慢性下背痛和健康成人在上坡行走時的後側肌肉鏈活化模式之比較

A Comparison of Posterior Muscle Chain Activation Pattern during Uphill Walking in Adults With and Without Chronic Low Back Pain

吳昱璇(Yu-Hsuan Wu)

指導教授 ： 陳淑媚

高雄醫學大學/健康科學院/物理治療學系碩士班/碩士(2017年)

摘要

研究背景與目的:慢性下背痛是常見的肌肉骨骼問題，可能因疼痛會改變後側肌肉鏈活化模式，包含肌肉收縮強度(amplitude)大小、肌肉起始收縮時間(onset time)和收縮排序(activation order)。本研究欲探討慢性下背痛患者和健康人行走於不同坡度的跑步機時，後側肌肉鏈(posterior muscle chain)活化模式。
研究方法:18位慢性下背痛受試者和18位健康受試者，以自選速度行走於不同坡度跑步機，採隨機順序，包含坡度0%、5%、10%和15%，透過表面肌電圖收集行走時的雙側闊背肌、豎脊肌、臀大肌和股二頭肌的肌電訊號，經由肌電圖分析結果，比較參數包含肌肉收縮強度、起始收縮時間和收縮排序。
結果:本研究結果指出兩組受試者的豎脊肌、臀大肌和股二頭肌及闊背肌、豎脊肌、臀大肌在行走於平面和坡度時的肌肉收縮排序無一致的結果。此外，兩組的肌肉起始收縮時間和收縮強度無統計顯著性差異，但股二頭肌收縮強度在坡度10%有組間的統計顯著性差異。
結論: 慢性下背痛患者與健康人行走於平面及坡度時，後側肌肉鏈無一致的肌肉收縮排序，未來研究需進一步地探討軀幹和下肢的運動學與肌肉活化模式的關係。

關鍵字

慢性下背痛 ； 後側肌肉鏈 ； 上坡行走

並列摘要

Background and Purpose: Chronic low back pain(CLBP) is a common musculoskeletal disorders .Alterations in posterior muscle chain activation pattern may due to pain, including muscles amplitude、onset time and activation order. The purpose of this study was to investigate posterior muscle chain activation pattern during uphill walking on a treadmill in adults with and without chronic low back pain .
Methods: Eighteen patients with CLBP and 18 healthy individuals walked on a treadmill at self-selected speed in four grades: 0%、5%、10% and 15% slope. Electromyography data of the latissimus dorsi , erector spinae, gluteus maximus, and biceps femoris were collected during walking using a surface electromyograph. Muscles activation order ,onset time, and amplitude were recorded in every trial.
Results: There was no a consistent order of muscle activation between both groups in the investigated muscles(erector spinae, gluteus maximus, and biceps femoris; latissimus dorsi ,erector spinae and gluteus maximus) in this study. Although there was no significant difference in the onset times, amplitude for all investigated muscles between the two groups, there was a significant difference between the two groups for biceps femoris amplitude on 10% slope.
Conclusions: A consistent order of muscle activation was not found in both healthy and CLBP subjects while walking on level and slopes. Further research needs to investigate relationship between the kinematics of the trunk and lower extremity and the muscle activation pattern.

並列關鍵字

Chronic low back pain ； Posterior muscle chain ； Uphill walking

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