散打运动员慢性腰痛的研究
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摘要
研究目的
以男性散打运动员为研究对象，依据训练专项的特点，结合流行病学调查，运用肌肉电生理、肌肉形态、生物力学等方法，研究慢性腰痛散打运动员的腰部肌肉控制、肌肉力量、本体感觉等变化，探索运用Anybody建模仿真软件分析鞭腿过程中腰部各肌肉发力的相关情况，分析散打运动员慢性腰痛的特征，尝试探讨其发生机制，为运动员慢性腰痛的康复、伤后训练及后续研究提供参考。
研究方法
运用散打运动员腰痛调查表（信效度检验符合要求）对上海市、浙江省、广东省、河南省等4个专业散打队男队及上海体育学院散打专项班的二、三年级的132名男性运动员进行调查。
以15名男性散打运动员为研究对象，其中慢痛组—实验组（8名慢性腰痛散打运动员），无痛组—对照组（7名无腰痛散打运动员）。分别进行不同动作下腰部肌电、活动度的测试，以及肌力、本体感觉和肌肉形态测量，分析慢性腰痛散打运动员的机能特征。
运用Anybody软件系统，依据1名散打运动员的身高、体重、大腿长、小腿长等测量参数构建人体骨骼肌肉模型。获取其鞭腿动作过程中的运动学和动力学C3d数据，对全身骨骼肌肉模型进行驱动。
研究结果
(1）流行病学调查显示，散打运动员腰痛的患病率为50%，其中慢性腰痛的患病率为14.4%，患病率较高。引起其腰部损伤的技术动作摔法占42.1%，腿法占31.6%，为易致伤技术动作。
(2）运用表面肌电评价腰部肌肉的前馈活动、激活时序及激活程度。结果发现慢痛组和无痛组的对侧多裂肌、同侧腹外斜肌、同侧腹内斜肌的激活时间之间存在显著性差异（P<0.05）。无痛组运动员躯干肌均以前馈活动方式激活的肌肉为双侧竖脊肌、多裂肌、腹内斜肌等7块肌肉，而慢痛组只有对侧竖脊肌、同侧多裂肌和对侧腹内斜肌3块肌肉。
右鞭腿时，慢痛组运动员躯干肌的激活顺序是对侧的腹内斜肌和竖脊肌最先激活，而无痛组运动员最先激活的肌肉是对侧腹内斜肌和同侧多裂肌。慢痛组的同侧竖脊肌均方根值大于无痛组，组间比较存在显著性差异（P<0.05）。
左侧踹时，慢痛组运动员躯干肌的激活顺序是对侧的竖脊肌和腹外斜肌最先激活，而无痛组运动员最先激活的肌肉是同侧腹内斜肌和对侧多裂肌。
(3)运用Contrex等动测力系统测试腰部肌肉的力量、耐力及本体感觉功能。结果显示，在60°/s、90°/s、120°/s三种不同角速度下，慢痛组运动员的屈伸肌肉的峰力矩值均小于无痛组的值（P>0.05），慢痛组的伸肌平均功率值均小于无痛组（P>0.05）。慢痛组运动员的屈、伸肌的平均功率值，在60°/s与90°/s、120°/s之间均存在极显著性差异（P<0.01）。躯干肌的耐力测试，慢痛组的峰力矩下降率分别为20.8%、23.3%小于无痛组的27.8%、29%。
本体感觉测试，慢痛组散打运动员在15°（P<0.05）和30°（P>0.05）时的角度复位误差值均大于无痛组。
(4)运用MRI技术测试腰部肌肉的形态变化。结果显示，横断面上慢痛组运动员xx的腰大肌面积明显大于无痛组yy，多裂肌、竖脊肌的肌纤维束较难辨别。正中矢状面上其脊柱前曲度明显变直，椎体和椎间盘呈现不同程度退行性病变。
(5)运用Vicon运动学分析技术，测试腰部的的活动度。结果显示，左侧踹和右鞭腿时，慢痛组运动员腰部的侧屈和旋转活动幅度均相对偏大。
(6)运用AnyBody人体建模仿真系统建立了散打运动员右鞭腿动作的模型。获取的肌肉激活峰值表明，在鞭腿的鞭击阶段，左侧竖脊肌的激活峰值要远远高于右侧，左侧多裂肌、左侧腹内斜肌的激活峰值明显低于右侧，与无痛组的肌电结果相似。
研究结论
（1）散打运动员慢性腰痛的患病率较高，腰部易致伤技术动作主要是摔法和腿法。
（2）慢性腰痛散打运动员躯干肌肌电活动存在控制异常和激活延迟现象，同时出现本体感觉功能下降。鞭腿和侧踹动作中，其腰部肌肉激活时序、激活程度等存在异常，提示慢性腰痛散打运动员腰部肌肉的协调和控制能力下降，导致脊柱的稳定性降低。
（3）慢性腰痛散打运动员的躯干肌力偏低，屈、伸肌力失衡，伸肌爆发力偏低。其腰段脊柱及周围组织的形态结构呈现不同程度退行性病变，说明散打运动员的慢性腰痛症状主要与腰部肌肉结构功能的改变、肌力下降和腰椎结构退变有关。
（4）在鞭腿和侧踹的整个动作过程中，慢性腰痛运动员腰部活动的变化幅度相对偏大，提示慢性腰痛散打运动员对于身体姿势的控制能力减弱。
（5）运用AnyBody人体建模仿真系统建立的散打运动员右鞭腿动作骨骼肌肉仿真模型，对探讨其发力特征具有一定的参考价值。
Objective:
In this research Sanda athletes are employed as the research objects. According tothe characteristics of the special training and epidemiological investigation, this studyis to analyze the waist muscle control and coordination mechanism of Sanda athleteswith the chronic low back pain（CLBP）, the muscle strength, proprioceptions, etc. bymuscle electrophysiology, muscle form, biomechanics research methods, to explorethe relevant circumstance of waist muscle force in the process of the round kicks byusing Anybody to model simulation software, investigate the CLBP characteristicsand mechanism of Sanda athletes so as to provide the reference of treatment,rehabilitation and the training after injury and further research related to the athleteswith CLBP.
Methods:
The132athletes of4male professional Sanda teams from Shanghai, Zhejiang,Guangdong, Henan provinces and two male professional Sanda classes of grade2-3inShanghai Sports university have been surveyed by using the self-designed back painquestionnaire (Reliability and validity meet the requirement.)
15Sanda athletes are chosen as the research objects. Among them, CLBP group—arranged as experimental group (8Sanda athletes with CLBP) and NLBP group—as control group (7normal Sanda athletes without low back pain). These2groupsreceive EMG test about the lower back muscle of different actions, waist mobility testof the different actions, waist muscle test, lumbar proprioception test and musclemorphology measurements respectively to analyze function characteristics of Sandaathletes with CLBP.
According to a Sanda athletes' height, weight, thigh length, leg length and othermeasurement parameters，building human musculoskeletal model With Anybodysoftware system. Get its whip leg movements in the process of kinematics anddynamics of C3d data to drive the body musculoskeletal model.
Results:
（1） As epidemiological survey,50.0%of Sanda athletes are liable to suffer fromLBP, among them14.4%was CLBP. The technological movements causing the waistinjury, throwing techniques account for31.6%, leg techniques,42.1%.
（2） Using surface electromyography to evaluate of back muscle feedforwardactivity, activation timing and degree of activation, the result is that CLBP group andNLBP group have significant differences between groups (P <0.05) in three muscles(opposite multifidus, ipsilateral external oblique and ipsilateral internal oblique). Andmuscle activation time of NLBP group is earlier than experimental group. NLBPgroup can use feedforward activity way to activate7muscles, that is, bilateral verticalspinal muscular, crack, internal oblique muscle and so on. While NLBP group onlyactivates3muscles, namely, vertical spinal muscular, side more muscle to crack andthe internal oblique muscle.
The left side kick, the activation order of CLBP group’ trunk muscle is thecontralateral erector spinae firstly then the activation of the external oblique muscle,while NLBP group was first activated muscle ipsilateral abdominal oblique andcontralateral multifidus muscle. Activation of dorsal muscles of the trunk of the CLBPgroup slightly higher than the painless group, there is no difference statistically.
When the Right leg whip, the CLBP group’ trunk muscle activation sequence isthat first activate contralateral abdominal oblique and erector spinae, and NLBP groupwas first activated muscle is the contralateral abdominal oblique muscle and theipsilatera lmultifidus muscle. RMS value of the ipsilateral erector spinaes groups aresignificant difference (P <0.05), the RMS value of the CLBP group is more large.
（3）Using of the Contrex isokinetic dynamometer to test back muscle strength,endurance and proprioception sensory function, the result is that in60°/s,90°/s,120°/s three different angular velocity, CLBP group’ Athletes in flexion andextension muscle peak torque values are less than the value of the NLBP group (P>0.05). The extensor average power values of CLBP group less than the painless group(P>0.05)。In CLBP group， there were significant differences (P <0.05) betweenflexor and extensor value of the average power，There were significant differences (P<0.05) between60°/s and120°/s. Comparison of trunk muscle endurance, CLBPgroup of peak torque decline rates were20.8%,23.3%less than27.8%of NLBPgroup’s and29%.
Using proprioception test, CLBP group’ reposition error value is greater than theNLBP group at15°(P <0.05) and30°angle (P>0.05).
（4）Using of MRI technology to test the morphological changes of the lumbarmuscles, the result is that one athlete of CLBP group (xx)，the cross sectional area ofPsoas muscle was significantly greater than the NLBP group, and muscle fiberbundles, multifidus, erector spinae is more difficult to be distinguished.
（5）Using Vicon kinematic technology to test the waist activity, the result is thatwhen the left side kick or Right leg whip, the range of trunk action of the CLBP groupin Y, Z-axis is relatively large.
（6）Building AnyBody body modeling and simulation system model of Sandaathletes right leg whip action. The degree of muscle activation obtained show that thestage of the whip leg whipping, the activation of the left erector spinae is much higherthan the right, whereas the left multifidus, is indeed significantly lower degree ofactivation of the left abdominal obliqueon the right.
Conclusions:
（1）The prevalence rate of CLBP of Sanda athletes is relatively high, and thetechnical movements to injury waist is mainly wrestling and leg.
（2） The trunk muscle electrical activity of Sanda athletes with CLBP exists tocontrol abnormal activation delay, while the decreased proprioception. Side kick andwhip leg movements, Sanda athletes with CLBP has back muscle activation time,activation of the abnormal, suggesting that the group of athletes waist musclecoordination and control drop.
（3）The trunk muscle strength of Sanda athletes with CLBP is low, extensorexplosiveness low. Morphological studies have shown that Sanda athletes with CLBPwaist muscles such as erector spinae, multifidus muscle tissue morphologydegenerative disorders, suggesting that the symptoms of Sanda athletes with CLBPhave related to the muscle strength decreased and lumbar structural degeneration.
（4）Throughout the course of action of the side kick and whip legs, the waistactivities change rate of Sanda athletes with CLBP is relatively large, suggesting thatSanda athletes with CLBP weaken the control of posture.
（5）Using theAnyBody human modeling and simulation system build the simulationmodel of skeletal muscle about right leg whip action of Sanda athletes, with a certainreference value to study the muscle force.
以男性散打运动员为研究对象，依据训练专项的特点，结合流行病学调查，运用肌肉电生理、肌肉形态、生物力学等方法，研究慢性腰痛散打运动员的腰部肌肉控制、肌肉力量、本体感觉等变化，探索运用Anybody建模仿真软件分析鞭腿过程中腰部各肌肉发力的相关情况，分析散打运动员慢性腰痛的特征，尝试探讨其发生机制，为运动员慢性腰痛的康复、伤后训练及后续研究提供参考。
研究方法
运用散打运动员腰痛调查表（信效度检验符合要求）对上海市、浙江省、广东省、河南省等4个专业散打队男队及上海体育学院散打专项班的二、三年级的132名男性运动员进行调查。
以15名男性散打运动员为研究对象，其中慢痛组—实验组（8名慢性腰痛散打运动员），无痛组—对照组（7名无腰痛散打运动员）。分别进行不同动作下腰部肌电、活动度的测试，以及肌力、本体感觉和肌肉形态测量，分析慢性腰痛散打运动员的机能特征。
运用Anybody软件系统，依据1名散打运动员的身高、体重、大腿长、小腿长等测量参数构建人体骨骼肌肉模型。获取其鞭腿动作过程中的运动学和动力学C3d数据，对全身骨骼肌肉模型进行驱动。
研究结果
(1）流行病学调查显示，散打运动员腰痛的患病率为50%，其中慢性腰痛的患病率为14.4%，患病率较高。引起其腰部损伤的技术动作摔法占42.1%，腿法占31.6%，为易致伤技术动作。
(2）运用表面肌电评价腰部肌肉的前馈活动、激活时序及激活程度。结果发现慢痛组和无痛组的对侧多裂肌、同侧腹外斜肌、同侧腹内斜肌的激活时间之间存在显著性差异（P<0.05）。无痛组运动员躯干肌均以前馈活动方式激活的肌肉为双侧竖脊肌、多裂肌、腹内斜肌等7块肌肉，而慢痛组只有对侧竖脊肌、同侧多裂肌和对侧腹内斜肌3块肌肉。
右鞭腿时，慢痛组运动员躯干肌的激活顺序是对侧的腹内斜肌和竖脊肌最先激活，而无痛组运动员最先激活的肌肉是对侧腹内斜肌和同侧多裂肌。慢痛组的同侧竖脊肌均方根值大于无痛组，组间比较存在显著性差异（P<0.05）。
左侧踹时，慢痛组运动员躯干肌的激活顺序是对侧的竖脊肌和腹外斜肌最先激活，而无痛组运动员最先激活的肌肉是同侧腹内斜肌和对侧多裂肌。
(3)运用Contrex等动测力系统测试腰部肌肉的力量、耐力及本体感觉功能。结果显示，在60°/s、90°/s、120°/s三种不同角速度下，慢痛组运动员的屈伸肌肉的峰力矩值均小于无痛组的值（P>0.05），慢痛组的伸肌平均功率值均小于无痛组（P>0.05）。慢痛组运动员的屈、伸肌的平均功率值，在60°/s与90°/s、120°/s之间均存在极显著性差异（P<0.01）。躯干肌的耐力测试，慢痛组的峰力矩下降率分别为20.8%、23.3%小于无痛组的27.8%、29%。
本体感觉测试，慢痛组散打运动员在15°（P<0.05）和30°（P>0.05）时的角度复位误差值均大于无痛组。
(4)运用MRI技术测试腰部肌肉的形态变化。结果显示，横断面上慢痛组运动员xx的腰大肌面积明显大于无痛组yy，多裂肌、竖脊肌的肌纤维束较难辨别。正中矢状面上其脊柱前曲度明显变直，椎体和椎间盘呈现不同程度退行性病变。
(5)运用Vicon运动学分析技术，测试腰部的的活动度。结果显示，左侧踹和右鞭腿时，慢痛组运动员腰部的侧屈和旋转活动幅度均相对偏大。
(6)运用AnyBody人体建模仿真系统建立了散打运动员右鞭腿动作的模型。获取的肌肉激活峰值表明，在鞭腿的鞭击阶段，左侧竖脊肌的激活峰值要远远高于右侧，左侧多裂肌、左侧腹内斜肌的激活峰值明显低于右侧，与无痛组的肌电结果相似。
研究结论
（1）散打运动员慢性腰痛的患病率较高，腰部易致伤技术动作主要是摔法和腿法。
（2）慢性腰痛散打运动员躯干肌肌电活动存在控制异常和激活延迟现象，同时出现本体感觉功能下降。鞭腿和侧踹动作中，其腰部肌肉激活时序、激活程度等存在异常，提示慢性腰痛散打运动员腰部肌肉的协调和控制能力下降，导致脊柱的稳定性降低。
（3）慢性腰痛散打运动员的躯干肌力偏低，屈、伸肌力失衡，伸肌爆发力偏低。其腰段脊柱及周围组织的形态结构呈现不同程度退行性病变，说明散打运动员的慢性腰痛症状主要与腰部肌肉结构功能的改变、肌力下降和腰椎结构退变有关。
（4）在鞭腿和侧踹的整个动作过程中，慢性腰痛运动员腰部活动的变化幅度相对偏大，提示慢性腰痛散打运动员对于身体姿势的控制能力减弱。
（5）运用AnyBody人体建模仿真系统建立的散打运动员右鞭腿动作骨骼肌肉仿真模型，对探讨其发力特征具有一定的参考价值。
Objective:
In this research Sanda athletes are employed as the research objects. According tothe characteristics of the special training and epidemiological investigation, this studyis to analyze the waist muscle control and coordination mechanism of Sanda athleteswith the chronic low back pain（CLBP）, the muscle strength, proprioceptions, etc. bymuscle electrophysiology, muscle form, biomechanics research methods, to explorethe relevant circumstance of waist muscle force in the process of the round kicks byusing Anybody to model simulation software, investigate the CLBP characteristicsand mechanism of Sanda athletes so as to provide the reference of treatment,rehabilitation and the training after injury and further research related to the athleteswith CLBP.
Methods:
The132athletes of4male professional Sanda teams from Shanghai, Zhejiang,Guangdong, Henan provinces and two male professional Sanda classes of grade2-3inShanghai Sports university have been surveyed by using the self-designed back painquestionnaire (Reliability and validity meet the requirement.)
15Sanda athletes are chosen as the research objects. Among them, CLBP group—arranged as experimental group (8Sanda athletes with CLBP) and NLBP group—as control group (7normal Sanda athletes without low back pain). These2groupsreceive EMG test about the lower back muscle of different actions, waist mobility testof the different actions, waist muscle test, lumbar proprioception test and musclemorphology measurements respectively to analyze function characteristics of Sandaathletes with CLBP.
According to a Sanda athletes' height, weight, thigh length, leg length and othermeasurement parameters，building human musculoskeletal model With Anybodysoftware system. Get its whip leg movements in the process of kinematics anddynamics of C3d data to drive the body musculoskeletal model.
Results:
（1） As epidemiological survey,50.0%of Sanda athletes are liable to suffer fromLBP, among them14.4%was CLBP. The technological movements causing the waistinjury, throwing techniques account for31.6%, leg techniques,42.1%.
（2） Using surface electromyography to evaluate of back muscle feedforwardactivity, activation timing and degree of activation, the result is that CLBP group andNLBP group have significant differences between groups (P <0.05) in three muscles(opposite multifidus, ipsilateral external oblique and ipsilateral internal oblique). Andmuscle activation time of NLBP group is earlier than experimental group. NLBPgroup can use feedforward activity way to activate7muscles, that is, bilateral verticalspinal muscular, crack, internal oblique muscle and so on. While NLBP group onlyactivates3muscles, namely, vertical spinal muscular, side more muscle to crack andthe internal oblique muscle.
The left side kick, the activation order of CLBP group’ trunk muscle is thecontralateral erector spinae firstly then the activation of the external oblique muscle,while NLBP group was first activated muscle ipsilateral abdominal oblique andcontralateral multifidus muscle. Activation of dorsal muscles of the trunk of the CLBPgroup slightly higher than the painless group, there is no difference statistically.
When the Right leg whip, the CLBP group’ trunk muscle activation sequence isthat first activate contralateral abdominal oblique and erector spinae, and NLBP groupwas first activated muscle is the contralateral abdominal oblique muscle and theipsilatera lmultifidus muscle. RMS value of the ipsilateral erector spinaes groups aresignificant difference (P <0.05), the RMS value of the CLBP group is more large.
（3）Using of the Contrex isokinetic dynamometer to test back muscle strength,endurance and proprioception sensory function, the result is that in60°/s,90°/s,120°/s three different angular velocity, CLBP group’ Athletes in flexion andextension muscle peak torque values are less than the value of the NLBP group (P>0.05). The extensor average power values of CLBP group less than the painless group(P>0.05)。In CLBP group， there were significant differences (P <0.05) betweenflexor and extensor value of the average power，There were significant differences (P<0.05) between60°/s and120°/s. Comparison of trunk muscle endurance, CLBPgroup of peak torque decline rates were20.8%,23.3%less than27.8%of NLBPgroup’s and29%.
Using proprioception test, CLBP group’ reposition error value is greater than theNLBP group at15°(P <0.05) and30°angle (P>0.05).
（4）Using of MRI technology to test the morphological changes of the lumbarmuscles, the result is that one athlete of CLBP group (xx)，the cross sectional area ofPsoas muscle was significantly greater than the NLBP group, and muscle fiberbundles, multifidus, erector spinae is more difficult to be distinguished.
（5）Using Vicon kinematic technology to test the waist activity, the result is thatwhen the left side kick or Right leg whip, the range of trunk action of the CLBP groupin Y, Z-axis is relatively large.
（6）Building AnyBody body modeling and simulation system model of Sandaathletes right leg whip action. The degree of muscle activation obtained show that thestage of the whip leg whipping, the activation of the left erector spinae is much higherthan the right, whereas the left multifidus, is indeed significantly lower degree ofactivation of the left abdominal obliqueon the right.
Conclusions:
（1）The prevalence rate of CLBP of Sanda athletes is relatively high, and thetechnical movements to injury waist is mainly wrestling and leg.
（2） The trunk muscle electrical activity of Sanda athletes with CLBP exists tocontrol abnormal activation delay, while the decreased proprioception. Side kick andwhip leg movements, Sanda athletes with CLBP has back muscle activation time,activation of the abnormal, suggesting that the group of athletes waist musclecoordination and control drop.
（3）The trunk muscle strength of Sanda athletes with CLBP is low, extensorexplosiveness low. Morphological studies have shown that Sanda athletes with CLBPwaist muscles such as erector spinae, multifidus muscle tissue morphologydegenerative disorders, suggesting that the symptoms of Sanda athletes with CLBPhave related to the muscle strength decreased and lumbar structural degeneration.
（4）Throughout the course of action of the side kick and whip legs, the waistactivities change rate of Sanda athletes with CLBP is relatively large, suggesting thatSanda athletes with CLBP weaken the control of posture.
（5）Using theAnyBody human modeling and simulation system build the simulationmodel of skeletal muscle about right leg whip action of Sanda athletes, with a certainreference value to study the muscle force.
引文
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