站姿和坐姿腰部表面肌电研究

目的探讨腰部肌肉功能状态的肌电评价指标，用于职业性下背痛的预防及指导人类工效学有关的研究。方法采用16通道单极表面肌电信号采集系统，测定10位健康受试者站姿和坐姿时腰部肌肉的表面肌电，分析人体不同姿势下腰部不同部位肌肉表面肌电的均方根值（RMS）和中频（MF）的变化，提出了用地形图直观地显示肌电信号特征参数的方法。结果对同一受试者，其不同部位的腰肌在同一种姿势下，肌电信号的MF和RMS具有一致的表现；而不同受试者在不同姿势时，其MF表现出一致性，而RMS则无此规律。结论MF是一个能有效地描述肌肉功能状态的参数，人体不同的姿势对腰肌疲劳的影响程度不同。     

青少年也要预防腰椎劳损

多数人认为腰椎间盘突出是中老年疾病,其实青少年也会患此病.尤其是中学生长期久坐,运动量少,易引起腰部肌肉劳损.当突然运动过度后,很容易造成腰椎间盘突出症的发生. 保持正确姿势 要不时变换姿势:在一个姿势下持续学习时间不宜过长,不要老是让腰部处于弯曲状态.一个姿势保持一段时间,应适当伸伸腰,也可自己轻轻锤锤腰,这样可以让紧张的腰部得以放松,防止腰部肌肉的疲劳.     

司机师傅,请护腰

汽车司机腰痛的发病率较高,这主要是由于开车时腰部长时间固定或腰部姿势不良及腰骶部长期受到上下震动所引起的。 汽车司机由于职业需要,要求他们保持坐姿驾驶,长期的体位固定,姿势变化较少,腰部和臀部肌肉常处于某个方向上的紧张状态,这些肌肉长期被动牵张或长时间连续收缩,可造成肌肉缺血、缺氧、水肿、粘连及无菌性炎症,发生挛缩或退行性变。此种无菌性炎症将     

腰肌劳损

1养成良好的姿势,站立时挺胸收腹。2弯腰、蹲下、在地面搬重物时,先屈髋、屈膝作蹲下姿势,腰部保持挺直。3加强腰、背、腹肌锻炼,注意劳动姿势,避免在一个固定姿势下工作时间过久,坚持做些伸腰活动的工间操。4最好睡硬板床。5急性腰肌损伤时,应休息1～3周,可接受推拿、按摩、理疗,并配合中西药治疗,以免迁延不愈。6进行重体力劳动或腰部剧烈运动时要使用宽腰带保护。腰肌劳损@张英     

坐位作业工人腰部负菏的生物力学分析

坐位作业容易引起腰部慢性肌肉骨骼损伤，但对其产生原因缺少分析方法。本研究结合我国人体高度和姿势特点建立了坐位作业腰部受力分析的生物力学模型，运用生物力学模型对坐位作业工人进行了分析，结果显示腰部受力与躯干角大小关系密切，躯干角小则腰部受力小，躯干角与腰背部损伤有关，说明工作中姿势负荷是引起腰部损伤的一个原因。坐位作业时腰部保持相对直立的姿势有利于作业人员健康。     

坐位作业工人腰部负荷的生物力学分析

坐位作业容易引起腰部慢性肌肉骨骼损伤，但对其产生原因缺少分析方法。本研究结合我国人体高度和姿势特点建立了坐位作业腰部受力分析的生物力学模型，运用生物力学模型对坐位作业工人进行了分析，结果显示腰部受力与躯干角大小关系密切，躯干角小则腰部受力小，躯干角与腰背部损伤有关，说明工作中姿势负荷是引起腰部损伤的一个原因。坐位作业时腰部保持相对直立的姿势有利于作业人员健康。     

颈肩腰背痛, "小毛病"也不能盲目治疗

只是看看电脑、手机,为什么会损伤颈肩腰 其实,看电脑、手机这些并不会直接损伤我们的颈肩腰,真正伤害它们的是我们使用电子产品时错误且长期维持的姿势.王刚主任告诉我们,颈肩腰背痛的发生主要与长期保持固定姿势、不正确姿势有关.长期处于这样的姿势中,会使我们的肌肉受到过高的负荷,容易导致肌肉与筋膜发生损伤,进而出现颈肩腰背痛.     

闪腰常事莫儿戏

正打个喷嚏居然闪了腰,一阵咳嗽后转不动腰了,搬东西不小心扭住腰……生活中,总会有点小意外让你防不胜防。在医学上,"闪腰"称为急性腰扭伤,是由姿势不当、用力过猛、超限活动及外力碰撞等造成的腰部肌肉、筋膜、韧带等软组织的急性损伤。一般以走路疼痛、肌肉痉挛多见,也有可能是发生了小关节损伤或急性腰椎间盘突出。闪腰后要正确处理。1.尽快平躺:不小心闪了腰,首先尽快平躺,以减少肌肉筋膜组织的受力或腰椎的压力,使     

汽车司机与腰腿痛病

汽车司机开车时,由于车子的颠簸和变速,腰部不断受到震荡。为了保持身体平衡和固定的姿势,肌肉不停地进行调整,有些肌肉一直处于紧张的收缩状态,容易引起疲劳、劳损,影响腰椎的稳定。日久天长,腰椎小关节、韧带以及椎间盘老化过程加快,容易出现损伤,发生无菌性炎     

教您为腰痛"减负"

传统医学认为:腰为一身之要,屈伸俯仰无不由之."站如松,坐如钟"是古代医家对坐与站最佳姿势的描述,千百年来被奉为圭臬.注意日常生活中的各种正确姿势,腰部肌肉就不易疲劳损伤,可避免腰部肌肉的过度劳累.防治腰痛的保健原则涉及日常生活中的坐、卧、行、动、食各个方面,应引起足够的重视.     

The effect of a tilting seat on back, lower back and legs during sitting work.

The purpose of this study was to examine the possible effects of a tilting seat on the back, lower back and legs. Ten healthy male subjects aged 22-28 performed word-processing operations while sitting on a chair for one hour under two different seating conditions: the rocking condition and the fixed condition. While the subjects were performing the task, measurements of lower leg swelling were taken using bioelectrical impedance plethysmography, and pain scores were recorded every five min for the neck, shoulders, back, lower back, hips and legs. Electromyograms (EMGs) of the back and lower back (at Th5-6, Th8-9, L1-2 and L3-4) were recorded every sec. In addition, the subjects were videotaped while using the rocking seat, in order to analyze the angle and frequency of seat tilting. At the end of the experiment, the subjects were asked to evaluate the two conditions with respect to localized fatigue and operational efficiency. There was no significant difference in lower leg swelling between the two conditions. EMGs were significantly different at Th5-6, Th8-9 and L1-2 between the two conditions. The rocking condition generated greater EMGs at Th5-6 and L1-2, whereas the fixed condition produced greater EMGs at Th8-9. The pain scores for the neck, shoulders, back and lower back were higher under the fixed condition, while those for the buttocks were higher under the rocking condition. The average tilting frequency was as low as 25.2 times per hour, with 15.6 times per hour for tilting angles ranging from 1 to 2 degrees, and 9.6 times per hour for tilting angles exceeding 2 degrees. As for the subjective evaluations of localized fatigue, seven of the ten subjects preferred the rocking condition, while two preferred the fixed condition and one subject had no preference. Thus, there was a significant difference in the subjective evaluations of the two chairs. These findings suggest that the rocking condition, in contrast to the fixed seating condition, reduced back and lower back pain as a result of its tilting capability. The results of EMGs suggest that the rocking condition reduced back and lower back pain by increasing the overall muscle activity of the back and lower back. The leg impedance measurements showed no effect of the rocking condition on the leg swelling, as compared with the fixed condition.     

一种骨科治疗牵引床的设计

目的：设计一种骨科治疗牵引床,让住院患者可以更方便地在医院病床上进行床边颈或腰部持续牵引,从而更好地治疗颈、腰椎间盘突出症.方法：使用框形支架挡板代替原床的实心挡板,便于牵引钩固定和牵引线穿过.结果：病床上一端连接在患者的颈或腰上,另一端与砝码连接,达到了牵引的目的.结论：该牵引床设计结构简单、操作方便,解决了骨科治疗腰椎或颈椎在床上做牵引的难题.     

The prevalence of spondylopathies among the crane operators in the port of Venice]

A group of 78 crane operators were examined using the "EPM Research Unit" method for assessing spine function. Crane operators work in a fixed posture characterized by a flexed position of the cervical spine, isometric load of the extensor cervical muscles and increased dorsal kyphosis. The prevalence of spinal disorders was 39.7% for the cervical tract, 37.2% for the dorsal tract and 38.5% for the lumbar region. The results were compared with those concerning a control group. A statistically significant difference was found in the number of cervical and dorsal complaints (O.R. = 3.33 and 2.69), whereas the difference was nearly significant for the lumbar tract (O.R. = 1.65). The results suggest that this category of workers may be subject to an increased risk for the spine.     

健康教育在降低患者复发腰椎间盘突出症的作用

目的探讨健康教育在降低患者再次发生腰椎间盘突出症的作用。方法选取73例腰椎间盘突出症患者,通过个性化、集中式、随机性及出院后随访教育,对患者、家属及照顾者进行疾病常识教育,指导正确的卧姿、坐姿、站姿、腰椎运动及腰腹部肌肉训练。结果本组患者健康教育知晓率达到98.6%,VAS疼痛指数平均降低66.8%,各项症状、体征明显改善,疾病复发率4.1%。结论有效的健康教育能提高患者健康教育知晓率、降低VAS疼痛指数、减少疾病复发率,提高患者生存质量。     

Body composition in older orthopaedic rehabilitation inpatients: Are field methods valid?

Aim: The assessment of body composition is an important aspect of the determination of nutritional health. This cross-sectional measurement study aimed to assess the relative validity of a range of field techniques for the measurement of body composition in a sample of older orthopaedic inpatients participating in rehabilitation. Methods: Assessment of percent fat-free mass of 31 adults, aged 65 years and over, was conducted under fasting conditions by two types of bioelectrical impedance analysis (multi-frequency and single frequency—using manufacturer's pre-programmed prediction equation) and compared with percent fat-free mass estimated by dual energy X-ray absorptiometry, a reference technique. Data from multi-frequency bioelectrical impedance analysis were also used to calculate percent fat-free mass from the prediction equation of Dey et al. for comparison. Skeletal muscle mass was derived from assessment of corrected arm muscle area and compared with skeletal muscle mass from dual energy X-ray absorptiometry analysis. Bland-Altman analysis was performed to determine the level of agreement between each field technique and dual energy X-ray absorptiometry. Results: Mean bias and limits of agreement between single frequency bioelectrical impedance analysis and dual energy X-ray absorptiometry were −5.7% (−24.0, 12.6), between multi-frequency bioelectrical impedance analysis (manufacturer's pre-programmed prediction equation) and dual energy X-ray absorptiometry were 1.4% (−13.4, 16.1), between multi-frequency bioelectrical impedance analysis (Dey et al. prediction equation) and dual energy X-ray absorptiometry were −5.0% (−16.6, 6.6) and between skeletal muscle mass as derived from assessment of corrected arm muscle area and skeletal muscle mass from dual energy X-ray absorptiometry analysis −0.97 kg (−8.37, 6.43). Conclusion: None of the methods assessed are clinically acceptable for assessment of body composition in older orthopaedic rehabilitation patients; however, estimation of skeletal muscle mass, as derived from corrected arm muscle area, is likely to be of more use in the clinical setting as there is no requirement for patients to be fasted.     

Within-day variability of whole-body and segmental bioelectrical impedance in a standing position

OBJECTIVE: To assess the variation in whole-body and segmental bioelectrical impedance measured in the standing position over the course of a day.Subjects:Sixteen healthy men aged 29.6 +/- 3.1 years participated in this study.Measurement:Impedance between the hands (Z H-H), the feet (Z F-F), and the both hands and feet (Z H-F) was measured using a bioelectrical impedance analysis (BIA) data acquisition system at 500 microA and 50 kHz. Body weight, Z H-H, Z F-F and Z H-F were measured every 3 h from 0900 to 1800. RESULTS: Body weight was slightly, but significantly, changed at 1200 (-0.4 +/- 0.4 kg, P < 0.05), 1500 (+0.4 +/- 0.3 kg, P < 0.05) and 1800 (-0.2 +/- 0.2 kg, P < 0.05) compared to their respective previous measurement values. Z H-H significantly increased (P < 0.05) and Z F-F significantly decreased (P < 0.05) over the course of a day. The mean changes in impedance from 0900 to 1800 were +27.2 Omega (Z H-H) and -31.8 Omega (Z F-F), respectively. There were no changes in Z H-H at 1500 and in Z F-F at 1800 compared to their respective previous measurement values. The Z H-F value did not change significantly between 0900 and 1800. CONCLUSION: Although changes in standing whole-body impedance during the day are small, arm and leg segmental impedance measurements change significantly. Therefore, it is necessary to measure the impedance at regularly scheduled times when evaluating whole-body %fat or body water content using the segmental BIA method.     

一种腰部助动康复器的设计

目的：设计一种腰部助动康复器,在增强腰部肌力的同时不加重腰椎的负荷,从而可对腰部肌体进行功能恢复训练。方法：利用电动机和变速器驱动变速器的输出轴上铰接的主动偏心轮,带动从动偏心轮和＂⊥＂型连杆运动,进一步带动位于腰部的半圆弧型运动支架运动。结果：特别设计的半圆弧型运动支架能够让腰部肌体达到360°全方位锻炼。结论：该设计结构简单、操作方便、效果好,是较好的主动训练器材,特别适用于康复期患者腰部肌体的功能恢复训练。     

视屏显示终端作业对骨骼肌肉系统影响的调查

目的探讨视屏显示终端（VDT）作业对骨骼肌肉系统的影响。方法采用断面流行病学方法,对337名从事VDT作业人员及203名对照组工人进行调查研究,用问卷调查、健康检查资料分析VDT作业对骨骼肌肉系统的影响。结果VDT组的骨骼肌肉酸痛不适的自觉症状的检出率为31.1%,其中以颈部（25.2%）、肩膀（19.3%）、下背部（18.1%）为主,高于对照组,差异有统计学意义（P〈0.05）;VDT组的颈椎及腰椎X线异常检出率分别为24.1%、17.3%,明显高于对照组（P〈0.05）;其中以颈曲变直（18.4%）、颈椎骨质增生（13.9%）、颈椎椎间隙变窄（9.8%）、腰椎骨质增生（13.6%）、腰椎退行性改变（11.3%）为主,分别高于对照组的相应的检出率,（均P〈0.05）;VDT组颈椎及或腰椎出现改变的平均患病年龄（34.9±7.3）岁,低于对照组,差异有统计学意义（P〈0.05）。结论VDT作业可能引起骨骼肌肉系统功能性及器质性损伤。     

Carpal tunnel syndrome as an expression of muscular dysfunction in the neck

Carpal tunnel syndrome (CTS) may be a consequence of increased forearm flexor activity secondary to muscle dysfunction in the neck. Eighteen CTS patients, with an average duration of symptoms of 10 months, were studied. Standardized nerve-conduction studies were administered before and after treatment. Surface-EMG techniques measured sternomastoid and cervical paraspinal muscle activity and flexor and extensor muscle activity during head movement. Both sets of neck muscles were found to be asymmetrical when compared side to side. Reduction of the sternomastoid asymmetry decreased forearm flexor EMG activity. Significant decreases in all nerve conduction measures were noted for every subject. Over half reported a loss of symptoms with post hoc analysis suggesting this may be related to the sternomastoid median frequency. It is suggested that increased flexor and/or extensor motor activity is an expression of dysfunctional sternomastoid activity. Possible mechanisms of dysfunction including the tonic neck reflex are discussed.     

Shoulder strain in keyboard workers and its alleviation by arm supports

Summary Keyboard work consists mostly of dynamic contractions of the small muscles of the forearms and hands. This is accompanied by continuous activity in the arm, shoulder and neck muscles keeping the head and hand in the correct position. Eliminating the weight from the arm by means of support and the position of the arms influences the electrical activity of shoulder muscles when working at a keyboard. We studied the influence of elbow angle, as well as that of different arm supports, on electrical activity of upper trapezius muscle during keyboard work in healthy workers and persons suffering from shoulder pains. The measurements were carried out in the laboratory. EMG activities, which where measured as mean square root (RMS)-values at every 100-millisecond period in trapezius muscle when working, were lower, the greater the elbow angle. Furthermore electrical activity decreased when subjects used arm supports while working. It is evident that the static load to shoulder muscles can be lowered significantly in keyboard work, when the forearms are at an angle of at least 100 degrees and by using arm supports. The most convienient and ergonomic working position can also be found individually be the method used here.