有和没有腰痛的牙医脊柱结构、活动性和能力的比较

Merve Keskin, Mehmet Irfan Karadede, Derya Ozer Kaya
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引用次数: 0

摘要

由于累积的微创伤和不适当的工作位置,牙科治疗会导致肌肉骨骼疼痛和功能障碍(1)。牙医肌肉骨骼疼痛的患病率在64%到93%之间(2)。据报道,牙医腰痛的患病率为47.6%,是最常见的肌肉骨骼功能障碍(3,4)。与没有腰痛的牙医相比,腰痛牙医的脊柱结构、活动性和能力有什么不同吗?本研究纳入65例腰痛牙医师(女性40例,男性25例,年龄25.57±2.83岁,体重67.64±13.20 kg,身高171.72±8.46 cm, BMI 22.75±3.25 kg/m2)和57例无痛匹配对照组(女性30例,男性27例,年龄26.36±3.94岁,体重69.05±13.00 kg,身高170.53±7.78 cm, BMI 23.64±3.52 kg/m2)。采用Valedo®Shape器械(Idiag, Fehraltorf,瑞士)评估脊柱结构、活动能力和矢状面和额面能力。以度为单位获取参数:胸椎角、腰椎角、骶髋角、躯干倾角(T1 - S1直线与垂直线之间的夹角)。将脊柱棘突标记为参考点后,评估者将Valedo®Shape装置移至从C7棘突开始的所有棘突至大约S3棘突。脊柱对负荷的反应是用体重来评估能力的。称重前测量结束后,要求被测者手拿砝码等待30秒,并重复测量(6)。数据的正态分布通过Shapiro-Wilk检验确定。在数据比较中,正态分布采用独立样本t检验,非正态分布采用Mann-Whitney U检验。腰痛患者矢状面倾斜角减小(p=0.045),骶骨角随负重而移位(p=0.037)。在矢状面和额状面,胸椎区角(p=0.292;0.074)和腰椎区角(p=0.369;p = 0.781)。在患有腰痛的参与者中,随着负荷的增加,矢状面倾斜角度减小,骶骨发生侧向移位反应。众所周知,腰骨盆区域的角度与脊柱的曲度以及该区域矢状面脊柱畸形的代偿机制直接相关(7)。在先前的研究中,下腰痛的牙医报告了倾斜角度的变化(8)。牙医脊柱的变化可能出现在下腰痛的发生中。在评估和治疗腰痛时应考虑到这一点。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comparison of spine structure, mobility, and competency in dentists with and without low back pain
Dental practices can cause musculoskeletal pain and dysfunction due to cumulative microtrauma and inappropriate working positions (1). The prevalence of musculoskeletal pain in dentists was declared between 64% and 93% (2). The prevalence of low back pain in dentists was reported as 47.6% as the most common musculoskeletal dysfunction (3,4). Is there a difference in spine structure, mobility, and competency of dentists with low back pain compared to those without low back pain? In the study, 65 dentists with low back pain (40 females, 25 males, age: 25.57±2.83 years, weight: 67.64±13.20 kg, height: 171.72±8.46 cm, BMI, 22.75±3.25 kg/m2) and 57 pain-free matched control group (30 females, 27 males, age: 26.36±3.94 years, weight: 69.05±13.00 kg, height: 170.53±7.78 cm, BMI, 23.64±3.52 kg/m2) were included. Spine structure, mobility, and competency in the sagittal and frontal planes were evaluated with the Valedo®Shape device (Idiag, Fehraltorf, Switzerland). Parameters were obtained in degrees: thoracic, lumbar, sacral/hip angle, and trunk inclination angle (angle between straight line from T1 to S1 and vertical line). After the spinous processes of the spine were marked as reference points, the Valedo®Shape device was moved down by the evaluator over all the spinous processes starting from the C7 spinous process to approximately the S3 spinous process. The response of the spine to loading was evaluated using weight for competency measurement. After measuring before the weight, the participant was asked to wait for 30 seconds with the weights in hand, and the measurement was repeated (6). The normality distributions of the data were determined by the Shapiro-Wilk test. In the comparison of the data, the independent sample t-test was used in those with normal distribution, and the Mann-Whitney U test was used for those that were not normally distributed. In patients with low back pain, in the sagittal plane, the inclination angle decreased (p=0.045), there was a shift in the sacral angle with loading (p=0.037). In the sagittal and frontal planes, there was no significant difference in thoracic region angles (p=0.292;0.074) and in the lumbar region angles (p=0.369; p=0.781). In participants with low back pain, the angle of inclination decreased in the sagittal plane and a lateral shift response occurred in the sacrum with loading. It is known that the angles of the lumbopelvic region are directly related to the curvature of the spine and compensatory mechanisms against spinal deformities in the sagittal plane in this region (7). In a previous study, a shift in the inclination angle was reported by dentists with low back pain (8). The changes in the spine in dentists may be seen in the occurrence of low back pain. This should be considered for the assessment and treatment of low back pain.
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