مقایسه زمان شروع فعالیت عضلات شکم در دو سمت تنه هنگام خم کردن اندام زبرین در افراد سالم : مطالعه‌ای درباره‌ی پاسخ‌های وضعیتی تنه

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دفتر تحقیقات و فن آوری دانشجویی. دانشجوی کاشناسی ارشد فیزیوتراپی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی ، تهران ، ایران

2 استادیار گروه فیزیوتراپی، مرکز تحقیقات فیزیوتراپی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی ، تهران، ایران

3 استاد گروه فیزیوتراپی ، دانشکده علوم توانبخشی ، دانشگاه علوم پزشکی شهید بهشتی ، تهران ، ایران

4 دانشیار گروه علوم پایه ، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی ، تهران ، ایران

5 دانشجوی دکترای تخصصی آمار زیستی ، گروه آمار زیستی ، دانشکده پیراپزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

چکیده

مقدمه و اهداف
هدف از این مطالعه بررسی زمان شروع فعالیت عضلات شکم در مقایسه با زمان شروع فعالیت عضله دلتویید اندام بالاتنه غالب هنگام پاسخ‌های وضعیتی پیش بینانه در افراد سالم می باشد.
مواد و روش ها
در این مطالعه‌ی مشاهده‌ای، 20 نفر خانم (با میانگین سنی25/3سال و22/36kg/m²BMI =) مورد بررسی قرار گرفتند . هنگام انجام حرکت خم کردن سریع شانه‌ی اندام غالب در وضعیت ایستاده ، داده های الکترومیوگرافی عضله عرضی شکم و مایل خارجی در هر دو سمت تنه و عضله دلتوییداندام غالب ثبت شد. در این افراد زمان شروع فعالیت عضلات تنه هنگام تنظیمات وضعیتی پیش بینانه بررسی شد .برای مقایسه زمان شروع فعالیت  عضلانی میان هر دو سمت تنه از آزمون آماری ناپارامتریک Wilcoxon signed ranked test استفاده شد .
یافته ها
در سمت مقابل اندام در حال حرکت عضله عرضی شکم و عضله مایل خارجیزودتر از عضله دلتوئید وارد عمل شدند اما عضلاتشکم در سمت اندام در حال حرکت به شکل قابل توجهی دیرتر از عضله دلتوئید شروع به فعالیت کردند و بین عضلات دو سمت تنه اختلاف معناداری از جهت زمان شروع فعالیت، دیده شد. (عضله عرضی شکمP=0/001, عضله مایل خارجیP=0/005)
بحث و نتیجه گیری
در افراد شرکت کننده در این مطالعه فعالیت پیش خوراندی عضلات شکم برای مقابله با اغتشاشات احتمالی ناشی از حرکت سریع اندام بالاتنه غالب تنها در سمت مقابل اندام  در حال حرکت مشاهده گردید  ولی عضلات شکم در سمت اندام در حال حرکت به شکل  پس خوراند وارد عمل شدند.  نتایج حاضر نشان دهنده ی  این  موضوع می باشد که عضلات شکم  نیز جزئی از سینرژی های مورب هستند که در ارتباط با انتقال مناسب حرکت و گشتاور تولیدی حاصل از حرکت اندام عمل می کنند. به نظر می رسد الگوی بکارگیری متقابل عضله عرضی شکم، الگوی مناسب تری نسبت به الگوی انقباض همزمان این عضله برای ثبات بخشیدن به تنه باشد.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Comparison of bilateral abdominal muscles onset times during upper limb flexion in healthy subjects: Investigation of anticipatory postural responses

نویسندگان [English]

  • Maryam Khaleqi-Sohi 1
  • Sedigheh Sadat Naimi 2
  • khosro khademi kalantari 3
  • Alireza Akbarzadeh Baghban 4
  • Erfan Ghasemi 5
1 Student Research Office. MSc student in Physical Therapy, Department of Physiotherapy, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Assistant Professor, Physiotherapy Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Professor, Department of Physiotherapy, School of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Associate Professor, PhD in Biostatistics, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5 Ph.D candidate, Department of Biostatistics, School of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
چکیده [English]

Background and Aim: The present study was conducted to compare bilateral abdominal muscles onset times with that of dominant upper limb deltoid muscle associated with anticipatory postural responses in healthy participants.
Materials and Methods: In the current observational study, 20 healthy female individuals (mean age 25.3 yrs and BMI =22.36kg/m2) were studied. While they were performing rapid arm flexion in standing position with their dominant limb, electromygraphic data of Transverse Abdominus (TrA) and External Oblique (EO) in both sides and the deltoid muscle of dominant limb were recorded. The onset times of these muscles were the main measured parameter during anticipatory postural response. Wilcoxon signed-ranked test was used to compare bilateral abdominal muscles onset times.
Results: Contra lateral TrA and EO were recruited prior to deltoid muscle, but in Ipsilateral side these muscles were activated primarily after deltoid. There were significant differences between abdominal muscles onset time in comparison between the two sides of the trunk (TrA: p=0.001, EO: p=0.005).
Conclusion: Feed-forward activation of the abdominal muscles, prior to perturbation due to rapid arm movements, was observed for one body side in healthy subjects but these muscles in Ipsilateral side were activated in feedback manner. The results of the present study show that abdominal muscles are a part of diagonal synergies related to transferring movement and torque efficiently produced by the moving limb. It seems that reciprocal pattern of TrA muscle activation is a more efficient pattern in comparison with co-contraction pattern previosely introduced.

کلیدواژه‌ها [English]

  • Anticipatory postural response
  • Onset time
  • Transverse abdominus muscle
  • External oblique muscle

مراجع

  1. Andersson GB. Epidemiological features of chronic low-back pain. The lancet. 1999;354(9178):581-5.##
  2. Balagué F, Mannion AF, Pellisé F, Cedraschi C. Non-specific low back pain. The Lancet. 2012;379(9814):482-91.##
  3. Shirado O, Ito T, Kaneda K, Strax TE. FLEXION-RELAXATION PHENOMENON IN THE BACK MUSCLES: A Comparative Study Between Healthy Subjects and Patients with Chronic Low Back Pain. American journal of physical medicine & rehabilitation. 1995;74(2):139-44.##
  4. .Langevin HM, Sherman KJ. Pathophysiological model for chronic low back pain integrating connective tissue and nervous system mechanisms. Medical hypotheses. 2007;68(1):74-80.##
  5. .Hodges PW, Richardson CA. Delayed postural contraction of transversus abdominis in low back pain associated with movement of the lower limb. Journal of Spinal Disorders & Techniques. 1998;11(1):46-56.##
  6. van Dieën JH, Selen LP, Cholewicki J. Trunk muscle activation in low-back pain patients, an analysis of the literature. Journal of Electromyography and Kinesiology. 2003,;13(4): 333–51.##
  7. Jacobs JV, Henry SM, Jones SL, Hitt JR, Bunn JY. A history of low back pain associates with altered electromyographic activation patterns in response to perturbations of standing balance. Journal of neurophysiology. 2011;106(5):2506-14.##
  8. Ferreira PH, Ferreira ML, Hodges PW. Changes in recruitment of the abdominal muscles in people with low back pain: ultrasound measurement of muscle activity. Spine. 2004;29(22):2560-6.##
  9. Vlaeyen JW, Kole-Snijders AM, Boeren RG, Van Eek H. Fear of movement/(re) injury in chronic low back pain and its relation to behavioral performance. Pain. 1995;62(3):363-72.##
  10. Ruget H, Blouin J, Teasdale N, Mouchnino L. Can prepared anticipatory postural adjustments be updated by proprioception? Neuroscience. 2008, 155 (3), 640-648.##
  11. Aruin AS, Latash ML. Directional specificity of postural muscles in feed-forward postural reactions during fast voluntary arm movements. Experimental Brain Research. 1995;103(2):323-32.##
  12. Zattara M, Bouisset S. Posturo-kinetic organisation during the early phase of voluntary upper limb movement. 1. Normal subjects. Journal of Neurology, Neurosurgery & Psychiatry. 1988;51(7):956-65.##
  13. Van der Fits I, Klip A, Van Eykern L, Hadders-Algra M. Postural adjustments accompanying fast pointing movements in standing, sitting and lying adults. Experimental Brain Research. 1998;120(2):202-16.##
  14. Belen'kii V, Gurfinkel V, Pal'tsev E. On The Control Elements Of Voluntary Movements. Biofizika. 1967.##
  15. Hodges PW. Changes in motor planning of feedforward postural responses of the trunk muscles in low back pain. Experimental brain research. 2001;141(2):261-6.##
  16. MacDonald D, Moseley GL, Hodges PW. Why do some patients keep hurting their back? Evidence of ongoing back muscle dysfunction during remission from recurrent back pain. Pain. 2009;142(3):183-8.##
  17. Radebold A, Cholewicki J, Polzhofer GK, Greene HS. Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with chronic idiopathic low back pain. Spine. 2001;26(7):724-30.##
  18. Hodges PW, Moseley GL. Pain and motor control of the lumbopelvic region: effect and possible mechanisms. Journal of Electromyography and Kinesiology. 2003;13(4):361-70.##
  19. Hall L, Tsao H, MacDonald D, Coppieters M, Hodges PW. Immediate effects of co-contraction training on motor control of the trunk muscles in people with recurrent low back pain. Journal of Electromyography and Kinesiology. 2009;19(5):763-73.##
  20. Tsao H, Hodges PW. Persistence of improvements in postural strategies following motor control training in people with recurrent low back pain. Journal of Electromyography and Kinesiology. 2008;18(4):559-67.##
  21. Gubler D, Mannion AF, Schenk P, Gorelick M, Helbling D, Gerber H, et al. Ultrasound tissue Doppler imaging reveals no delay in abdominal muscle feed-forward activity during rapid arm movements in patients with chronic low back pain. Spine. 2010;35(16):1506-13.##
  22. Marshall P, Murphy B. The validity and reliability of surface EMG to assess the neuromuscular response of the abdominal muscles to rapid limb movement. Journal of Electromyography and Kinesiology. 2003;13(5):477-89.##
  23. Silfies SP, Mehta R, Smith SS, Karduna AR. Differences in feedforward trunk muscle activity in subgroups of patients with mechanical low back pain. Archives of physical medicine and rehabilitation. 2009;90(7):1159-69.##
  24. Hodges PW, Richardson CA. Altered trunk muscle recruitment in people with low back pain with upper limb movement at different speeds. Archives of physical medicine and rehabilitation. 1999;80(9):1005-12.##
  25. Solnik S, DeVita P, Rider P, Long B, Hortobágyi T. Teager–Kaiser Operator improves the accuracy of EMG onset detection independent of signal-to-noise ratio. Acta of bioengineering and biomechanics/Wroclaw University of Technology. 2008;10(2):65.##
  26. .Morris S, Lay B, Allison G. Transversus abdominis is part of a global not local muscle synergy during arm movement. Human movement science. 2013;32(5):1176-85.##
  27. Morris SL, Lay B, Allison GT. Corset hypothesisrebutted—Transversus abdominis does not co-contract in unison prior to rapid arm movements. Clinical Biomechanics. 2012;27(3):249-54.##
  28. Andersson EA, Grundström H, Thorstensson A. Diverging intramuscular activity patterns in back and abdominal musclesduring trunk rotation. Spine. 2002;27(6):E152-E60.##
  29. Hodges P, Cresswell A, Thorstensson A. Preparatory trunk motion accompanies rapid upper limb movement. Experimental Brain Research. 1999;124(1):69-79.##
  30. Hodges PW, Richardson CA. Inefficient muscular stabilization of the lumbar spine associated with low back pain: a motor control evaluation of transversus abdominis. Spine. 1996;21(22):2640-50.##
دوماهنامه علمی - پژوهشی طب توانبخشی
دوره 5، شماره 2
خرداد و تیر 1395
صفحه 52-60

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سابقه مقاله

  • تاریخ دریافت: 20 اردیبهشت 1394
  • تاریخ بازنگری: 27 شهریور 1394
  • تاریخ پذیرش: 22 مهر 1394
  • تاریخ اولین انتشار: 01 تیر 1395

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