触觉反馈对无症状健康成人和下腰痛患者多裂肌活动的影响  

Effect of tactile feedback on polyfidus activity in asymptomatic healthy adults and patients with low back pain

作　　者：岳剑宁[1] 郭玉娜[1] 刘京杰[1] 王琦[1] 赖光辉[1] 武百山[1] 杨立强[1] 倪家骧[1] YUE Jian-ning;GUO Yu-na;LIU Jing-jie;WANG Qi;LAI Guang-hui;WU Bai-shan;YANG Li-qiang;NI Jia-xiang(Department of Pain, Xuanwu Hospital, Capital Medical University, Beijing, 100053,China)

机构地区：[1]首都医科大学宣武医院疼痛科

出　　处：《颈腰痛杂志》2019年第3期289-292,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨触觉反馈对下腰痛(Low back pain,LBP)患者多裂肌活动的影响。方法纳入20名健康成人(对照组)和20名慢性LBP患者(LBP组),在L5节段将两个肌电图(EMG)电极放置于两侧多裂肌位置。施术者将手与参与者的多裂肌部位进行直接、连续的接触,以施加触觉反馈,分别在有、无触觉反馈的情况下,记录以下体位时的EMG信号:①参与者静息状态时,记录EMG活动信号3次;②参与者对侧臂抬起期间,记录EMG信号5次。将对照组右侧和LBP组患侧的相对EMG值进行统计学分析。结果①在静息状态期间,两组有、无触觉反馈时的相对EMG值均无显著组间差异(P=0.829),但总体而言,触觉反馈条件下EMG值显著降低(P=0.013)。②在对侧臂抬高期间,两组间有、无触觉反馈时的相对EMG值均无显著组间差异(P=0.878),但总体而言,触觉反馈条件下EMG值显著降低(P=0.010)。结论无论是常人抑或LBP患者,触觉反馈对其腰椎多裂肌活动均具有抑制作用,甚至可能降低预期的治疗效果。Objective To investigate the effect of tactile feedback on the activity of multifidus muscle in patients with low back pain (LBP). Methods A total of 20 healthy adults (control group) and 20 chronic LBP patients (LBP group) were enrolled in this study. Two electromyogram (EMG) electrodes were placed in bilateral polyfidus at L5 segment. The operator contacted the multifidus muscles of the participants directly and continuously to give tactile feedback. With or without tactile feedback, EMG signals were recorded in the following positions:(1) EMG activity signals were recorded three times in the resting state of the participants;and (2) EMG signals were recorded five times during the lifting of the participants' opposite arm. The relative EMG values of the right side of the control group and the affected side of the LBP group were analyzed statistically. Results During the resting state, there was no significant difference in the relative EMG values between the two groups with or without tactile feedback (P=0.829), but in general, the EMG values under tactile feedback decreased significantly (P=0.013).(2) During the contralateral arm elevation, there was no significant difference in the relative EMG values between the two groups with or without tactile feedback (P=0.878), but in general, the EMG values under tactile feedback decreased significantly (P=0.010). Conclusion Tactile feedback can inhibit the activity of lumbar spine multifidus muscle in both normal people and LBP patients, and may even reduce the expected therapeutic effect.

关 键 词：脊柱 下腰痛 多裂肌 肌电图 触觉反馈 康复锻炼 

分 类 号：R493[医药卫生—康复医学]