The Mechanism and Function of Lumbosacral Orthoses

腰骶矫形器的机理和功能

• 批准号: 6914887
• 负责人: Jacek Cholewicki
• 金额: $ 28.5万
• 依托单位: YALE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-01 至 2007-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6914887
• 关键词: adult human (21+); assistive device /technology; backache; bioenergetics; biomechanics; clinical research; electromyography; ergonomics; functional ability; gait; human subject; human therapy evaluation; lumbosacral region; medical rehabilitation related tag; muscle contraction; patient oriented research; proprioception /kinesthesia; questionnaires; rehabilitation

DESCRIPTION (provided by applicant): New mechanisms and function of lumbosacral orthoses (LSOs) in the management of low back pain (LBP) are explored in this application by testing four hypotheses. These hypotheses are based on the rationale of LSO-enhanced spine stability, which has not been considered in this context before. The LSO provides additional stability to the lumbar spine and, therefore, patients with LBP will (i) exhibit less trunk antagonistic muscle co-contraction when wearing the LSO as compared to the "No LSO" condition, (ii) respond with a smaller number of muscles and longer latency to sudden trunk loading when wearing the LSO as compared to the "No LSO" condition, (iii) walk with gait closer resembling a normal pattern when wearing the LSO as compared to walking without the LSO, and (iv) exhibit enhanced proprioception in the lumbar spine when wearing the LSO as compared to the "No LSO" condition. Twenty LBP subjects for the experimental group and 20 control LBP subjects will be recruited from the Yale Spine Service clinics to test each hypothesis. The subjects in the experimental group will wear the LSO for 4-6 weeks. All subjects will be tested every two weeks with and without the LSO in 3 separate experiments to address each hypothesis. These experiments will consist of (1) the EMG Experiment to address hypotheses (i) and (ii), (2) the Gait Experiment to address hypothesis (iii), and (3) the Proprioception Experiment to address hypothesis (iv). New research developments will allow us to overcome several methodological and conceptual difficulties to make the proposed research now feasible. Therefore, the application of the following features will distinguish the proposed research from past studies: (i) the concept and quantification of spine stability, (ii) an experimental design tuned to detect very small LSO effects in EMG activity, (iii) a novel, submaximal exertion procedure for normalizing EMG data for patients with LBP, who are reluctant or unable to exert maximum effort, and (iv) a long-term (4-6 weeks) study, which may be necessary for acclimatization to the LSO. The results from these studies could be used in formulating rational guidelines for the prescription of LSOs as well as for improving their designs. In addition, data generated from the proposed research will also carry-over into advancing our understanding of the mechanisms and function of ergonomic lumbar supports.

描述（由申请人提供）：本申请通过测试四个假设来探索腰骶矫形器（LSO）在腰痛（LBP）治疗中的新机制和功能。这些假设是基于 LSO 增强脊柱稳定性的基本原理，此前在这方面尚未考虑过这一点。 LSO 为腰椎提供了额外的稳定性，因此，与“无 LSO”情况相比，LBP 患者 (i) 在佩戴 LSO 时表现出较少的躯干拮抗肌共同收缩，(ii) 响应较小的数量与“无 LSO”条件相比，佩戴 LSO 时肌肉的收缩和躯干突然负荷的潜伏期更长，(iii) 与不佩戴 LSO 时相比，佩戴 LSO 时的行走步态更接近正常模式，以及 (iv)展览与“无 LSO”条件相比，佩戴 LSO 时腰椎的本体感觉增强。将从耶鲁大学脊柱服务诊所招募 20 名实验组 LBP 受试者和 20 名对照 LBP 受试者来检验每个假设。实验组的受试者将佩戴 LSO 4-6 周。所有受试者将每两周在使用和不使用 LSO 的情况下进行 3 个独立实验的测试，以解决每个假设。这些实验将包括 (1) 用于解决假设 (i) 和 (ii) 的肌电图实验，(2) 用于解决假设 (iii) 的步态实验，以及 (3) 用于解决假设 (iv) 的本体感觉实验。 新的研究进展将使我们能够克服一些方法论和概念上的困难，使拟议的研究现在变得可行。因此，以下特征的应用将使所提出的研究与过去的研究区分开来：（i）脊柱稳定性的概念和量化，（ii）旨在检测 EMG 活动中非常小的 LSO 效应的实验设计，（iii）一种新颖的方法，亚最大运动程序，用于使 LBP 患者的肌电图数据正常化，这些患者不愿意或无法发挥最大努力，以及 (iv) 长期（4-6 周）研究，这对于适应 LSO 可能是必要的。这些研究的结果可用于制定 LSO 处方的合理指南以及改进其设计。此外，拟议研究产生的数据也将有助于加深我们对人体工程学腰部支撑的机制和功能的理解。