在具有挑战性的姿势条件下，腰痛减少了对节段旋转机制的依赖

IF 2.2 3区医学 Q3 NEUROSCIENCES

Gait & posture Pub Date : 2025-04-09 DOI:10.1016/j.gaitpost.2025.04.010

R. Tisserand , M. Billot , R. Bechet , J. Plard , R. Cabirol , P. Rigoard , R. David , T. Robert

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引用次数: 0

摘要

腰痛（LBP）被认为会改变姿势控制，但在腰痛人群中，姿势控制的结果仍然是不同的。一种可能的解释是，在非挑战性解剖条件下，姿势控制主要以“压力中心”（CoP）机制为特征，忽略了“节段旋转”机制的贡献（即全身角动量的改变）。本研究的目的是描述腰痛对非挑战性和挑战性两足直立姿势的姿势控制的影响，使用指标说明CoP和节段旋转机制对姿势控制的贡献。方法20例成人慢性下腰痛患者和20例同龄成人非下腰痛患者分别在解剖睁眼、解剖闭眼、连续睁眼和连续闭眼4种体位条件下静立在力板上。采用方差分析来比较各组和条件之间CoP和节段旋转机制的贡献指标。结果两组间CoP机制指标无明显差异。与对照组相比，在闭眼条件下，LBP组观察到的反映节段旋转机制的中外侧指标结果较小。这些研究结果表明，当腰痛的作用很大且不能通过视觉反馈来补偿时，腰痛会损害对节段旋转机制（即全身角动量的改变）对姿势控制的依赖。因此，在LBP群体中，与CoP机制互补的节段旋转机制应该被量化。

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Low back pain reduces reliance on the segment rotation mechanism for postural control in challenging postural conditions

Introduction

Low back pain (LBP) is considered to alter postural control, yet postural control results remain heterogenous in the LBP population. A potential explanation is that postural control has been predominantly characterised by the ‘center of pressure’ (CoP) mechanism in non-challenging anatomical conditions, omitting the contribution of the ‘segment rotation’ mechanism (i.e. modification of whole-body angular momentum). The objective of this study was to characterise the impact of LBP on postural control in non-challenging and challenging bipedal upright postures, using indicators illustrating the contribution of both the CoP and segment rotation mechanisms to postural control.

Methods

Twenty adults with chronic LBP and twenty age-matched adults without LBP stood quietly on a forceplate in four postural conditions: anatomical with eyes open, anatomical with eyes closed, tandem with eyes open and tandem with eyes closed. ANOVAs were used to compare indicators illustrating the contribution of the CoP and segment rotation mechanisms between groups and conditions.

Results

No difference in indicators of the CoP mechanism were observed between the two groups. Smaller results in mediolateral indicators accounting for the segment rotation mechanism were observed for the LBP group in the tandem with eyes closed condition, compared to the control group.

Discussion

These findings suggest that LBP impairs reliance on the segment rotation mechanism (i.e. modification of whole-body angular momentum) for postural control, when its contribution is substantial and cannot be compensated by visual feedbacks. Consequently, the segment rotation mechanism should be quantified complementarily to the CoP mechanism in the LBP population.

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来源期刊

Gait & posture 医学-神经科学

CiteScore

4.70

自引率

12.50%

发文量

616

审稿时长

6 months

期刊介绍： Gait & Posture is a vehicle for the publication of up-to-date basic and clinical research on all aspects of locomotion and balance. The topics covered include: Techniques for the measurement of gait and posture, and the standardization of results presentation; Studies of normal and pathological gait; Treatment of gait and postural abnormalities; Biomechanical and theoretical approaches to gait and posture; Mathematical models of joint and muscle mechanics; Neurological and musculoskeletal function in gait and posture; The evolution of upright posture and bipedal locomotion; Adaptations of carrying loads, walking on uneven surfaces, climbing stairs etc; spinal biomechanics only if they are directly related to gait and/or posture and are of general interest to our readers; The effect of aging and development on gait and posture; Psychological and cultural aspects of gait; Patient education.