Kontraktilne lastnosti mišic vzravnalk hrbtenice pri ljudeh z in brez ledvene segmentne nestabilnosti : magistrsko delo

Pukšič, Žan (author), Kacin, Alan (mentor), Vodičar, Miha (comentor), Vauhnik, Renata (reviewer)

Uvod: Mišice vzravnalke hrbtenice so nagnjene k preobremenitvam, njihova šibkost pa lahko pomembno vpliva na razvoj degenerativnih sprememb. Merjenje kontraktilnih lastnosti mišic vzravnalk hrbtenice z uporabo tenziomiografije (TMG) je neinvazivno in ne zahteva aktivnosti pacienta zato bi lahko bilo uporabno kadar aktivni testi mišične funkcije zaradi bolečine niso izvedljivi. Namen: Namen raziskave je bil ovrednotiti zanesljivost TMG meritev kontraktilnih lastnosti mišic vzravnalk hrbtenice pri ljudeh brez bolečin v spodnjem delu hrbta ter nato vrednosti TMG parametrov primerjati s pacienti s segmentno nestabilnostjo ledvene hrbtenice. Metode dela: V raziskavo je bilo vključenih 44 preiskovancev, od tega je bilo 22 zdravih prostovoljcev, brez bolečine v spodnjem delu hrbta ter 22 prostovoljcev z diagnozo segmentne nestabilnosti ledvene hrbtenice. Pri zdravih preiskovancih smo TMG meritve ponovili v obdobju 3 minut in 72 ur. Pri preiskovancih s segmentno nestabilnostjo smo TMG meritev izvedli le enkrat. Za primerjavo osnovnih karakteristik preiskovancev in vrednosti TMG parametrov Dm, Tc, Vc, Td in ILS med skupinama smo uporabili Studentov t-test ter in Mann Whitney U test za neodvisne vzorce. Zanesljivost preiskovalca smo preverili z dvosmernim ICC za mešane učinke in 95% intervalom zaupanja. Rezultati: Pri zdravih ljudeh smo ugotovili odlično zanesljivost (ICC > 0,97) preiskovalca za parametre Dm, Tc, Vc in Td v obdobju 3 minut in dobro do odlično zanesljivost (ICC > 0,88) preiskovalca za parametre Dm, Tc, Vc in Td v obdobju 72 ur. Za parameter ILS smo ugotovili slabo zanesljivost preiskovalca po 3 minutah in 72 urah. Za parametre Dm, Tc, Vc, Td in ILS mišic vzravnalk hrbtenice smo ugotovili statistično pomembne razlike (p < 0,05) med preiskovanci brez bolečin v spodnjem delu hrbta in pacienti s segmentno nestabilnostjo. Razprava in zaključek: Večina TMG parametrov kontraktilnosti mišic vzravnalk hrbtenice zdravih preiskovancev ima dobro do odlično zanesljivost preiskovalca v obdobju 3 minut in 72 ur. Kontraktilne lastnosti mišic vzravnalk hrbtenice se pomembno razlikujejo med preiskovanci s segmentno nestabilnostjo ledvene hrbtenice in brez nje, kar kaže na pomembno povezanost med nestabilnostjo hrbtenice in funkcijo vzravnalk hrbtenice.

• Language: Slovenian
• Keywords: magistrska dela, fizioterapija, tenziomiografija, mišice vzravnalke hrbtenice, segmentna nestabilnost
• Work type: Master's thesis/paper
• Typology: 2.09 - Master's Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [Ž. Pukšič]
• Year: 2023
• Number of pages: 33 str., [4] str. pril.
• PID: 20.500.12556/RUL-151232
• UDC: 615.8
• COBISS.SI-ID: 167169027
• Publication date in RUL: 01.10.2023

Secondary language

• Language: English
• Title: Contractile properties of the spinal erector muscles in people with and without lumbar segmental instability : master thesis

Abstract

Introduction: The muscles of the spine are prone to overload and their weakness can significantly influence the development of degenerative changes. Measuring the contractile properties of the spinal erectors using tensiomyography (TMG) is non-invasive and does not require patient activation, so it may be useful when active testing of muscle function is not feasible due to pain. Aim: The aim of the study was to evaluate the reliability of TMG measurements of the contractile properties of the spinal erectors in subjects without low back pain and to compare them with the contractile properties of the same muscles in patients with segmental lumbar instability. Methods: 44 subjects were included in the study, of which 22 were healthy subjects with no history or presence of low back pain and 22 subjects with a diagnosis of segmental lumbar instability. In the healthy subjects, TMG of the spinal erectors was repeated over a period of 3 minutes and 72 hours. In subjects with segmental instability, TMG of the spinal erectors was performed only once. Student's t-test and Mann Whitney U-test for independent samples were used to compare baseline characteristics of subjects and values of parameters Dm, Tc, Vc, Td and ILS between groups. Inter-examiner reliability was assessed using the two-way ICC for mixed effects with 95% confidence intervals. Results: In healthy individuals, we found excellent intra-rater reliability (ICC > 0.97) of the parameters Dm, Tc, Vc and Td over a 3-minute period and good to excellent intra-rater reliability (ICC > 0.88) of Dm, Tc, Vc and Td over a 72-hour period. We found poor intra-rater reliability of ILS parameters at 3 minutes and 72 hours. The Dm, Tc, Vc, Td and ILS of the spinal erectors differed significantly (p < 0.05) between healthy subjects and patients with segmental instability. Discussion and conclusion: In healthy subjects, most TMG parameters of the spinal extensors show good to excellent intra-rater reliability over periods of 3 minutes and 72 hours. The values of the contractile muscle properties of the spinal erectors differ significantly between subjects with and without segmental lumbar instability, indicating a significant relationship between spinal instability and spinal erector function.

• Keywords: master's theses, physiotherapy, tensiomyography, erector spinae muscles, segmental instability