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慢性下腰痛患者腰屈伸肌的等速肌力评价

占飞 沈莉 吴毅 胡永善 范振华

摘要 目的:通过对慢性下腰痛患者腰屈伸肌进行等速向心、离心肌力测试,定量评价患者腰屈伸肌肌力的变化,为慢性下腰痛患者腰屈伸肌肌肉功能的康复训练提供依据。方法:运用Cybex-6000型等速测力系统分别对30例慢性下腰痛患者及30例正常人在慢速(30°/s)和中速(90°/s)条件下进行腰屈伸肌的等速向心和离心肌力测试,评价屈肌与伸肌的峰力矩/体重比值,以及腰屈伸肌向心与离心的峰力矩/体重比值。结果:两种测试速度下,患者组与正常组相比,腰屈肌向心测试和屈、伸肌离心测试的峰力矩/体重值降低,伸肌向心测试的峰力矩/体重值较正常组显著下降(P<0.001);向心测试屈、伸肌峰力矩与体重比值显著增大(P<0.01),离心测试屈、伸肌峰力矩与体重比值增大;屈肌向心、离心测试的峰力矩与体重的比值降低,伸肌向心、离心测试的峰力矩与体重的比值显著降低(P<0.01)。结论:慢性下腰痛患者腰屈伸肌存在屈伸肌力的下降及失衡,需针对性地进行屈伸肌肌力训练,以恢复屈伸肌对腰椎主动稳定和功能性活动的作用,避免肌源性下腰痛的反复发作和牵延难愈。
关键词 下腰痛;肌力;向心收缩; 离心收缩

An isokinetic evaluation on strength of trunk muscles in patients with chronic low-back pain

ZHAN Fei, SHEN Li, WU Yi,et al
Chinese Journal of Rehabilitation Medicine,1999,14(6):247~250

Abstract Objective: To clarify the difference between concentric and eccentric strength of healthy subjects and those patients with chronic low-back pain (CLBP). Method: Flexors and extensors peak torque/body weight (PT/BW) were measured at two angular velocities (30°/s、90°/s) in concentric and eccentric contractions modes in 30 patients with CLBP and 30 healthy subjects with Cybex-6000 isokinetic testing system, to evaluate flexor/extensor peak torque ratio (F/E) during concentric and eccentric contraction and concentric/eccentric peak torque ratios (C/E) of flexors and extensors. Result: At two velocities, concentric PT/BW of extensors in patients were significantly lower than those of healthy subjects (29.6% vs. 25.4%, P<0.001),flexors concentric PT/BW(peaktorque/body weight) decreased, but there were no significant difference between the patients and healthy subjects. F/E ratios of concentric and eccentric in patients were greater than those of healthy subjects , but those of eccentric peak torque were no significant difference. C/E ratios of flexors and extensors declined, and those of extensors were significantly declined. Conclusion: Muscle strength of both flexors and extensors

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