基于肌张力描记技术测量的慢性非特异性腰痛竖脊肌收缩特性分析

doi:10.3969/j.issn.1006-9771.2021.04.010

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (4): 450-455.doi: 10.3969/j.issn.1006-9771.2021.04.010

基于肌张力描记技术测量的慢性非特异性腰痛竖脊肌收缩特性分析

李绪¹,许子琢²,鲁俊³,保沁彤¹,刘欣荣¹,赵若欣¹,许光旭^3,⁴()

^1.南京医科大学，江苏南京市 210029
^2.School of Kinesiology and Health Study of Queen University，Canada，K7L 3N6
^3.南京医科大学第一附属医院老年康复医学科，江苏南京市 210029
^4.南京医科大学附属江苏盛泽医院康复医学科，江苏苏州市 215228

收稿日期:2020-11-16 修回日期:2021-01-15 出版日期:2021-04-25 发布日期:2021-04-20
通讯作者: 许光旭 E-mail:xuguangxu1@126.com
作者简介:李绪(1995-)，女，汉族，江苏徐州市人，硕士研究生，医师，主要研究方向：运动康复和神经康复|许光旭(1966-)，男，汉族，博士，主任医师，主要研究方向：脊髓损伤康复临床与治疗、运动创伤的诊断与临床康复治疗、中枢神经损伤运动控制分析与康复干预等研究。
基金资助:
苏州市临床医学专家团队引进项目(SZYJTD201725)

Contractile Properties of Erector Spinae in Patients with Chronic Nonspecific Low Back Pain: Based on Tensiomyography

Xu LI¹,Zi-zhuo XU²,Jun LU³,Qin-tong BAO¹,Xin-rong LIU¹,Ruo-xin ZHAO¹,Guang-xu XU^3,⁴()

^1.Nanjing Medical University, Nanjing, Jiangsu 210029, China
^2.School of Kinesiology and Health Study of Queen University, Canada, K7L 3N6
^3.Department of Geriatric Rehabilitation Medicine, The First Affiliated Hospital of Nangjing Medical University, Nanjing, Jiangsu 210029, China
^4.Department of Rehabilitation Medicine, Jiangsu Shengze Hospital Aaffiliated to Nanjing Medical University, Suzhou, Jiangsu 215228, China

Received:2020-11-16 Revised:2021-01-15 Published:2021-04-25 Online:2021-04-20
Contact: Guang-xu XU E-mail:xuguangxu1@126.com
Supported by:
Introduced Project of Suzhou Clinical Medical Expert Team(SZYJTD201725)

摘要/Abstract

摘要： 目的

分析慢性非特异性腰痛(CNLBP)患者竖脊肌的收缩特性，探讨其与疼痛和功能障碍的相关性。

方法

2020年1月至6月，采用肌张力描记技术对24例老年康复科门诊和病房CNLBP患者(CNLBP组)以及26例无症状志愿者(对照组)进行竖脊肌收缩特性测量，包括径向最大位移(Dm)、收缩时间(Tc)、延迟时间(Td)、持续时间(Ts)、放松时间(Tr)和双侧对称性(LS)，根据相应测量指标计算收缩速度(V_C)。CNLBP患者的肌张力描记技术参数与患者的疼痛视觉模拟评分(VAS)和功能障碍指数(ODI)进行相关性分析。

结果

与对照组右侧比较，CNLBP组疼痛侧和非疼痛侧竖脊肌Td、Ts、Tc、Tr和LS无显著性差异(P > 0.05)， Dm和V_C均降低(t > 2.058, P < 0.01)，且Dm、V_C与VAS、ODI均无显著性相关(P > 0.05)。

结论

CNLBP患者双侧竖脊肌的僵硬程度和疲劳程度高于无症状人群，但与患者的疼痛与功能障碍程度不相关。肌张力描记技术可为CNLBP患者的精准诊疗提供依据。

关键词: 慢性非特异性腰痛, 肌张力描记技术, 竖脊肌, 收缩特性

Abstract: Objective

To analyze the contractile properties of the lumbar erector spinae in patients with chronic nonspecific low back pain (CNLBP), and to explore their correlation with pain and dysfunction.

Methods

From January to June, 2020, 24 patients with CNLBP in the outpatient and the ward of geriatric rehabilitation medicine department and 26 asymptomatic volunteers were included. Their contractile properties of the lumbar erector spinae were measured with tensiomyography, including maximum radial muscle displacement (Dm), contraction time (Tc), delay time (Td), sustain time (Ts), half-time relaxation (Tr) and lateral symmetry (LS). The contraction velocity (V_C) was calculated. Potential associations of tensiomyography parameters to Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were assessed using correlation analysis.

Results

No significant differences were found in Td, Ts, Tc, Tr and LS between two groups (P > 0.05). Dm and Vc were significantly lower in both sides of CNLBP group than in the control group (t > 2.058, P < 0.01). Dm or Vc were not correlated with VAS and ODI (P > 0.05).

Conclusion

Erector spinae are stiff and fatiguable in patients with CNLBP, however, they are not associated with pain and dysfunction. Tensiomyography could be used for accurate diagnosis and treatment of CNLBP.

Key words: chronic nonspecific low back pain, tensiomyography, erector spinae, contractile properties

中图分类号:

R681.5

李绪,许子琢,鲁俊,保沁彤,刘欣荣,赵若欣,许光旭. 基于肌张力描记技术测量的慢性非特异性腰痛竖脊肌收缩特性分析[J]. 《中国康复理论与实践》, 2021, 27(4): 450-455.

Xu LI,Zi-zhuo XU,Jun LU,Qin-tong BAO,Xin-rong LIU,Ruo-xin ZHAO,Guang-xu XU. Contractile Properties of Erector Spinae in Patients with Chronic Nonspecific Low Back Pain: Based on Tensiomyography[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(4): 450-455.

图/表 4

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表3

参考文献 41

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项目	对照组 (n = 26)	CNLBP组(n = 24)	t值	P值
年龄(岁)	43.12±15.14	47.67±13.85	-1.106	0.274
性别(男/女)	11/15	11/13	-0.246	0.807
病程(月)	-	8.79±4.34	-	-
身高(cm)	165.15±7.37	167.58±8.79	-1.062	0.294
体质量(kg)	61.58±10.13	66.75±10.54	-1.769	0.083
体质量指数 (kg/m²)	22.50±2.88	23.72±3.10	-1.443	0.156
利手(右/左)	26/0	24/0	-	-
VAS	-	5.50±0.72	-	-
ODI(%)	-	30.49±13.72	-	-

TMG参数	对照组右侧(n = 26)	非疼痛侧(n = 24)	疼痛侧(n = 24)	t/Z值^a	P值^a	t/Z值^b	P值^b	t/Z值^c	P值^c
Dm(mm)	3.50±0.66	2.56±1.47	2.22±1.04	-0.926	0.358	5.263	< 0.001	3.105	0.003
Tc(ms)	33.39(22.83, 41.72)	31.71(23.41, 41.66)	32.01(21.11, 46.13)	-0.351	0.726	-0.117	0.907	-0.350	0.727
Td(ms)	23.85(22.16, 26.81)	24.53(21.59, 28.68)	26.05(23.06, 28.35)	-0.516	0.606	-1.748	0.081	-0.563	0.573
Ts(ms)	442.42±175.21	487.16±161.96	468.30±191.94	-0.368	0.715	-0.498	0.621	-0.935	0.354
Tr(ms)	146.31(105.07, 205.65)	132.08(73.80, 217.41)	148.69(97.57, 286.35)	-0.928	0.353	-0.408	0.683	-0.718	0.472
V_C(mm/s)	94.95±36.47	58.65(32.62, 97.11)	59.70(37.49, 76.90)	-0.268	0.789	2.846	0.006	-2.058	0.040

TMG参数	VAS		ODI
TMG参数	r值	P值	r值	P值
Dm	-0.065	0.763	-0.080	0.710
V_C	0.143	0.506	-0.358	0.086

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基于肌张力描记技术测量的慢性非特异性腰痛竖脊肌收缩特性分析

Contractile Properties of Erector Spinae in Patients with Chronic Nonspecific Low Back Pain: Based on Tensiomyography

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