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DOI: 10.1055/s-2007-963466
© Georg Thieme Verlag KG Stuttgart · New York
Assessment und Rehabilitation der stabilisierenden Funktion des M. psoas major[1]
Assessment and Rehabilitation of the Stabilising Function of Psoas Major MusclePublication History
Publication Date:
11 September 2007 (online)
Zusammenfassung
Der M. psoas major als der größte Muskel im unteren LWS-Bereich trägt zur körperlichen Stabilität bei. Die vorliegende Arbeit stellt das klinische Assessment und die Rehabilitationsstrategien zur stabilisierenden Funktion des M. psoas major dar. Ein besseres Verständnis dieser Funktion kann die klinische Behandlung von damit im Zusammenhang stehenden Dysfunktionen verbessern.
Abstract
Psoas major muscle as the largest muscle at lower levels of lumbar spine provides physical stability. This article portrays clinical assessment and rehabilitation strategies of the stability function of psoas major. Better understanding of its function may improve clinical management of related dysfunction.
Schlüsselwörter
M. psoas major - stabilisierende Funktion - Assessment - Rehabilitation
Key words
psoas major muscle - stabilising function - assessment - rehabilitation
1 Die Arbeit ist das „Update” einer älteren Abhandlung, die der Autor zusammen mit Mark Comerford und Pete Emerson verfasst hat. Der Autor würdigt an dieser Stelle ausdrücklich den Beitrag und die Ideen dieser beiden Personen.
Literatur
- 1 Andersson E, Oddsson L, Grundstrom H. et al . The role of the psoas and iliacus muscles for stability and movement of the lumbar spine, pelvis and hip. Scand J Med Sci Sports. 1995; 5 10-16
- 2 Andersson E A, Nilsson J, Thorstensson A. Intramuscular EMG from the hip flexor muscles during human locomotion. Acta Physiol Scand. 1997; 161 361-370
- 3 Bachrack R M, Nicelorra J, Winuk C. The relationship of low back pain to psoas insufficiency. Journal of Orthopedic Medicine. 1991; 13 34-40
- 4 Barker K L, Shamley D R, Jackson D. Changes in the cross sectional area of multifidus and psoas in patients with unilateral back pain. Spine. 2004; 29 E515-E519
- 5 Bartlink D L. The role of intra-abdominal pressure in relieving the pressure on the lumbar vertebral discs. Journal of Bone and Joint Surgery. 1957; 39B 718-725
- 6 Bogduk N, Pearcy M, Hadfield G. Anatomy and biomechanics of psoas major. Clinical Biomechanics. 1992; 7 109-119
- 7 Comerford M J, Mottram S L. Movement and stability dysfunction - contemporary developments. Manual Therapy. 2001; 6 15-26
- 8 Dangaria T R, Naesh O. Changes in cross-sectional area of psoas major muscle in unilateral sciatica caused by disc herniation. Spine. 1998; 23 928-931
- 9 Dostal W F, Soderberg G L, Andrews J G. Actions of hip muscles. Physical Therapy. 1986; 66 351-361
- 10 Ferreira P H, Ferreira M L, Maher C G. et al . Specific stabilization exercise for spinal and pelvic pain: A systematic review. Australian Journal of Physiotherapy. 2006; 52 79-88
- 11 Gibbons S GT. A review of the anatomy, physiology and function of psoas major: A new model of stability. Proceedings of the 11th Annual National Orthopaedic Symposium - The Tragic Hip: Trouble in the Lower Quadrant,, Nov 6 - 7 Halifax/Canada; 1999
- 12 Gibbons S GT. The model of psoas major stability function. Proceedings of the 1st International Conference on Movement Dysfunction. Sept 21 - 23 Edinburgh/Scotland; 2001
- 13 Gibbons S GT, Pelley B, Molgaard J. Biomechanics and stability mechanisms of psoas major. Proceedings of the 4th Interdisciplinary World Congress on Low Back Pain. November 9 - 11 Montreal/Canada; 2001
- 14 Gibbons S GT, Comerford M J, Emerson P. Rehabilitation of the stability function of psoas major. Orthopaedic Division Review. 2002; 2 7-16
- 15 Gibbons S GT. A Hypothetical Link between Psychosocial Factors, Pain and Sensory Motor Function Using a Biomechanical Model of Psoas Major (MSc Thesis in Health Ergonomics). Surrey; University of Surrey 2004
- 16 Gibbons S GT. Muscle function - A Critical Evaluation. Proceedings of the 2nd International Conference on Movement Dysfunction - Pain and Performance: Evidence & Effect. September 23 - 25 Edinburgh/Scotland; 2005
- 17 Gibbons S GT. A randomized controlled trial of specific motor control stability exercise versus specific directional exercises in acute low back pain. New directions towards prognostic indicators (submitted for publication 2007)
- 18 Gibbons S GT, Holmes M WR, Grandy C. et al .Altered hip and trunk muscle recruitment in subjects with chronic low back pain during a specific exercise for the psoas major muscle (submitted for publication 2007).
- 19 Gracovetsky S, Farfan H F, Lamy C. The mechanism of the lumbar spine. Spine. 1981; 6 249-262
- 20 Hides J A, Stokes M J, Saide M. et al . Evidence of lumbar multifidus muscle wasting ipsilateral to symptoms in patients with acute/subacute low back pain. Spine. 1994; 19 165-172
- 21 Hodges P W, Richardson C A, Gandevia S C. Contractions of specific abdominal muscles in postural tasks are affected by respiratory maneuvers. Journal of Applied Physiology. 1997; 83 753-760
- 22 Hodges P, Kaigle Holm A, Holm S. et al . Intervertebral stiffness of the spine is increased by evoked contraction of transversus abdominis and the diaphragm: in vivo porcine studies. Spine. 2003; 28 2594-2601
- 23 Janevic J, Ashton-Miller J A, Schultz A B. Large compressive pre-loads decrease lumbar motion segment flexibility. Journal of Orthopedic Research. 1991; 19 228-236
- 24 Juker D, McGill S, Kropf P. et al . Quantitative intramuscular myoelectric activity of lumbar portions of psoas and the abdominal wall during a wide variety of tasks. Medicine & Science in Sports & Exercise. 1998; 30 301-310
- 25 Jull G. Deep cervical flexor muscle dysfunction in whiplash. Journal of Musculoskeletal Pain. 2000; 8 143-154
- 26 Maher C G, Latimer J, Hodges P W. et al . The effect of motor control exercise versus placebo in patients with chronic low back pain. BMC Musculoskeletal Disorders. 2005; 6 54
- 27 McGill S M, Patt N, Norman R W. Measurement of the trunk musculature of active males using CT scan radiography: Implications for force and moment generating capacity about the L4 / L5 joint. Journal of Biomechanics. 1988; 21 329-341
- 28 McGill S. Low Back Disorders. Evidence-Based Prevention and Rehabilitation. Champaign; Human Kinetics 2002
- 29 Morris J M, Lucas D B, Bresler B. Role of the trunk in stability of the spine. The Journal of Bone and Joint Surgery. 1961; 43A 327-351
- 30 Moseley G L, Hodges P W, Gandevia S C. Deep and superficial fibers of the lumbar multifidus muscle are differentially active during voluntary arm movements. Spine. 2002; 27 E29-E36
- 31 Nachemson A. The possible importance of the psoas muscle for stabilisation of the lumbar spine. Acta Orthopaedica Scandinavica. 1968; 39 47-57
- 32 O’Sullivan P B, Twomey L, Allison G. et al . Altered patterns of abdominal muscle activation in patients with chronic low back pain. Australian Journal of Physiotherapy. 1997; 43 91-98
- 33 Rab G T, Chao E YS, Stauffer R N. Muscle force analysis of the lumbar spine. Orthopaedic Clinics of North America. 1977; 8 193-199
- 34 Richardson C, Hodges P, Hides. Therapeutic Exercise for Lumbopelvic Stabilization. Edinburgh; Churchill Livingstone 2004 2nd ed
- 35 Rothstein J, Roy S, Wolf S. The Rehabilitation Specialist’s Handbook. Philadelphia; F. A. Davis 1991
- 36 Richardson C, Jull G, Hides J. et al .Therapeutic Exercise for Spinal Stabilisation: Scientific basis and practical techniques. Edinburgh; Churchill Livingstone 1999
- 37 Richardson C A, Snijders C J, Hides J A. The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain. Spine. 2002; 27 399-405
- 38 Rothstein J M. Muscle biology. Clinical Considerations. Physical Therapy. 1982; 62 823-830
- 39 Sahrmann S A. Diagnosis and Treatment of Movement Impairment Syndrome. St. Louis; Mosby 2002
- 40 Santaguida P L, McGill S M. The psoas major: a three dimensional geometric study. Journal of Biomechanics. 1995; 28 339-345
- 41 Sapsford R R, Hodges P W, Richardson C A. et al . Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurology and Urodynamics. 2001; 20 31-42
- 42 Shirley D, Hodges P W, Eriksson A EM. et al . Spinal stiffness changes throughout the respiratory cycle. Journal of Applied Physiology. 2003; 95 1467-1475
- 43 Snijders C J, Vleeming A, Stoeckart R. et al . Biomechanical modelling of sacroiliac joint stability in different postures. Spine: State of the Art Reviews. 1995; 9 419-432
- 44 Williams P L, Warwick R, Dyson M. et al .Grey’s Anatomy. Edinburgh; Churchill Livingstone 1989 37th ed
- 45 Yoshio M, Murakami G, Sato T. et al . The function of the psoas major muscle: passive kinetics and morphological studies using donated cadavers. Journal of Orthopaedic Science. 2002; 7 199-207
1 Die Arbeit ist das „Update” einer älteren Abhandlung, die der Autor zusammen mit Mark Comerford und Pete Emerson verfasst hat. Der Autor würdigt an dieser Stelle ausdrücklich den Beitrag und die Ideen dieser beiden Personen.
Sean G. T. Gibbons, BSc (Hons), PT MSc Ergonomics, MCPA
Direktor Kinetic Control Canada Ltd., Direktor und klinischer Leiter Stability Physiotherapy, Professional Associate, School of Human Kinetics and Recreation, Memorial University of Newfoundland
CDN-St. John’s
Neufundland
Email: gibbi@nfld.com