张珊珊,王艳君,赖建洋,等.慢性腰痛患者腰部深层多裂肌超声形态特征分析[J].中华物理医学与康复杂志,2020,42(3):228-231
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| 慢性腰痛患者腰部深层多裂肌超声形态特征分析 |
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| DOI：DOI:10.3760/cma.j.issn.0254-1424.2020.03.009 |
| 中文关键词: 慢性腰痛 深层多裂肌 肌骨超声 形态学 |
| 英文关键词: Back pain Deep multifidus Ultrasound imaging Morphology |
| 基金项目:国家自然科学基金（81772434）；广东省医学科研基金（A2018021） |
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| 中文摘要: |
| 目的 采用肌骨超声观察慢性腰痛（cLBP）患者腰部深层多裂肌静息及收缩时形态结构特征变化，并分析疼痛强度、持续时间与多裂肌形态特征间的相关性。 方法 采用肌骨超声对21例cLBP患者（纳入腰痛组）及30例健康体检者（纳入健康对照组）进行腰部深层多裂肌形态学测量，观察指标包括多裂肌静息时厚度、横截面积及最大随意收缩时肌肉厚度变化，并分析多裂肌形态学指标与行为学数据间的相关性。 结果 入选cLBP患者腰部深层多裂肌静息状态下厚度［(1.68±0.21)cm］及横截面积［(2.91±0.74)cm2］均明显不及健康对照组水平（P＜0.01）；多裂肌在最大等长收缩时厚度［(2.20±0.34)cm］也明显不及健康对照组水平（P＜0.01）。此外入选cLBP患者多裂肌静息时厚度与疼痛持续时间呈负相关（r=-0.49，P＜0.05），与疼痛强度视觉模拟评分（VAS）无明显相关性（r=0.09，P＞0.05）。 结论 cLBP患者腰部深层多裂肌发生萎缩，自主收缩能力下降，故临床制订康复方案时应强化腰部多裂肌力量及协调功能训练。 |
| 英文摘要: |
| Objective To observe the morphological changes of the deep lumbar multifidus (DM) during rest and movement among persons with chronic low back pain (cLBP) using ultrasound imaging. Methods Twenty-one cLBP patients and 30 pain-free healthy controls were studied. The resting thickness of the DM muscle was measured, and then its cross-sectional area and thickness during maximum voluntary isometric contraction (MVIC). The results were correlated with pain intensity and duration. Results The cLBP patients showed significant reductions in the DM′s resting thickness, and in its cross-sectional area and thickness during a MVIC compared with the healthy controls. The resting thickness of the DM was positively correlated with pain duration, but not with pain intensity. Conclusions These results suggest that cLBP patients have atrophy and less thickness change during an MVIC. This should be considered in planning clinical rehabilitation training. |
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