從機械生物學探討核心穩定度與慢性腰痛

Exploring Core Stability and Chronic Low Back Pain from a Mechanobiological Perspective

李炯達(Chung-Da Lee)

《休閒觀光與運動健康學報》 6卷3期 (2016/06) Pp. 26-43

摘要

本研究引用近期漸受重視的機械生物學結合傳統的生物力學，從機械力改變生物組織、結構及機械性質的理論基礎，來探討核心穩定度與腰痛的關係。腰痛是國際性大眾健康的主要問題之一。雖然核心強度運動被認為是一個有效的腰痛處方，但尚未能獲得一致性的認同。因此，若可探討運動時機械力如何改變生物細胞及組織，應有助於釐清運動處方的設計與執行要素。本文依序，藉由生物力學說明核心穩定度主宰腰椎結構對於機械負荷的承受度，而張力完整結構理論說明人體是一個結合拉力與壓力元件群所組成的預張-自我平衡系統。張力完整系統理論提供核心穩定度的力平衡架構。機械生物學則探討機械因素對組織結構與機械性質的影響，如肌腱與韌帶等結締組織在往復拉伸負荷的作用下可增進其成纖細胞的化學訊號及基因表現，進而改善組織結構、成分與機械性質。故而，從巨觀的生物力學探討核心穩定度與結構的關聯性，結合機械力在微觀細胞生物與組織生理的影響，應有助於闡明核心穩定度與腰痛的生物機制，進而，提供研發核心穩定運動處方的理論基礎及方向，以期達到有效的修復及預防效益。

關鍵字

核心穩定度 ； 張拉完整系統 ； 機械生物學 ； 成纖細胞 ； 體內平衡

並列摘要

The goal of this study was to develop the biological relationship between core stability and chronic low back pain by integrating biomechanics and mechanobiology to explore the influence of mechanical forces on mechanical properties of connective tissues. Low back pain is one of the most common public health problems. Although core stability exercise seems to be as effective treatment to relieve the functional status of patients with chronic pain and prevent back injuries, high quality research and scientific clinical evidence are clear needed before making a firm conclusion. Therefore, the biological mechanisms of the mechanical forces on the changes of the mechanical properties of tissues are required to provide a solid theoretical foundation for designing and executing a proper therapeutic exercise. From Biomechanics point of view, both mechanical loading history and mechanical properties of our body elements are key factors of low back pain. Human body is composed of opposing tension and compression elements that self-stabilizes its shape through force balance named as a tensegrity structure. Tensegrity theory provides an organism balance concept of core stability. Mechanobiolgy demonstrates about how tendons respond to cyclic stretching forces by altering their structure, composition, and mechanical properties. Therefore, biomechanics and mechanobiology are applied to study the relationship between core stability and lumbar spine structure at macroscale and the effects of mechanical forces on cells and tissues at microscale. This holistic study may help to clarify the biological mechanisms between core stability exercise and chronic low back pain which may provide the design guideline for core stability exercise in order to heal and prevent low back pain effectively.

並列關鍵字

Core stability ； Tensegrity ； Mechanobiology ； Fibroblast ； Homeostasis