腰背疼痛病史对持续性体力活动中骨盆和躯干协调的影响（英文）
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摘要
目的:对比有无下腰痛病史人群在进行持续非对称重复提举任务过程中躯干和骨盆间的协调关系。方法:志愿者将位于脚踝高度、重量为11 kg的箱子提起至一个斜45o到达腰部高度的架子上,再降至起始位置。该动作持续10 min,每分钟循环做12组。在测试过程中左右侧循环交替升降。采用连续相对相位计算起始(1 min)、中间(5 min)和结束(9 min)阶段骨盆和躯干旋转之间的协调。结果:虽然组间无显著差别,但时间和组之间存在显著的交互作用,这表明在额状面上,无下腰痛病史组在结束阶段时存在更多反相位协调,而对照组中则无差异。矢状轴(弯曲和扭转)协调的分析表明有下腰痛病史组在整个周期的结束阶段存在更明显的同相协调,而对照组则无此种表现。结论:根据不同组别间的差异,即使无下腰痛病史的人在实验前6个月无疼痛,下腰痛症状也会留下后遗症。有下腰痛病史组中更多同相的协调可能代表"守卫步态"模式,并可能借此分析出这些个体面临再次损伤的原因。
Purpose:The purpose of this study was to compare the coordination between the trunk and the pelvis during a sustained asymmetric repetitive lifting task between a group with a history of low back pain(LBP;HBP) and a group with no history of LBP(NBP).Methods:Volunteers lifted a 11-kg box from ankle height in front to a shelf 45° off-center at waist height,and lowered it to the start position at12 cycles/min for 10 min.Lifting side was alternated during the trial.Continuous relative phase was used to calculate coordination between the pelvis and trunk rotation at the beginning(Min 1),middle(Min 5),and end of the bout(Min 9).Results:While there were no main effects for group,a significant interaction between time and group indicated that,in the frontal plane,the NBP group coordination was more anti-phase toward the end of the bout,with no such differences for the HBP group.Analysis of sagittal-axial(bend and twist) coordination revealed the HBP group coordination was more in-phase at the end of the bout over the entire cycle and for the lifting phase alone,with no such differences for the NBP group.Conclusion:Differences between groups demonstrate residual consequences of LBP in an occupational scenario,even though the HBP group was pain-free for >6 months prior to data collection.More in-phase coordination in the HBP group may represent a coordination pattern analogous to"guarded gait" which has been observed in other studies,and may lend insight as to why these individuals are at increased risk for re-injury.
Purpose:The purpose of this study was to compare the coordination between the trunk and the pelvis during a sustained asymmetric repetitive lifting task between a group with a history of low back pain(LBP;HBP) and a group with no history of LBP(NBP).Methods:Volunteers lifted a 11-kg box from ankle height in front to a shelf 45° off-center at waist height,and lowered it to the start position at12 cycles/min for 10 min.Lifting side was alternated during the trial.Continuous relative phase was used to calculate coordination between the pelvis and trunk rotation at the beginning(Min 1),middle(Min 5),and end of the bout(Min 9).Results:While there were no main effects for group,a significant interaction between time and group indicated that,in the frontal plane,the NBP group coordination was more anti-phase toward the end of the bout,with no such differences for the HBP group.Analysis of sagittal-axial(bend and twist) coordination revealed the HBP group coordination was more in-phase at the end of the bout over the entire cycle and for the lifting phase alone,with no such differences for the NBP group.Conclusion:Differences between groups demonstrate residual consequences of LBP in an occupational scenario,even though the HBP group was pain-free for >6 months prior to data collection.More in-phase coordination in the HBP group may represent a coordination pattern analogous to"guarded gait" which has been observed in other studies,and may lend insight as to why these individuals are at increased risk for re-injury.
引文
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7.Lincoln AE,Smith GS,Amoroso PJ,Bell NS.The natural history and risk factors of musculoskeletal conditions resulting in disability among USArmy personnel.Work 2002;18:99-113.
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10.Cassidy JD,Cote P,Carroll LJ,Kristman V.Incidence and course of low back pain episodes in the general population.Spine 2005;30:2817-23.
11.Hoy D,Brooks P,Blyth F,Buchbinder R.The epidemiology of low back pain.Best Pract Res Clin Rheumatol 2010;24:769-81.
12.Greene HS,Cholewicki J,Galloway MT,Nguyen CV,Radebold A.Ahistory of low back injury is a risk factor for recurrent back injuries in varsity athletes.Am J Sports Med 2001;29:795-800.
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14.Nadler SF,Moley P,Malanga GA,Rubbani M,Prybicien M,Feinberg JH.Functional deficits in athletes with a history of low back pain:a pilot study.Arch Phys Med Rehabil 2002;83:1753-8.
15.Hamill J,van Emmerik RE,Heiderscheit BC,Li L.A dynamical systems approach to lower extremity running injuries.Clin Biomech(Bristol,Avon)1999;14:297-308.
16.Seay JF.Lumbo-sacral loads and pelvis trunk coordination in runners with chronic and resolved acute low back pain.Amherst,MA:University of Massachusetts Amherst;2008.[Dissertation].
17.Seay JF,Van Emmerik RE,Hamill J.Influence of low back pain status on pelvis-trunk coordination during walking and running.Spine2011;36:E1070-9.
18.Marras WS.Occupational low back disorder causation and control.Ergonomics 2000;43:880-902.
19.Nahit ES,Macfarlane GJ,Pritchard CM,Cherry NM,Silman AJ.Short term influence of mechanical factors on regional musculoskeletal pain:a study of new workers from 12 occupational groups.Occup Environ Med2001;58:374-81.
20.Peek-Asa C,Mc Arthur DL,Kraus JF.Incidence of acute low-back injury among older workers in a cohort of material handlers.J Occup Environ Hyg2004;1:551-7.
21.Prado-Leon LR,Celis A,Avila-Chaurand R.Occupational lifting tasks as a risk factor in low back pain:a case-control study in a Mexican population.Work 2005;25:107-14.
22.Hoogendoorn WE,van Poppel MN,Bongers PM,Koes BW,Bouter LM.Physical load during work and leisure time as risk factors for back pain.Scand J Work Environ Health 1999;25:387-403.
23.Buller MJ,Tharion WJ,Karis A,Santee W,Mullen S,Hoyt R.Real time physiological monitoring of encapsulated team members of the 1st Civil Support Team-Weapons of Mass Destruction(CST-WMD).Natick,MA:U.S.Army Research Institute of Environmental Medicine;2007.
24.Sharp MA,Patton JF,Vogel JA.A database of physically demanding tasks performed by U.S.Army soldiers.Human Factors and Ergonomics Society40th Annual Meeting Proceedings.Philadelphia,PA.September 2-6,1996.p.673-7.
25.Seay JF,Sauer SG,Frykman PN,Roy TC.A history of low back pain affects pelvis and trunk mechanics during a sustained lift/lower task.Ergonomics 2013;56:944-53.
26.Hamill J,van Emmerick REA.Variability and stability:a dynamical systems perspective.J Appl Biomech 2000;16:392-3.
27.Selles RW,Wagenaar RC,Smit TH,Wuisman PI.Disorders in trunk rotation during walking in patients with low back pain:a dynamical systems approach.Clin Biomech(Bristol,Avon)2001;16:175-81.
28.Lamoth CJ,Meijer OG,Wuisman PI,van Dieen JH,Levin MF,Beek PJ.Pelvis-thorax coordination in the transverse plane during walking in persons with nonspecific low back pain.Spine 2002;27:E92-9.
29.Seay JF,Van Emmerik RE,Hamill J.Low back pain status affects pelvis-trunk coordination and variability during walking and running.Clin Biomech(Bristol,Avon)2011;26:572-8.
30.Seay JF,Van Emmerik RE,Hamill J.Trunk bend and twist coordination is affected by low back pain status during running.Eur J Sport Sci2014;14:563-8.
31.Peters BT,Haddad JM,Heiderscheit BC,Van Emmerik RE,Hamill J.Limitations in the use and interpretation of continuous relative phase.JBiomech 2003;36:271-4.
32.Cohen J.Statistical power analysis for the behavioral sciences.2nd ed.Hillsdale,NJ:L.Erlbaum Associates;1988.
33.Al-Obaidi SM,Al-Zoabi B,Al-Shuwaie N,Al-Zaabie N,Nelson RM.The influence of pain and pain-related fear and disability beliefs on walking velocity in chronic low back pain.Int J Rehabil Res 2003;26:101-8.
34.Jones SL,Henry SM,Raasch CC,Hitt JR,Bunn JY.Individuals with non-specific low back pain use a trunk stiffening strategy to maintain upright posture.J Electromyogr Kinesiol 2012;22:13-20.
35.Hodges PW,Tucker K.Moving differently in pain:a new theory to explain the adaptation to pain.Pain 2011;152:S90-8.
36.Nelson JM,Walmsley RP,Stevenson JM.Relative lumbar and pelvic motion during loaded spinal flexion/extension.Spine 1995;20:199-204.
2.Plante DA,Rothwell MG,Tufo HM.Managing the quality of care for low back pain.In:Frymoyer JW,editor.The adult spine:principles and practice.2nd ed.Philadelphia,PA:Lippincott-Raven;1997.
3.Helfenstein M,Goldenfum MA,Siena C.Occupational low back pain.Rev Assoc Med Bras 2010;56:583-9.
4.Armed Forces Health Surveillance Center.Ambulatory visits among members of active components,U.S.Armed Forces,2006.Annual Summary 2007.April 2007.
5.Armed Forces Health Surveillance Center.Absolute and relative morbidity burdens attributable to various illnesses and injuries,U.S.Armed Forces,2011.MSMR 2012;19:4-9.
6.Reynolds K,Cosio-Lima L,Creedon J,Gregg R,Zigmont T.Injury occurrence and risk factors in construction engineers and combat artillery soldiers.Mil Med 2002;167:971-7.
7.Lincoln AE,Smith GS,Amoroso PJ,Bell NS.The natural history and risk factors of musculoskeletal conditions resulting in disability among USArmy personnel.Work 2002;18:99-113.
8.Kent PM,Keating JL.The epidemiology of low back pain in primary care.Chiropr Osteopat 2005;13:13.
9.Hestbaek L,Leboeuf-Yde C,Manniche C.Low back pain:what is the long-term course?A review of studies of general patient populations.Eur Spine J 2003;12:149-65.
10.Cassidy JD,Cote P,Carroll LJ,Kristman V.Incidence and course of low back pain episodes in the general population.Spine 2005;30:2817-23.
11.Hoy D,Brooks P,Blyth F,Buchbinder R.The epidemiology of low back pain.Best Pract Res Clin Rheumatol 2010;24:769-81.
12.Greene HS,Cholewicki J,Galloway MT,Nguyen CV,Radebold A.Ahistory of low back injury is a risk factor for recurrent back injuries in varsity athletes.Am J Sports Med 2001;29:795-800.
13.Milgrom C,Finestone A,Lubovsky O,Zin D,Lahad A.A controlled randomized study of the effect of training with orthoses on the incidence of weight bearing induced back pain among infantry recruits.Spine2005;30:272-5.
14.Nadler SF,Moley P,Malanga GA,Rubbani M,Prybicien M,Feinberg JH.Functional deficits in athletes with a history of low back pain:a pilot study.Arch Phys Med Rehabil 2002;83:1753-8.
15.Hamill J,van Emmerik RE,Heiderscheit BC,Li L.A dynamical systems approach to lower extremity running injuries.Clin Biomech(Bristol,Avon)1999;14:297-308.
16.Seay JF.Lumbo-sacral loads and pelvis trunk coordination in runners with chronic and resolved acute low back pain.Amherst,MA:University of Massachusetts Amherst;2008.[Dissertation].
17.Seay JF,Van Emmerik RE,Hamill J.Influence of low back pain status on pelvis-trunk coordination during walking and running.Spine2011;36:E1070-9.
18.Marras WS.Occupational low back disorder causation and control.Ergonomics 2000;43:880-902.
19.Nahit ES,Macfarlane GJ,Pritchard CM,Cherry NM,Silman AJ.Short term influence of mechanical factors on regional musculoskeletal pain:a study of new workers from 12 occupational groups.Occup Environ Med2001;58:374-81.
20.Peek-Asa C,Mc Arthur DL,Kraus JF.Incidence of acute low-back injury among older workers in a cohort of material handlers.J Occup Environ Hyg2004;1:551-7.
21.Prado-Leon LR,Celis A,Avila-Chaurand R.Occupational lifting tasks as a risk factor in low back pain:a case-control study in a Mexican population.Work 2005;25:107-14.
22.Hoogendoorn WE,van Poppel MN,Bongers PM,Koes BW,Bouter LM.Physical load during work and leisure time as risk factors for back pain.Scand J Work Environ Health 1999;25:387-403.
23.Buller MJ,Tharion WJ,Karis A,Santee W,Mullen S,Hoyt R.Real time physiological monitoring of encapsulated team members of the 1st Civil Support Team-Weapons of Mass Destruction(CST-WMD).Natick,MA:U.S.Army Research Institute of Environmental Medicine;2007.
24.Sharp MA,Patton JF,Vogel JA.A database of physically demanding tasks performed by U.S.Army soldiers.Human Factors and Ergonomics Society40th Annual Meeting Proceedings.Philadelphia,PA.September 2-6,1996.p.673-7.
25.Seay JF,Sauer SG,Frykman PN,Roy TC.A history of low back pain affects pelvis and trunk mechanics during a sustained lift/lower task.Ergonomics 2013;56:944-53.
26.Hamill J,van Emmerick REA.Variability and stability:a dynamical systems perspective.J Appl Biomech 2000;16:392-3.
27.Selles RW,Wagenaar RC,Smit TH,Wuisman PI.Disorders in trunk rotation during walking in patients with low back pain:a dynamical systems approach.Clin Biomech(Bristol,Avon)2001;16:175-81.
28.Lamoth CJ,Meijer OG,Wuisman PI,van Dieen JH,Levin MF,Beek PJ.Pelvis-thorax coordination in the transverse plane during walking in persons with nonspecific low back pain.Spine 2002;27:E92-9.
29.Seay JF,Van Emmerik RE,Hamill J.Low back pain status affects pelvis-trunk coordination and variability during walking and running.Clin Biomech(Bristol,Avon)2011;26:572-8.
30.Seay JF,Van Emmerik RE,Hamill J.Trunk bend and twist coordination is affected by low back pain status during running.Eur J Sport Sci2014;14:563-8.
31.Peters BT,Haddad JM,Heiderscheit BC,Van Emmerik RE,Hamill J.Limitations in the use and interpretation of continuous relative phase.JBiomech 2003;36:271-4.
32.Cohen J.Statistical power analysis for the behavioral sciences.2nd ed.Hillsdale,NJ:L.Erlbaum Associates;1988.
33.Al-Obaidi SM,Al-Zoabi B,Al-Shuwaie N,Al-Zaabie N,Nelson RM.The influence of pain and pain-related fear and disability beliefs on walking velocity in chronic low back pain.Int J Rehabil Res 2003;26:101-8.
34.Jones SL,Henry SM,Raasch CC,Hitt JR,Bunn JY.Individuals with non-specific low back pain use a trunk stiffening strategy to maintain upright posture.J Electromyogr Kinesiol 2012;22:13-20.
35.Hodges PW,Tucker K.Moving differently in pain:a new theory to explain the adaptation to pain.Pain 2011;152:S90-8.
36.Nelson JM,Walmsley RP,Stevenson JM.Relative lumbar and pelvic motion during loaded spinal flexion/extension.Spine 1995;20:199-204.