Background

Wearing a lumbosacral orthosis (LSO) is known to influence spine mechanics, but less is known about how LSOs affect motor control. Whether the use of a LSO can negatively affect motor control of the lumbar spine is still under debate.

Objective

The current study examined the immediate effects of two flexible LSOs (extensible and non-extensible) on the anticipatory postural adjustments that prepare the spine for a predictable perturbation.

Design

A comparative study using a repeated measures design in a laboratory setting.

Methods

Healthy controls (n = 20) and participants with low back pain (n = 40) performed a rapid arm flexion/extension cycle with and without these LSOs. The latency between the activations of the shoulder and different back (iliocostalis lumborum) and abdominal (rectus abdominis, internal and external obliques) muscles, as measured with surface electromyography, was used as the outcome.

Results

The effects, which were comparable between groups and between LSOs, were mixed, with some muscles showing significantly (p ˂ 0.05) earlier activation and others showing delayed activation with the use of a LSO, relative to the control condition. The corresponding effect sizes were low to average (Hedges's g range: 0.17–0.48).

Conclusions

These findings suggest a change in the motor program before task initiation, which might be generalizable to other activities of daily living or work. However, none of the effects were large, making it difficult to provide clear conclusions with regard to their clinical relevance. It remains to be tested whether these immediate adaptations in motor planning can induce long term detrimental effects to the control of lumbar stability.

中文翻译：

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可伸展和不可伸展腰骶矫形器对腰痛参与者和健康对照者预期姿势调整的影响

背景

众所周知，佩戴腰骶矫形器 (LSO) 会影响脊柱力学，但人们对 LSO 如何影响运动控制知之甚少。使用 LSO 是否会对腰椎的运动控制产生负面影响仍在争论中。

客观的

当前的研究检查了两种灵活的 LSO（可扩展和不可扩展）对预期姿势调整的直接影响，这些调整使脊柱为可预测的扰动做好准备。

设计

在实验室环境中使用重复测量设计的比较研究。

方法

健康对照（n = 20）和腰痛参与者（n = 40）在有和没有这些 LSO 的情况下进行了快速的手臂屈曲/伸展循环。使用表面肌电图测量的肩部和不同背部（腰肋肌）和腹部（腹直肌、腹内斜肌和腹外斜肌）肌肉激活之间的潜伏期作为结果。

结果

组间和 LSO 之间的效果是混合的，相对于对照条件，一些肌肉显示出显着的早期激活 (p ˂ 0.05)，而其他肌肉在使用 LSO 时显示延迟激活。相应的效果大小低于平均水平（Hedges 的g范围：0.17–0.48）。

结论

这些发现表明任务开始前的运动程序发生了变化，这可能适用于其他日常生活或工作活动。然而，这些影响都不是很大，因此很难就其临床相关性提供明确的结论。运动规划中的这些即时适应是否会对腰椎稳定性的控制产生长期的不利影响，还有待测试。