内功推拿结合倒走治疗非特异性腰痛的临床研究
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摘要
目的:观察内功推拿结合倒走对非特异性腰痛(NLBP)患者疼痛及功能障碍的影响。方法:90例NLBP患者随机分为3组:常规推拿组(A组)、内功推拿组(B组)、内功结合倒走组(C组)各30例,用视觉类比VAS评分、JOA下腰痛评分、Oswestry腰椎功能障碍指数量表,观察患者疼痛、肢体功能以及生活质量的变化。结果:治疗后3组VAS评分较治疗前均有改善(P<0.05);治疗后C组VAS评分改善优于A组和B组(P<0.01);B组疗效优于A组(P<0.05),C组疗效优于A组和B组(P<0.01);C组ODI评分改善优于A组和B组(P<0.01)。结论:常规推拿、内功推拿、内功推拿结合倒走3种治疗方法均可以改善NLBP患者的疼痛、功能障碍以及生活质量,但内功推拿结合倒走的改善效果明显优于常规推拿和内功推拿。
Objective: To observe the effect of internal qigong tuina combined with reverse walking on pain and dysfunction of non-specific lumbar pain(NLBP) patients. Methods: A total of 90 patients with NLBP were randomly divided into three groups, routine tuina group(group A), the internal qigong tuina group(group B) and internal qigong tuina combined with reverse walking group(group C), 30 cases in each group. Visual Analogue Scale(VAS), Japanese Orthopaedic Association(JOA) Score on low back pain and Oswestry Disability Index(ODI)Scale were used to observe the difference of pain, limb function and life quality before and after the treatment.Results: VAS scores were all improved after treatment than before in three groups(P <0.05), and the effect of group C on VAS was better than that of group A and group B(P<0.01). Group B showed better efficacy than group A(P<0.05), and Group C showed better efficacy than group A and group B(P<0.01). Group C showed better effect on ODI than group A and group B(P<0.01). Conclusion: Routine tuina, internal qigong tuina and internal qigong tuina combined with reserve walking, all can improve pain, dysfunction and the quality of life on NLBP patients. And the improvement of internal qigong tuina combined with reserve walking is superior to routine tuina and internal qigong tuina.
Objective: To observe the effect of internal qigong tuina combined with reverse walking on pain and dysfunction of non-specific lumbar pain(NLBP) patients. Methods: A total of 90 patients with NLBP were randomly divided into three groups, routine tuina group(group A), the internal qigong tuina group(group B) and internal qigong tuina combined with reverse walking group(group C), 30 cases in each group. Visual Analogue Scale(VAS), Japanese Orthopaedic Association(JOA) Score on low back pain and Oswestry Disability Index(ODI)Scale were used to observe the difference of pain, limb function and life quality before and after the treatment.Results: VAS scores were all improved after treatment than before in three groups(P <0.05), and the effect of group C on VAS was better than that of group A and group B(P<0.01). Group B showed better efficacy than group A(P<0.05), and Group C showed better efficacy than group A and group B(P<0.01). Group C showed better effect on ODI than group A and group B(P<0.01). Conclusion: Routine tuina, internal qigong tuina and internal qigong tuina combined with reserve walking, all can improve pain, dysfunction and the quality of life on NLBP patients. And the improvement of internal qigong tuina combined with reserve walking is superior to routine tuina and internal qigong tuina.
引文
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[24]秦元,姚斐,尤艳利,等.12周传统健身功法少林内功锻炼对大学生体质的影响[J].中国运动医学杂志,2011,30(10):948-950.
[25]陈丽霞,华桂茹.下腰痛的评定及运动疗法[J].中华物理医学与康复杂志,2001,23(3):48-49.
[26] Lidstmm A, Zachtfsson M. Pysicaltherapy on low back painand sciatica[J].Stand J Rehabil Med,1970(2):37-42.
[2] Deyo R A,weinstein J N.Low back pain[J].N Eng J Med,2001(344):263-270.
[3] Wenig C M, Schmidt C O, Kohlmann T, et al. Costs of back pain in Germany[J].Eur J Pain,2009(13):280-286.
[4] Dagenais S, J Caro, S Haldeman. A systematic review of low back pain cost of illness studies in the United States and internationally[J].Spine J,2008,8(1):8-20.
[5] Henschke N. Prevalence of and screening for serious spinal pathology in patients presenting to primary care settings with acute low back pain[J].Arthritis Rheum,2009,60(10):3072-80..
[6] Maher C,M Underwood,R Buchbinder. Non-specific low back pain[J].Lancet,2017,389(10070):736-747.
[7]黄雷,李军汉.躯干等速肌力训练与腰腹肌功能锻炼治疗非特异性腰痛的疗效对比研究[J].中国康复医学杂志,2015,30(11):1148-1151.
[8]黄琪.增强核心肌群稳定性训练预防腰痛的发生[J].医疗装备,2015,28(12):75-76.
[9] Roger Chou,Amir Qaseem,Vicenza Snow,et al. Diagnosis and Treatment of Low Back Pain:A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society[J].Ann Intern Med,2007(147):478-491.
[10] Deyo RA,Dworkin SF,Amtmann D,et al. Report of the NIH Task Force on research standards for chronic low-back pain[J].Pain Medicine,2014,15(8):1249-1267.
[11]王勇,郭力群.内功推拿联合倒走锻炼治疗非特异性腰痛45例临床观察[J].河北中医,2013,35(11):1661-1662,1666.
[12]胡永善.下腰痛的生物力学特点及康复[J].颈腰痛杂志,2004,25(2):73-75.
[13] Bergmark A.Stability of the lumbar spine. A study in mechanical engineering[J].Acta Orthop Scand Suppl,1989(230):1-54.
[14] Bailey J F. From the international space station to the clinic:how prolonged unloading may disrupt lumbar spine stability[J]. Spine J,2018,18(1):7-14.
[15] Tesh K M, J S Dunn, J H. Evans The abdominal muscles and vertebral stability[J].Spine(Phila Pa 1976),1987,12(5):501-508.
[16]胡鸢,秦江,唐金树.腰椎稳定性训练治疗慢性非特异性腰痛的研究[J].中国疼痛医学杂志,2011,17(3):146-149.
[17] Hooper T L,Dunn D M,Props J E,et al. The effects of graded forward and backward walking on heart rate and oxygencon-sumption[J].J Orthop Sports Phys Ther,2004,34(2):65-71.
[18] Masumoto K,Takasuqi S,Hotta N,et a1. A comparison of muscle activity and heart fate response during backward and forward walking on an underwater treadmi U[J].Gait Pos ture,2007,25(2):222-228.
[19]吕晓梅,赵焕彬,张海涛.健身反向走的生物力学分析[J].中国体育科技,2008,44(4):139-143.
[20]吴宝平,闫松华,张宽,等.大学生不同运动方式下的足底压力分布研究[J].北京生物医学工程,2016,35(2):161-166,179.
[21]王新,舒适,方凡夫,等.慢性非特异性腰痛患者腰椎位置觉与腰肌耐力、疼痛的相关性[J].中国康复理论与实践,2017,23(7):820-823.
[22]邱燕春.运动训练性下腰痛患者肌肉及腰椎组织的生物力学变化[J].中国组织工程研究与临床康复,2007,11(49):9906-9909.
[23] Holland A E,Hill C J,Nehez E,et al. Does unsupported upper limb exercise training improve symptoms and quality of life for patients with chronic obstructive pulmonary disease[J].J Cardipolmon Rehabil,2004,24(6):422-427.
[24]秦元,姚斐,尤艳利,等.12周传统健身功法少林内功锻炼对大学生体质的影响[J].中国运动医学杂志,2011,30(10):948-950.
[25]陈丽霞,华桂茹.下腰痛的评定及运动疗法[J].中华物理医学与康复杂志,2001,23(3):48-49.
[26] Lidstmm A, Zachtfsson M. Pysicaltherapy on low back painand sciatica[J].Stand J Rehabil Med,1970(2):37-42.