation “Shuguang Program” (No. 18SG48)

摘要/Abstract

摘要： 目的通过表面肌电信号(sEMG)分析，对比非特异性腰痛(NLBP)患者与正常人在静态平衡模式改变时，上肢肌群与腰背部核心肌群激活时间的差异。方法 2017年9月至12月，纳入NLBP患者(NLBP组)与正常受试者(正常组)各21例。两组于站立位分别完成右侧上肢前屈与外展各2次，记录右侧三角肌前束、中束，双侧竖脊肌和双侧多裂肌的肌电信号，计算各肌肉与主动肌之间的相对激活时间并比较。结果上肢前屈时，两组右侧多裂肌、双侧竖脊肌均在主动肌(三角肌前束)之前激活，而左侧多裂肌在主动肌之后激活；NLBP组右侧竖脊肌的相对激活时间大于正常组(t = -2.393, P = 0.019)。上肢外展时，正常组双侧多裂肌和双侧竖脊肌在主动肌(三角肌中束)之前激活；NLBP组左侧竖脊肌在主动肌之前激活，双侧多裂肌、右侧竖脊肌在主动肌之后激活；两组对应肌肉的相对激活时间均无显著性差异(t < 1.393, P > 0.05)。结论正常人通过上肢的前屈和外展来改变静态平衡时，腰背部核心肌群会提前激活，而NSLBP患者的核心肌群则有延迟激活的趋势。

关键词: 非特异性腰痛, 表面肌电, 核心肌群, 延迟激活

Abstract: Objective To compare the difference in the onset time of the trunk muscles activity in individuals with and without nonspecific low back pain (NLBP) during upper limb flexion and abduction. Methods From September to December, 2017, 21 patients with NLBP (NLBP group) and 21 volunteers (control group) participated in this study. Surface electromyography (sEMG) signals were recorded from the anterior deltoid, middle deltoid, multifidus and erector spinae muscles during upper limb flexion and abduction in standing position. Relative differences in the onset times between each muscle and the prime mover were calculated. Results During upper limb flexion, the right multifidus muscle, bilateral erector spinae were activated in advance of the agonist muscle (anterior deltoid), while the left multifidus muscle was delayed relative to the agonist muscle in both groups. The onset time of the right erector spinae was significantly delayed in NLBP group than in the control group (t = -2.393, P = 0.019). During upper limb abduction, bilateral multifidus muscle and bilateral erector spinae were activated in advance of the agonist muscle (middle deltoid) in the control group. Additionally, in NLBP group, the left erector spinae was activated in advance of the agonist muscle, bilateral multifidus and right erector spinae were delayed relative to the agonist muscle. There was no significant difference in the relative onset time between both groups (t < 1.393, P > 0.05). Conclusion During upper limb flexion and abduction, the trunk muscles of the lower back are activated in advance for healthy individuals, while individuals with NLBP have a possibly delayed activation of trunk muscles.

Key words: nonspecific low back pain, surface electromyography, core muscles, delayed onset

中图分类号:

R681.5

郑依莉, 胡浩宇, 刘晓晨, 董煜琳, 张娟, 龚迪, 宋歌, 王雪强. 非特异性腰痛患者腰背肌群延迟激活的研究[J]. 《中国康复理论与实践》, 2019, 25(10): 1187-1192.

ZHENG Yi-li, HU Hao-yu, LIU Xiao-chen, DONG Yu-lin, ZHANG Juan, GONG Di, SONG Ge, WANG Xue-qiang. Activation of Multifidus and Erector Spinae Muscles during Upper Limb Flexion and Abduction in Patients with Nonspecific Low Back Pain[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(10): 1187-1192.

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非特异性腰痛患者腰背肌群延迟激活的研究

Activation of Multifidus and Erector Spinae Muscles during Upper Limb Flexion and Abduction in Patients with Nonspecific Low Back Pain

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