頸椎症性神経根症患者における頸部伸筋群の脂肪浸潤と平衡機能との関係

• Published in: 理学療法学 Vol. 41; no. 2; pp. 66 - 74
• Main Authors: 光武 翼, 中田 裕治, 大石 豪, 堀川 悦夫
• Format: Journal Article
• Language: Japanese
• Published: Japanese Physical Therapy Association 2014; 公益社団法人日本理学療法士協会
• Subjects: 平衡機能; 筋肉内脂肪浸潤; 頸部多裂筋
• ISSN: 0289-3770; 2189-602X
• DOI: 10.15063/rigaku.kj00009352620

Purpose: This study aimed to clarify the association of muscle fat infiltration with cervical extensor muscle laterality and postural stability in patients with cervical spondylotic radiculopathy. Methods: We evaluated 20 patients with cervical spondylotic radiculopathy. The measure of the amount of fat within the muscles was obtained by the ratio of the pixel intensities of the upper trapezius and cervical multifidus muscles to the pixel intensity of a standardized region of intermuscular fat using magnetic resonance imaging. In the stabilometer test, postural sway determined by a shift in the center of pressure was measured in the upright position on a platform with the subject's eyes closed for 60s. We used two parameters for evaluation: locus length (LNG) and environmental area (EA). Spearman's rank and partial correlation test was used to analyze the association between fat indices in the upper trapezius and multifidus muscles and the results of the LNG. To determine whether any factor could the LNG, a step-wise multiple regression analysis was performed with LNG as the dependent variable and age, gender, body mass index, neck disability index and muscle fat infiltration with cervical extensor muscle laterality as independent variable. Results: Impaired cervical multifidus muscle had a significant correlation with LNG. The multiple regression analysis demonstrated that muscle fat infiltration with impaired cervical multifidus muscle was significant contributors to LNG, accounting for 62% of the variability. Conclusion: In the patients with cervical spondylotic radiculopathy, muscle fat infiltration with impaired cervical multifidus muscle possibly affected postural control. 【目的】本研究は,頸椎症性神経根症患者における頸部伸筋群の脂肪浸潤と平衡機能との関係について明確にすることを目的とした。【方法】対象は,本研究に同意が得られた頸椎症性神経根症患者20名とした。筋肉内脂肪の評価はMRIを使用し,両側の頸部多裂筋および僧帽筋上部線維におけるpixel信号強度を用いて算出した。平衡機能は重心動揺計を用いて閉眼静的立位時の総軌跡長と外周面積を計測した。総軌跡長と年齢,BMI,NDIおよび各筋の脂肪浸潤との関係を検証した。総軌跡長に影響を及ぼす因子を決定するために,総軌跡長を従属変数,年齢,性別,BMI,NDI,頸部伸筋群の脂肪浸潤を独立変数とした重回帰分析(stepwise method)を行った。【結果】頸部多裂筋障害側の脂肪浸潤と総軌跡長は高い相関が得られ,これらの寄与率は約62%であった。【結論】頸椎症性神経根症患者は,障害側における頸部多裂筋の筋肉内脂肪浸潤が平衡機能に影響を及ぼす可能性が示唆された。