目的 本研究试图通过分析专业马术运动员和业余骑手腰椎及髋关节影像学资料,了解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 本研究中选取了27名上海市马术运动管理中心马术运动员或业余爱好者。按照病史分为慢性腰部疼痛组,慢性髋部疼痛组和正常组。收集他们髋腰部相关病史资料,髋腰部X线、MRI及核心肌群表面肌电测试。结果 慢性腰痛者腰椎JOA评分明显低于正常组(P＜0.05)。志愿者慢性髋关节疼痛相对较轻,但Harris评分明显低于正常组(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VAS和Harris评分与影像学参数无明显相关性。伴有慢性腰痛的18名志愿者中,有8名志愿者PI-LL>10°。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(RMS)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-髋的矢状位序列骨盆倾斜角和骶骨倾斜角的变化可反映马术运动员腰部僵硬程度。
: Objective To analyze the lumbar and hip imaging data of professional equestrian athletes and amateur riders to understand the explore of chronic diseases in the hip and waist of the rider. Methods Twenty-seven equestrian athletes or amateurs from Shanghai Equestrian Sports Management Center were selected. They were divided into chronic waist pain group, chronic hip pain group and normal group. Collect their hip and waist related medical history data, hip and waist X-ray, MRI and surface electromyography test of core muscle group. Results The JOA score of the lumbar spine of patients with chronic low back pain was significantly lower than that of the normal group (P＜0.05). The volunteers had relatively mild chronic hip pain, but the Harris score was significantly lower than that of the normal group (P＜0.05). The JOA score of the equestrian rider’s waist is significantly correlated with the Pfirrmann grading. However, the VAS and Harris scores of hip pain have no significant correlation with imaging parameters. Among the 18 volunteers with chronic low back pain, 8 volunteers had PI-LL>10°. The root mean square amplitude (RMS) of rectus abdominis, erector spinalis, rectus femoris, gluteus medius and multifidus in riding position were greater than those in normal sitting position (P＜0.05). Conclusion The cause of chronic waist pain for the riders may be mainly related to soft tissue overwork and lumbar degeneration. The changes in the lumbar-hip sagittal sequence pelvic inclination angle and sacral inclination angle can reflect the degree of lumbar stiffness of the riders.