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目的:非特异性腰背疼痛已经成为影响青少年身体健康的公共卫生问题,脊柱形态与功能的改变可能是青少年非特异性腰背疼痛的影响因素。通过对青少年脊柱形态与功能的全面测试,可以为青少年非特异性疼痛的预防以及治疗提供可靠的依据。方法:使用spinal mouse电子脊柱测量仪对非特异性腰背疼痛组273名(男,121名;女,152名)学生和对照组127名(男,63名;女,64名)学生进行脊柱形态与功能测试。测试指标包括直立位、坐位以及负重状态(Matthiass test)下的胸椎后凸角(TKA)、腰椎前凸角(LLA)、骶骨倾角(SA)、倾斜角(INA),以及前屈、后伸、左右侧屈时脊柱各节段活动度。使用偏相关分析探讨非特异性腰背疼痛与年龄的相关性,使用二分类logistics回归模型对脊柱形态与功能等指标与非特异性腰背疼痛进行相关性分析。结果:1)初中生TKA异常率分别为47.0%,53.0%(男生、女生);高中生TKA异常率为52.6%,48.0%(男生、女生)。2)初中生LLA异常率为67.5%,45.2%(男生、女生);高中生LLA异常率为52.6%和21.7%(男生、女生)。3)胸椎后凸角(P<0.05,OR=1.236)和腰椎从屈曲位到后伸位的活动度(P<0.01,OR=0.975)与青少年非特异性腰背疼痛具有相关性。结论:本研究受试者中,TKA与LLA异常的比例较高。TKA较大以及腰椎总体活动度不足是青少年发生非特异性腰背疼痛的危险因素。
OBJECTIVE: Nonspecific low back pain has become a public health problem affecting the health of adolescents. Changes in spinal morphology and function may be the influencing factors of nonspecific low back pain in adolescents. Through the comprehensive examination of adolescent spine morphology and function, it can provide a reliable basis for the prevention and treatment of adolescent non-specific pain. METHODS: A total of 273 (male, 121 female; 152 female) and 127 female (male, 63 female, 64 female) students from the nonspecific lower back pain group underwent spinal morphometry And functional testing. Tests included upright position, sitting position and thoracic kyphosis (TKA), lumbar lordosis (LLA), sacral inclination (SA), incline angle (INA) under the Matthiass test, , Left and right lateral flexion of the activities of the various segments. Partial correlation analysis was used to explore the correlation between nonspecific low back pain and age. Logistic regression analysis was used to analyze the relationship between spinal morphology and function and nonspecific low back pain. Results: 1) The abnormal rates of TKA in junior high school students were 47.0% and 53.0% respectively (boys and girls). The abnormal rates of TKA were 52.6% and 48.0% (boys and girls) in high school. 2) The abnormal rate of LLA in junior high school students was 67.5% and 45.2% respectively (boys and girls). The abnormal rates of LLA in high school students were 52.6% and 21.7% (boys and girls). 3) The activities of thoracic kyphosis (P <0.05, OR = 1.236) and lumbar flexion to posterior extension (P <0.01, OR = 0.975) were correlated with unspecific lower back pain in adolescents. Conclusion: The proportion of TKA and LLA abnormalities in this study was high. TKA larger and overall lack of lumbar spine is a risk factor for non-specific low back pain in adolescents.