目的:研究腰椎间盘突出症(Lumbar Disc Herniation, LDH)患者在坐立过程中疼痛对腰椎和髋关节力矩的影响。方法:应用AMTI测力台采集20例健康对照与20例LDH受试者的动力学数据,通过统计参数映射(Statistical Parametric Mapping,SPM)分析两组在坐立任务中腰椎与髋关节在矢状面和冠状面的力矩差异。结果:1)在坐立任务中,LDH受试者腰椎最大屈曲力矩与髋关节最大内收力矩明显增高(p＜0.05)；2)SPM分析显示两组在站立初期(37-42%)阶段,LDH组的髋关节外展力矩大于健康对照组,存在统计学差异(p=0.007)。结论:LDH受试者在坐立过程中腰椎骨盆不够稳定,尤其站立静止阶段,难以使身体达到平衡状态,需增加髋关节外展力矩来维持骨盆稳定。在临床评估治疗中应重点关注脊柱与骨盆的稳定功能。
Objective: To study the effect of pain on lumbar and hip joint torque in patients with lumbar disc herniation (LDH) during sitting and standing. Method: The dynamic data of 20 healthy controls and 20 LDH subjects were collected using an AMTI dynamometer. Statistical Parameter Mapping (SPM) was used to analyze the difference in torque between the lumbar spine and hip joints in the sagittal and coronal planes during the sitting and standing task between the two groups. Result: 1) In the sitting and standing task, the maximum lumbar flexion moment and maximum hip adduction moment of LDH subjects significantly increased (p<0.05); 2) SPM analysis showed that during the initial stage of standing (37-42%), the hip joint abduction torque of the LDH group was greater than that of the healthy control group, with a statistical difference (p=0.007). Conclusion: LDH subjects have unstable lumbar spine and pelvis during sitting and standing, especially during the stationary stage, which makes it difficult to achieve balance in their body. Therefore, it is necessary to increase the hip joint abduction torque to maintain pelvic stability. In clinical evaluation and treatment, emphasis should be placed on the stable function of the spine and pelvis.