躯干运动变异性的大小和结构的总结性测量能否区分慢性腰痛患者和非慢性腰痛患者？

IF 1.4 3区医学 Q4 ENGINEERING, BIOMEDICAL

Clinical Biomechanics Pub Date : 2025-02-01 DOI:10.1016/j.clinbiomech.2024.106416

Florian Abu Bakar , Alexis F. Homs , J. Bart Staal , Ryan B. Graham , Christophe Demattei , Pascal Kouyoumdjian , Arnaud F. Dupeyron , Jaap H. van Dieën

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引用次数: 0

摘要

背景：有不一致的证据表明，与没有慢性腰痛的人相比，慢性腰痛患者重复躯干运动的变异性可能有所不同。这些不一致可能是由于运动可变性测量的低可靠性和任务依赖性，这可以通过使用多个运动任务和汇总测量来解决。方法：招募有或没有慢性腰痛的参与者。测量过程包括在矢状面、横向面和复合面重复30次的运动。通过放置在骶骨和胸腔上的惯性传感器来估计骨盆、胸腔和腰椎的运动学。运动变异性的大小被量化为在每个运动轴的标准化周期中，胸腔、骨盆和腰椎的欧拉角的平均标准差，共有27个变量。此外，利用Lyapunov指数评估了局部动态稳定性的变异结构，产生了9个额外的变量。主成分分析减少了每个可变性测量（幅度和结构）的维度。逐步逻辑回归与主成分得分检验组间差异。结果：在变异性分析的幅度中，保留了四个主成分。前两个主成分在腰痛患者和对照组之间有显著差异，分别占总方差的32.5%和14%。在变异性分析的结构中，没有发现主成分对两组之间的差异有显著贡献。结论：对慢性腰痛患者和非慢性腰痛患者的躯干运动变异性进行大小而非结构的总结性测量。临床试验号：NCT02059317， CPP: 2013.11.09bis Sud msamditerransame III, N°RCB: 2013-A01379-36。

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Can summary measures of magnitude and structure of trunk movement variability differentiate between people with and without chronic low back pain?

Background

There is inconsistent evidence suggesting that people with chronic low back pain may differ in variability of repeated trunk movements compared to people without chronic low back pain. These inconsistencies may be due to low reliability and task dependence of movement variability measures, which can be addressed using multiple movement tasks and summary measures.

Methods

Participants with and without chronic low back pain were recruited. Measurement sessions involved 30 repetitions of movements in the sagittal, transverse, and combined planes. Kinematics of the pelvis, thorax, and lumbar spine were estimated using inertial sensors placed on the sacrum and thorax. Magnitude of movement variability was quantified as the mean standard deviation of Euler angles for the thorax, pelvis, and lumbar spine across normalized cycles for each movement axes, resulting in 27 variables. Additionally, structure of variability was assessed using Lyapunov exponents for local dynamic stability, yielding 9 additional variables. Principal Component Analysis reduced the dimensionality of each variability measure (magnitude and structure). Stepwise logistic regression with principal component scores tested for differences between groups.

Findings

In the magnitude of variability analysis, four principal components were retained. The first two principal components significantly differentiated between people with low back pain and controls, accounting for 32.5 % and 14 % of the total variance, respectively. In the structure of variability analysis, no principal components were found to significantly contribute to differentiating between the two groups.

Interpretation

Summary measures of the magnitude, but not the structure, of trunk movement variability differentiated between people with and without chronic low back pain.

Clinical trial: NCT02059317, CPP: 2013.11.09bis Sud Méditerranée III, N° RCB: 2013-A01379-36.

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来源期刊

Clinical Biomechanics 医学-工程：生物医学

CiteScore

3.30

自引率

5.60%

发文量

189

审稿时长

12.3 weeks

期刊介绍： Clinical Biomechanics is an international multidisciplinary journal of biomechanics with a focus on medical and clinical applications of new knowledge in the field. The science of biomechanics helps explain the causes of cell, tissue, organ and body system disorders, and supports clinicians in the diagnosis, prognosis and evaluation of treatment methods and technologies. Clinical Biomechanics aims to strengthen the links between laboratory and clinic by publishing cutting-edge biomechanics research which helps to explain the causes of injury and disease, and which provides evidence contributing to improved clinical management. A rigorous peer review system is employed and every attempt is made to process and publish top-quality papers promptly. Clinical Biomechanics explores all facets of body system, organ, tissue and cell biomechanics, with an emphasis on medical and clinical applications of the basic science aspects. The role of basic science is therefore recognized in a medical or clinical context. The readership of the journal closely reflects its multi-disciplinary contents, being a balance of scientists, engineers and clinicians. The contents are in the form of research papers, brief reports, review papers and correspondence, whilst special interest issues and supplements are published from time to time. Disciplines covered include biomechanics and mechanobiology at all scales, bioengineering and use of tissue engineering and biomaterials for clinical applications, biophysics, as well as biomechanical aspects of medical robotics, ergonomics, physical and occupational therapeutics and rehabilitation.