马术骑手髋腰部慢性损伤的影像学和生物力学分析

目的 通过分析专业马术骑手腰椎及髋关节影像学和表面肌电信息,了解马术骑手髋部和腰部慢性疾病发病率,探究骑手慢性疼痛的发病原因。方法 选取25名上海市马术运动管理中心马术骑手,按照病史分为慢性腰部疼痛组和慢性髋部疼痛组。同时选取12名无髋腰部疼痛普通人作为对照组,收集受试者髋腰部相关病史资料和髋腰部X线、磁共振成像及核心肌群表面肌电数据。结果 慢性腰痛者腰椎JOA评分明显低于对照组(P<0.05)。骑手慢性髋关节疼痛相对较轻,但Harris评分明显低于对照组(P<0.05)。马术骑手腰部JOA评分与Pfirrmann分级明显相关。而髋部疼痛视觉模拟评分和Harris评分与影像学参数无明显相关性。腹直肌、竖脊肌、股直肌、臀中肌和多裂肌在骑坐姿势的均方根振幅大于正常坐位(P<0.05)。结论 马术骑手的慢性腰部疼痛发病原因主要可能与软组织过度劳损和腰椎退变相关;腰-髋矢状位序列骨盆倾斜角和骶骨倾斜角的变化可以反映马术骑手腰部僵硬程度。

Analysis of Imaging and Biomechanics of the Hip and Waist of Equestrian Riders with Chronic Injury

Objective To analyze the lumbar/hip imaging and surface electromyography data of professional equestrian riders, to understand the incidence of chronic diseases in the hip and lower back of the rider, and to explore the causes of chronic pain in riders. Methods Twenty-five equestrian riders from the Shanghai Equestrian Sports Management Center were divided into chronic lower-back pain and chronic hip pain groups. Twelve healthy subjects without hip or lower-back pain were included in the control group. Medical history, X-ray, and magnetic resonance imaging of the hip and lower back, and surface electromyography data of the core muscle were collected. Results The JOA score of the lumbar spine in patients with chronic lower-back pain was significantly lower than that in the control group (P < 0.05). The riders had relatively mild chronic hip pain, but the Harris score was significantly lower than that of the control group (P<0.05). The JOA score of the equestrian rider’s waist significantly correlated with the Pfirrmann grading. However, the visual analog scale and Harris hip pain scores were not significantly correlated with imaging parameters. The root mean square amplitudes of the rectus abdominis, erector spinalis, rectus femoris, gluteus medius, and multifidus were greater in the riding position than in the normal sitting position (P < 0.05). Conclusions The cause of chronic lower-back pain in riders may be related to soft tissue overwork and lumbar degeneration. Changes in the lumbar-hip sagittal sequence pelvic and sacral inclination angles can reflect the degree of lumbar stiffness of the riders.