Background

Individuals with chronic low back pain demonstrate impaired responses to volitional and externally-generated postural perturbations that may impact stability whilst performing activities of daily living. Understanding how balance may be impaired by strategy selection is an important consideration during rehabilitation from low back pain to prevent future injurious balance loss.

Research question

This cross-sectional study explored the influence of an active pain episode on volitional movement patterns and stability during a sit-to-stand task in individuals with chronic low back pain compared to those with no low back pain history.

Methods

Thirteen participants with low back pain who were in an active flare-up and 13 without pain sat on a height-adjusted chair and performed 5 sit-to-stand movements. Sagittal plane kinematics, kinetics, and surface electromyography were used to compute neuromuscular variables across Acceleration, Transition and Deceleration phases. Stability was assessed using times to contact of body centers of mass and pressure to base of support boundaries. Independent samples t-tests were used to examine group effects, and repeated measures analyses of variance assessed within-subjects effects across movement phases.

Results

Individuals with low back pain tended to restrict proximal joint motions through heightened muscle activity while increasing distal joint movement and distal muscle contributions. Individuals with low back pain used a greater driving force, indicated by a longer time to contact of the center of pressure, to achieve comparable center of mass stability. Individuals with low back pain may prioritize trunk restriction and stability through the sit-to-stand movement, possibly related to fear of pain or movement.

Significance

The tendency for individuals with active low back pain to restrict trunk movements may require additional effort to maintain stability. Further research should examine whether trunk restriction is related to pain-related fear of movement and whether additional cognitive resources are required to maintain movement stability.

中文翻译：

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躯干限制和稳定性的双重目标是有慢性腰痛的个体在自主运动期间优先考虑的

背景

患有慢性腰痛的个体表现出对意志和外部产生的姿势扰动的反应受损，这些姿势扰动可能会在进行日常生活活动时影响稳定性。了解策略选择如何损害平衡是腰痛康复期间的一个重要考虑因素，以防止未来的伤害性平衡丧失。

研究问题

这项横断面研究探讨了与没有腰痛病史的人相比，慢性腰痛患者在坐站任务期间主动疼痛发作对意志运动模式和稳定性的影响。

方法

13 名有腰痛的参与者在活动性发作中和 13 名没有疼痛的参与者坐在高度调整的椅子上，并进行了 5 次从坐到站的动作。矢状面运动学、动力学和表面肌电图用于计算加速、过渡和减速阶段的神经肌肉变量。使用身体质心接触时间和支撑边界底部的压力来评估稳定性。独立样本 t 检验用于检查组效应，重复测量方差分析评估跨运动阶段的受试者内效应。

结果

腰痛患者倾向于通过增加肌肉活动来限制近端关节运动，同时增加远端关节运动和远端肌肉贡献。腰痛患者使用更大的驱动力，通过更长的时间接触压力中心来实现相当的质心稳定性。腰痛患者可能会通过坐到站运动优先考虑躯干限制和稳定性，这可能与对疼痛或运动的恐惧有关。

意义

活动性腰痛患者限制躯干运动的倾向可能需要额外的努力来保持稳定性。进一步的研究应该检查躯干限制是否与疼痛相关的运动恐惧有关，以及是否需要额外的认知资源来维持运动稳定性。