慢性腰痛患者的屈曲放松现象与年龄有关

IF 4.3 3区工程技术 Q1 BIOTECHNOLOGY & APPLIED MICROBIOLOGY

Frontiers in Bioengineering and Biotechnology Pub Date : 2024-09-04 DOI:10.3389/fbioe.2024.1388229

Tianwei Zhang, Ali Firouzabadi, Daishui Yang, Sihai Liu, Hendrik Schmidt

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Electromyographic (EMG) measurements were conducted to assess the activity of lumbar erector spinae (ESL), thoracic erector spinae (EST), and multifidus (MF). Lumbar, thoracic, and pelvic angles at the onset (OnsetL/T/P) and offset of the FRP (OffsetL/T/P) and maximum trunk inclination (MaxL/T/P) were calculated. The FRP was evaluated using a flexion relaxation ratio (FRR).ResultscLBP patients showed smaller FRR in MF and right ESL compared to no-BP individuals (p &lt; 0.05), while no differences were found in flexion angles between two groups. Subjects over 40 showed smaller FRR in MF and ESL, and smaller flexion angles on OffsetL and MaxL (p &lt; 0.05). Age-related analysis in the cLBP group revealed that patients over 40, compared to younger ones, had smaller FRR in MF and ESL, and smaller values in all thoracic and lumbar flexion angles (p &lt; 0.05). While in no-BP group, significant larger flexion angles in OnsetL and OffsetT (p &lt; 0.05) were observed in participants over 40. 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引用次数: 0

摘要

背景屈曲松弛现象（FRP）的特征是脊柱完全屈曲时脊柱旁肌肉活动突然减少。以往的研究表明，慢性腰背痛（cLBP）患者的 FRP 和屈曲角度与无腰背痛（no-BP）的人相比存在明显差异。然而，在老年人群中，FRP 和屈曲角度之间的关系仍未得到充分了解。因此，本研究调查了 FRP 和屈曲角度与年龄和是否患有 cLBP 之间的关系。方法四十名无腰背痛受试者（20 米/20 英尺；平均年龄 41.5 岁）和三十八名 cLBP 患者（19 米/19 英尺；平均年龄 43.52 岁）进行了最大上半身完全屈曲任务。通过肌电图（EMG）测量来评估腰椎竖棘肌（ESL）、胸椎竖棘肌（EST）和多侧肌（MF）的活动。计算了 FRP 开始（OnsetL/T/P）和偏移（OffsetL/T/P）时的腰椎、胸椎和骨盆角度以及最大躯干倾斜度（MaxL/T/P）。结果与无脑瘫患者相比，脑瘫患者在中频和右 ESL 的 FRR 较小（p &p;lt;0.05），而两组之间的屈曲角度没有差异。40 岁以上的受试者中频和 ESL 的 FRR 较小，OffsetL 和 MaxL 的屈曲角度较小（p &;lt;0.05）。对 cLBP 组进行的年龄相关分析显示，与年轻患者相比，40 岁以上患者的 MF 和 ESL 的 FRR 较小，所有胸椎和腰椎屈曲角度的值也较小（p&;lt; 0.05）。而在无 BP 组中，40 岁以上的参与者在 OnsetL 和 OffsetT 中的屈曲角度明显更大（p&p;lt; 0.05）。老年组疼痛相关分析显示，与无 BP 患者相比，cLBP 患者右侧 MF 和右侧 ESL 的 FRR 较小，所有腰椎和胸椎屈曲角度的值也较小（p & p;lt;0.05），而在年轻组中，FRR 没有明显的疼痛相关差异，所有腰椎屈曲角度的值较大（p & p;lt;0.05）。结论我们的研究结果表明，与无腰椎间盘突出症的人相比，cLBP 患者的 FRP 减少或消失，年龄是一个重要因素，因为与年轻人相比，40 岁以上的人表现出较小的 FRP 和屈曲角度。

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Age-dependent flexion relaxation phenomenon in chronic low back pain patients

BackgroundThe flexion relaxation phenomenon (FRP) is characterized by suddenly reduced paraspinal muscle activity during full flexion. Previous studies showed significant differences in FRP and flexion angles in chronic low back pain (cLBP) patients compared to individuals without back pain (no-BP). However, the relationship between FRP and flexion angles remains insufficiently understood in older populations. Thus, this study investigated the relationship between FRP and flexion angles concerning to the age and presence of cLBP.MethodsForty no-BP subjects (20m/20f; mean age 41.5 years) and thirty-eight cLBP patients (19m/19f; mean age 43.52 years) performed maximum full upper body flexion task. Electromyographic (EMG) measurements were conducted to assess the activity of lumbar erector spinae (ESL), thoracic erector spinae (EST), and multifidus (MF). Lumbar, thoracic, and pelvic angles at the onset (OnsetL/T/P) and offset of the FRP (OffsetL/T/P) and maximum trunk inclination (MaxL/T/P) were calculated. The FRP was evaluated using a flexion relaxation ratio (FRR).ResultscLBP patients showed smaller FRR in MF and right ESL compared to no-BP individuals (p < 0.05), while no differences were found in flexion angles between two groups. Subjects over 40 showed smaller FRR in MF and ESL, and smaller flexion angles on OffsetL and MaxL (p < 0.05). Age-related analysis in the cLBP group revealed that patients over 40, compared to younger ones, had smaller FRR in MF and ESL, and smaller values in all thoracic and lumbar flexion angles (p < 0.05). While in no-BP group, significant larger flexion angles in OnsetL and OffsetT (p < 0.05) were observed in participants over 40. Pain-related analysis in the older group revealed that the cLBP patients, compared to no-BP individuals, had smaller FRR in right MF and right ESL, and smaller values in all lumbar and thoracic flexion angles (p < 0.05), while in younger group, there were no significant pain-related differences in FRR, with larger values in all lumbar flexion angles (p < 0.05).ConclusionOur findings indicate a reduction or absence of FRP in cLBP patients compared to no-BP individuals, with age being a significant factor as those over 40 showed smaller FRP and flexion angles compared to younger individuals.

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来源期刊

Frontiers in Bioengineering and Biotechnology Chemical Engineering-Bioengineering

CiteScore

8.30

自引率

5.30%

发文量

2270

审稿时长

12 weeks

期刊介绍： The translation of new discoveries in medicine to clinical routine has never been easy. During the second half of the last century, thanks to the progress in chemistry, biochemistry and pharmacology, we have seen the development and the application of a large number of drugs and devices aimed at the treatment of symptoms, blocking unwanted pathways and, in the case of infectious diseases, fighting the micro-organisms responsible. However, we are facing, today, a dramatic change in the therapeutic approach to pathologies and diseases. Indeed, the challenge of the present and the next decade is to fully restore the physiological status of the diseased organism and to completely regenerate tissue and organs when they are so seriously affected that treatments cannot be limited to the repression of symptoms or to the repair of damage. This is being made possible thanks to the major developments made in basic cell and molecular biology, including stem cell science, growth factor delivery, gene isolation and transfection, the advances in bioengineering and nanotechnology, including development of new biomaterials, biofabrication technologies and use of bioreactors, and the big improvements in diagnostic tools and imaging of cells, tissues and organs. In today`s world, an enhancement of communication between multidisciplinary experts, together with the promotion of joint projects and close collaborations among scientists, engineers, industry people, regulatory agencies and physicians are absolute requirements for the success of any attempt to develop and clinically apply a new biological therapy or an innovative device involving the collective use of biomaterials, cells and/or bioactive molecules. “Frontiers in Bioengineering and Biotechnology” aspires to be a forum for all people involved in the process by bridging the gap too often existing between a discovery in the basic sciences and its clinical application.