健康成人下背彎曲度與下背伸肌活動度之相關性研究

The Correlation of Lumbar Spine Flexibility and Lumbar Extensor Activity in Healthy Adults

林仲哲(Chung-Che Lin) ； 魏大森(Ta-Sen Wei) ； 劉鵬達(Pen-Ta Liu)

《台灣復健醫學雜誌》 40卷3期 (2012/09) Pp. 161-169

https://doi.org/10.6315/2012.40(3)05

摘要

臨床上檢查彎腰功能的修改式指尖地板距離量測法，常用來查知病人下背伸肌活動情形。本研究以同步記錄下背伸肌表面肌電訊號，以便探討兩者之間的關聯性，我們假設：下背彎曲度愈差者則下背伸肌表面肌電活動收縮愈大。研究對象為中部某醫院無下背疼痛的員工，受試者年齡28.9±5.3歲，共收集36例（男12例，女24例）。受試者站在木箱上接受修改式指尖地板距離量測，下背彎曲度測量以刻度0（也就是受試者所站木箱的高度）為分界，大於0（受試者指尖到達處在木箱的高度以下）者為優，小於等於0（受試者指尖到達處在木箱的高度水平或以上）者為差，同時以表面電極擺位在第二、三腰椎脊中線旁開2公分處記錄肌肉活動，利用SPSS統計軟體分析結果。研究結果顯示：(1)表面肌電圖的可信度佳（組內相關係數：0.614~0.977）；(2)下背彎曲度差組其下背伸肌的離心性收縮肌電強度顯著高於下背彎曲度優組（p=0.009），證明本研究之假設，惟進一步的研究是有必要的。結論：修改式指尖地板距離量測法是一個簡單有效且可信度高的腰椎活動功能檢測法。我們建議：彎腰可以做為臨床及一般人自我評估下背伸肌活動的簡明可靠的檢查方法。

關鍵字

修改式指尖地板距離量測 ； 下背伸肌 ； 表面肌電圖

並列摘要

The modified fingertip-to-floor method is one of the clinical measurements used to assess forward bending. The present research is based on recording the measurements obtained by lumbar extensor surface electromyography (EMG) during the modified ”fingertip-to-floor” method in order to investigate the correlation between the two approaches. Our hypothesis is that poorer flexibility of the low back is associated with larger amplitude of low back extensor surface EMG activity.Measurements were obtained from 36 subjects (12 male and 24 female aged 28.9±5.3 year-old). The subjects stood on a wooden box and bent forward so that measurements could be taken. The top of the wooden box was the dividing line and was taken as measurement zero (0). Those whose fingertips could reach beyond the height of the wooden box (designated＞0) had good flexibility of the low back, whilst those who could not reach the zero point (designated≤0) had poor flexibility of the low back. During the experimental protocol, we had placed four surface electrodes in positions two centimeters away on either side from the mid-line of the second and third lumbar vertebrae of the subject in order to record muscle activity.The following results were obtained. The surface EMG measurements appeared to have acceptable reliability (ICC: 0.614~0.977). Individuals within the poor flexibility group underwent significantly larger eccentric contractions of the lumbar extensor than individuals from the good flexibility group (p=0.009). The results therefore support our original hypothesis, although further research is still necessary. Nonetheless, it can be concluded that the modified ”fingertip-to-floor” method is a simple, efficient and highly reliable lumbar function test. We suggest that forward bending should be used an easy and reliable method when clinically assessing lumbar function and also as a method of self-assessment.

並列關鍵字

modified fingertip-to-floor measurement ； lumbar extensor ； surface electromyography