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当院における腰痛例の筋肉の血流動態について

当院における腰痛例の筋肉の血流動態について. 三愛病院　整形外科 桑原忠義　　 佐々木一成　　　 竹田浩樹　　　済陽輝久. Purpose. To evaluate objectively the trunk muscle hemodynamics in patient with chronic low back pain (LBP), by use of near-infrared spectroscopy (NIRS). Materials. Subjects LBP Healthy Cases 57 20 Sex all female all female

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当院における腰痛例の筋肉の血流動態について

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  1. 当院における腰痛例の筋肉の血流動態について当院における腰痛例の筋肉の血流動態について 三愛病院　整形外科 桑原忠義　　 佐々木一成　　　竹田浩樹　　　済陽輝久

  2. Purpose To evaluate objectively the trunk muscle hemodynamics in patient with chronic low back pain (LBP), by use of near-infrared spectroscopy (NIRS)

  3. Materials SubjectsLBPHealthy Cases5720 Sexall femaleall female Age (ave,) 16～80 (48.1) 21～62 (45.1)

  4. Method • Performed treatment during 15 sec., by use of low frequency current therapeutic machine (TENS21R ,Homann-ion, Japan) frequency(Hz) 300 200 100 80 50 20 10 5 5 10 15 time(sec.) Dynamic pattern of frequency

  5. 2 Measured the changes in regional saturation oxygen(rSO2)and hemoglpbin index(HbI), by use of NIRS(TOS-96R,Tostec,Japan)

  6. Evaluation details 1 Measurements of Visualanalogscale (VAS) change for LBP subjects after treatment 2 The amount of relative change between LBP subjects and healthy subjects in rSO2 ,HbI before treatment

  7. Results

  8. rSO2in healthy subjects n=20 before after NS ： ： Left Right 65.75±4.75 65.21±6.37 60.15±5.85 59.70±6.11 NS (T-test)

  9. HbIin healthy subjects n=20 before after NS ： ： Left Right 0.42±0.13 0.45±0.14 0.43±0.08 0.45±0.14 ： ：右 NS (T-test)

  10. VAS in LBP subjects n=57 before after **P<0.01 ** 5.2±2.4 3.1±2.1 VAS ： ** (T-test)

  11. rSO2in LBP subjects n=57 ** before after **P<0.01 ** ： ： Left Right 62.17±7.74 59.43±7.51 64.56±5.83 60.09±6.52 ：左 ：右 ** (T-test)

  12. HbIin LBP subjects n=57 before after **P<0.01 ** ： ： Left Right 0.43±0.18 0.45±0.18 0.45±0.18 0.51±0.27 ：左 ：右 ** (T-test)

  13. Discussion

  14. Healthy vs LBP groups There was significant different in oxygen use but not blood volume between healthy and LBP subjects at the tissue level. Kovacs KM 2001

  15. Relationship between healthy and LBP groups The elector spinae muscle’s thickness, tissue blood volume, and its oxygenation are increased during extension and decreased during flexion shown by NIRS Masuda T 2005

  16. Intramuscular pressure With increasing age, There was a decrease of oxygenated hemoglogin rise associated with muscle contraction during lumber extension. Patients with chronic low back pain showed similar patterns to elderly subjects. Oxygenated hemoglogin fall during flexion that seemed to be related to the intramuscular pressure increases was significantly higher than healthy subjects.Sakai Y2005

  17. Muscle oxygenation-blood volume changes LBP Subjects : Muscle oxygenation and blood volume recovery time were slower than healthy subjects. That suggest that erector spinae aerobic capacity can influence muscle endurance performance. Kell RT 2006

  18. LBP subjects After treatment, it was neccesory to provide oxygen more according to increasing blood volume Oxygen supply was not enough, because of muscle endurance performance was limited rSO2was decrease

  19. Healty subjects After treatment, it was neccesory to provide oxygen more according to increasing blood volume Oxygen supply was enough, because of muscle endurance performance was retain rSO2was no change

  20. Conclusion

  21. 1 Evaluated objectively the trunk muscle hemodynamics in patient with LBP, by use of NIRS It was suspected that LBP subjects was showed muscle endurance performance was limited, compared with healthy subjects These observations suggest that factor of chronic low back pain can influence muscle rSO2

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