ارتباط بین اختلال در کنترل حرکتی لمبوپلویک و کمردردهای مزمن غیراختصاصی: یک مرور سیستماتیک

نوع مقاله: مقاله مروری

نویسندگان

1 مرکز توسعه تحقیقات بالینی، بیمارستان امام رضا، دانشگاه علوم پزشکی کرمانشاه، کرمانشاه، ایران

2 استادیار گروه آسیب‌شناسی ورزشی و حرکات اصلاحی، دانشکده علوم ورزشی، دانشگاه رازی، کرمانشاه، ایران

3 دانشجوی گروه آسیب‌شناسی ورزشی و حرکات اصلاحی، دانشکده علوم ورزشی، دانشگاه رازی، کرمانشاه، ایران

چکیده

مقدمه و اهداف
امروزه کمردرد مزمن غیراختصاصی (NLBP) یکی از شایع­ترین اختلالات اسکلتی-عضلانی بوده که انجمن بین­المللی درد و تشخیص آناتومیکی، آن را به عنوان درد ناحیه کمری یا خاجی تعریف کرده است. بر اساس نتایج مطالعات انجام­شده، 84% افراد حداقل برای یک بار کمردرد را در طول عمر خود تجربه می­کنند که از این بین 23% آن­ها مزمن می­شوند. هدف از مطالعه­ی مروری حاضر، بررسی رابطه بین دردهای مزمن کمری غیراختصاصی و اختلالات کنترل لمبوپلویک می­باشد.
مواد و روش ­ها
در مطالعه مروری حاضر، با استفاده از بانک­های اطلاعاتی PubMed، Science Direct، Google Scholar، Elsevier، Springer، IEEE، EBSCO، Scopus جستجوی جامعی انجام گرفت و مقالات موجود در بازه زمانی 2000 تا 2018 میلادی به هر دو زبان فارسی و انگلیسی جستجو شد. برای استخراج مقالات از کلید­واژهای“Lumbopelvic Control” or “Lumbopelvic or Trunk Stability” “Lumbopelvic Motor Control” or   “Trunk Control” or “Spinal Stability”استفاده شد. در مرحله اول معیار انتخاب تنها بر اساس عنوان و چکیده مقالات بود که در این مرحله حدود 1900 مقاله یافت شد. پس از غربالگری اولیه، متن کامل مقالاتی که انتخاب شدند، استخراج شده و تنها 7 مورد برای ارزیابی پایانی انتخاب گردید.
یافته ­ها
پس از تجزیه و تحلیل مقالات استخراج­شده که همه از نوع مطالعات توصیفی-تحلیلی، از نوع Case Control بود، مشخص شد شش مقاله از مقالات استخراج­شده که کینماتیک کنترل حرکات لمبوپلویک را ارزیابی کرده و دو مورد از آن­ها که علاوه بر ارزیابی کینماتیکی حرکات لمبوپلویک، فعالیت عضلات آن ناحیه را نیز بررسی کرده بود، به وجود اختلال در کنترل ناحیه لمبوپلویک افراد مبتلا به کمردرد مزمن اشاره نموده بودند.
نتیجه­ گیری
با توجه به مطالعه و تحلیل هفت مقاله­ی انجام­شده در زمینه کنترل لمبوپلویک افراد مبتلا به کمردرد مزمن غیراختصاصی، به نظر می­رسد که وجود اختلال در کنترل ناحیه لمبوپلویک این افراد رایج بوده و می­طلبد تا مطالعات آتی با به­کارگیری راهکارهایی جهت کنترل لمبوپلویک افراد مبتلا و اثربخشی آن در کاهش دردهای مزمن به انجام رسد.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Relationship between LumboPelvic Motor Control Deficiency and Non-Specific Chronic Low Back Pain: A Systematic Review

نویسندگان [English]

  • Shirin Asar 1
  • Farzaneh Gandomi 2
  • Pari Fadaei Dehcheshmeh 3
1 Clinical Research Development Center, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermananshah, Iran
2 Assistant Professor, Department of Corrective Exercises and Sport Injuries, Faculty of Physical Education and Sport Sciences, Razi University, Kermanshah, Iran
3 MSc. Student, Department of Corrective Exercises and Sport Injuries, Faculty of Physical Education and Sport Sciences, Razi University, Kermanshah, Iran
چکیده [English]

Background and Aims: Non-specific low back pain (NLBP) is one of the most common musculoskeletal disorders and the International Association for Pain and Anatomical Diagnosis has defined it as a lumbar or sacrum pain. According to the results of the previous studies, 84% of people has experienced back pain and 23% of these pains become chronic. The purpose of the present review study was to investigate the relationship between lumbopelvic motor control disorders and chronic non-specific low back pain.
Materials and Methods: In the current review paper, a comprehensive search was conducted in PubMed, Science Direct, Google Scholar, Elsevier, Springer, IEEE, EBSCO, and Scopus databases from 2000 to 2018, using the following keywords lumbopelvic control, lumbopelvic, trunk stability, lumbopelvic motor control, trunk control, and spinal stability. A total of 1900 articles were found after reviewing the abstract and titles. Next, based on the main subject of the present study as well as inclusion and exclusion criteria, seven articles were selected for the final analysis.
Results: All studies selected for the final review were case-control studies. Five articles investigated the kinematic aspects of lumbopelvic movements control two of which, in addition to the kinematic evaluation of lumbopelvic movements control, assessed the activity of the lumbopelvic region muscles.
Conclusion: According to the results reported in these seven papers, we showed that lumbopluvic movement control disorders are commonly reported in patients with chronic low back pain. So, more studies should be conducted to better understand the issue.

کلیدواژه‌ها [English]

  • lumbopelvic control
  • non-specific low back pain
  • Spine
1. Malliou P, Gioftsidou A, Beneka A, Godolias G. Measurements and evaluations in low back pain patients. Scandinavian journal of medicine & science in sports. 2006;16(4):219-30.##

2. Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. The Lancet. 2012;379(9814):482-91##

3. Nelson-Wong E, Alex B, Csepe D, Lancaster D, Callaghan JP. Altered muscle recruitment during extension from trunk flexion in low back pain developers. Clinical biomechanics. 2012;27(10):994-8. ##

4. Waddell G. The back pain revolution, 2nd edn, vol xiii. Edinburgh/New York: Churchill Livingstone; 2004. p. 475. ## 

5. Matheve T, Brumagne S, Demoulin C, Timmermans AJJon, rehabilitation. Sensor-based postural feedback is more effective than conventional feedback to improve lumbopelvic movement control in patients with chronic low back pain: a randomised controlled trial. Journal of neuroengineering and rehabilitation. 2018;15(1):85. ##

6. Panjabi MMJJoe, kinesiology. Clinical spinal instability and low back pain. Journal of electromyography and kinesiology.2003;13(4):371-9. ##

7. Ferguson SA, Marras WS, Burr DL, Davis KG, Gupta P. Differences in motor recruitment and resulting kinematics between low back pain patients and asymptomatic participants during lifting exertions. Clinical Biomechanic (Bristol, Avon). 2004;19(10):992–9. ##

 8. van Dieen JH, Selen LPJ, Cholewicki J. Trunk muscle activation in low-back pain patients, an analysis of the literature. J Electromyogr Kinesiol. 2003;13:333–51. ##

9. Nelson-Wong E, Callaghan JP. Is muscle co-activation a predisposing factor for low back pain development during standing? A multifactorial approach for early identification of at-risk individuals. J Electromyograghy Kinesiology. 2010;20:256–63. ##

10. Marshall PWM, Patel H, Callaghan JP. Gluteus medius strength, endurance, and co-activation in the development of low back pain during prolonged standing. Human Movement Sci. 2011;30(1):63–73.  ##

11. Denteneer L, Stassijns G, De Hertogh W, Truijen S, Van Daele UJAopm, rehabilitation. Inter-and intrarater reliability of clinical tests associated with functional lumbar segmental instability and motor control impairment in patients with low back pain: a systematic review. Archives of physical medicine and rehabilitation. 2017;98(1):151-64. ##

12. Airaksinen  O, Brox  JI,  Cedraschi C,  Hildebrandt  J, Klaber-Moffett J,Kovacs F, Mannion AF, Reis S, Staal JB, Ursin H, Zanoli G. Chapter 4. European guidelines for the management of chronic nonspecific low back pain. European Spine Journal. 2006; 2: S192  –  S300      ##                                                                                                     

13. Sahrmann S, Azevedo DC, Van Dillen LJBjopt. Diagnosis and treatment of movement system impairment syndromes. Brazilian journal of physical therapy. 2017;21(6):391-9. ##

14. Flores-León A, Redenz G, Valencia OD, Guzmán-Venegas R, Araneda OF, Berral de la Rosa FJPt, et al. Coordination of the rotational movement of the pelvis and the hip in men without low back pain, with control impairment of the lumbopelvic region in the sagittal plane. Physiotherapy theory and practice. 2018:1-8. ##

15. Park K-n, Kwon O-y, Yi C-h, Cynn H-s, Weon J-h, Kim T-h, et al. Effects of motor control exercise vs muscle stretching exercise on reducing compensatory lumbopelvic motions and low back pain: a randomized trial. Journal of manipulative and physiological therapeutics. 2016;39(8):576-85. ##

16. Grosdent S, Demoulin C, Rodriguez de La Cruz C, Giop R, Tomasella M, Crielaard J-M, et al. Lumbopelvic motor control and low back pain in elite soccer players: a cross-sectional study. Journal of sports sciences. 2016;34(11):1021-9. ##

17. Nelson-Wong E, Poupore K, Ingvalson S, Dehmer K, Piatte A, Alexander S, et al. Neuromuscular strategies for lumbopelvic control during frontal and sagittal plane movement challenges differ between people with and without low back pain. Electromyography and Kinesiology. 2013;23(6):1317-24. ##

18. Hoffman SL, Johnson MB, Zou D, Harris-Hayes M, Van Dillen LRJMT. Effect of classification-specific treatment on lumbopelvic motion during hip rotation in people with low back pain. Manual Therapy. 2011;16(4):344-50. ##

19. Winnard A, Debuse D, Wilkinson M, Tahmosybayat R, Caplan NJMS, Practice. The immediate effects of exercise using the Functional Re-adaptive Exercise Device on lumbopelvic kinematics in people with and without low back pain. Musculoskeletal Science and Practice. 2017;27:S47-S53. ##

20. Hodges PW, Moseley GLJJoe, kinesiology. Pain and motor control of the lumbopelvic region: effect and possible mechanisms. Journal of electromyography and kinesiology. 2003;13(4):361-70##

21. Cholewicki J, Silfies SP, Shah RA, Greene HS, Reeves NP, Alvi K, et al. Delayed trunk muscle reflex responses increase the risk of low back injuries. Spine, 2005;30(23):2614-20. ##

22. Hides JA, Jull GA, Richardson CAJS. Long-term effects of specific stabilizing exercises for first-episode low back pain. Spine. 2001;26(11):e243-e8. ##

23. Roussel N, De Kooning M, Schutt A, Mottram S, Truijen S, Nijs J, et al. Motor control and low back pain in dancers. International journal of sports medicine. 2013;34(02):138-43. ##

24. Nelson-Wong E, Gallant P, Alexander S, Dehmer K, Ingvalson S, McClenahan B, et al. Multiplanar lumbopelvic control in patients with low back pain: is multiplanar assessment better than single plane assessment in discriminating between patients and healthy controls? . Journal of Manual & Manipulative Therapy. 2016;24(1):45-50. ##

25. Sorensen CJ, Johnson MB, Norton BJ, Callaghan JP, Van Dillen LRJHms. Asymmetry of lumbopelvic movement patterns during active hip abduction is a risk factor for low back pain development during standing. Human movement science. 2016;50:38-46. ##

26. Namnik N, Salehi R, Esfandiarpour F, Mehravar M, Orakifar NJJoRS, Research. Comparison of lumbopelvic movement pattern in people with and without low back pain during stair descending task. Rehabilitation Sciences & Research. 2018;5(3):81-5. ##

27. Babiolakis CS, Kuk JL, Drake JDJE. Differences in lumbopelvic control and occupational behaviours in female nurses with and without a recent history of low back pain due to back injury. Ergonomics. 2015;58(2):235-45. ##

28. Sahrmann S. Movement System Impairment Symdromes of The Extremities, Cervical and Thoracic Spines. St Louis, MO: Elsevier Mosby. Inc; 2011##

29. Ferguson SA, Marras WS, Burr DL, Davis KG, Gupta P. Differences in motor recruitment and resulting kinematics between low back pain patients and asymptomatic participants during lifting exertions. Clinical Biomechanic (Bristol, Avon). 2004;19(10):992–9. ##

 30. van Dieen JH, Selen LPJ, Cholewicki J. Trunk muscle activation in low-back pain patients, an analysis of the literature. Journal of Electromyograpgy and Kinesiology. 2003;13:333–51. ##