悬吊运动训练治疗慢性非特异性腰痛的效果
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摘要
目的观察悬吊运动训练结合针刺对慢性非特异性腰痛(CNLBP)的疗效。方法 2017年2月至2018年2月,将84例CNLBP患者按随机数字表法分为对照组和观察组,每组42例。观察组给予悬吊运动训练结合针刺,对照组仅予针刺。分别于治疗前、治疗1个月和3个月随访时对患者进行视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)评价。结果治疗前两组VAS、ODI评分无显著性差异(t <1.638, P> 0.05)。治疗1个月和3个月随访时,两组VAS、ODI评分较治疗前明显降低(P <0.01)。3个月随访时,对照组VAS、ODI评分与治疗1个月时比较升高(t> 2.219, P <0.05);观察组无显著性差异(t <1.738, P> 0.05)。治疗1个月,观察组VAS、ODI评分显著低于对照组(t> 3.535, P <0.001)。结论悬吊运动训练结合针刺治疗CNLBP疗效优于单纯针刺,且疗效具有持续性。
Objective To observe the effect of sling exercise therapy on chronic nonspecific low back pain.Methods From February, 2017 to February, 2018, 84 patients with chronic nonspecific low back pain were randomly divided into control group and observation group, with 42 cases in each group. The observation group was treated with the combination of the sling exercise therapy and acupuncture, and the control group only received acupuncture. They were assessed with Visual Analogue Scale(VAS) and Oswestry Disability Index(ODI) before treatment, one month after treatment and at three-month follow-up.Results Before treatment, there was no statistically significant difference in the scores of VAS and ODI between two groups(t < 1.638, P > 0.05). One month after treatment and at three-month follow-up, the scores of VAS and ODI decreased in both groups(P < 0.01). Compared with one month after treatment, the scores of VAS and ODI increased in the control group at three-month follow-up(t > 2.219, P < 0.05), however, no difference was found in the observation group(t < 1.738, P > 0.05). One month after treatment, the scores of VAS and ODI were lower in the observation group than in the control group(t > 3.535, P < 0.001).Conclusion Sling exercise therapy combined with acupuncture is superior to simple acupuncture in treating chronic nonspecific low back pain, and the curative effect is persistent.
Objective To observe the effect of sling exercise therapy on chronic nonspecific low back pain.Methods From February, 2017 to February, 2018, 84 patients with chronic nonspecific low back pain were randomly divided into control group and observation group, with 42 cases in each group. The observation group was treated with the combination of the sling exercise therapy and acupuncture, and the control group only received acupuncture. They were assessed with Visual Analogue Scale(VAS) and Oswestry Disability Index(ODI) before treatment, one month after treatment and at three-month follow-up.Results Before treatment, there was no statistically significant difference in the scores of VAS and ODI between two groups(t < 1.638, P > 0.05). One month after treatment and at three-month follow-up, the scores of VAS and ODI decreased in both groups(P < 0.01). Compared with one month after treatment, the scores of VAS and ODI increased in the control group at three-month follow-up(t > 2.219, P < 0.05), however, no difference was found in the observation group(t < 1.738, P > 0.05). One month after treatment, the scores of VAS and ODI were lower in the observation group than in the control group(t > 3.535, P < 0.001).Conclusion Sling exercise therapy combined with acupuncture is superior to simple acupuncture in treating chronic nonspecific low back pain, and the curative effect is persistent.
引文
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[14]李祖虹,刘琦.核心稳定性训练治疗腰椎病患者的疗效观察[J].中华物理医学与康复杂志,2014,36(11):864-866.
[15]刘洪举,朱思刚,丘云锋,等.腰椎核心稳定性训练结合电针治疗慢性非特异性腰痛的疗效观察[J].中国康复,2015,30(4):296-297.
[16]于瑞,王楚怀,潘翠环,等.悬吊运动疗法治疗慢性非特异性下腰痛后站立位腰屈伸运动表面肌电信号的变化[J].中国康复理论与实践,2015,21(8):943-946.
[17]朱雯丽,徐道明,刘静,等.电针结合核心肌群训练治疗非特异性下腰痛的疗效观察[J].中国康复,2016,31(4):283-285.
[18]Lee N K,Kwon J W,Son S M,et al.Changes of plantar pressure distributions following open and closed kinetic chain exercise in patients with stroke[J].NeuroRehabilitation,2013,32(2):385-390.
[19]孙戴,林德快,蔡涵,等.推拿结合悬吊运动训练对慢性非特异性腰痛的临床疗效观察[J].颈腰痛杂志,2014,35(2)134-136.
[20]Prieske O,Muehlbauer T,Borde R,et al.Neuromuscular and athletic performance following core strength training in elite youth soccer:role of instability[J].Scand J Med Sci Sports2016,26(1):48-56.
[21]高琼璧.针刺治疗腰痛分子机制的探讨[D].广州:广州中医药大学,2000.
[22]王华,杜元灏.针灸学[M].北京:中国中医药出版社,2014232-233.
[23]金鑫,朱荣光.电针结合推拿治疗腰椎间盘突出症31例临床观察[J].江苏中医药,2014,46(11):53-54.
[24]张梦丽.电针配合中频治疗腰椎间盘突出症疗效观察[J]中医临床研究,2015,32(7):28-30.
[25]王轩,程为平,于致顺,等.电针配合电鍉针罐治疗腰背筋膜疼痛症候群疗效观察[J].上海针灸杂志,2016,35(1):63-65.
[2]Imamura M,Imamura S T,Targino R A,et al.Paraspinous lidocaine injection for chronic nonspecific low back pain:a randomized controlled clinical trial[J].J Pain,2016,17(5):569-576.
[3]Delitto A,George S Z,Van Dillen L R,et al.Low back pain[J]J Orthop Sports Phys Ther,2012,42(4):A1-A57.
[4]李志新,郭险峰.社区骨科康复手册[M].北京:人民军医出版社,2011:141-142.
[5]张雪艳,卓春萍.平衡针治疗腰痛的临床疗效观察[J].中国康复医学杂志,2009,24(7):635-637.
[6]Tsao H,Hodges P W.Immediate changes in feedforward postural adjustments following voluntary motor training[J].Exp Brain Res,2007,181(4):537-546.
[7]Sung D H,Yoon S D,Park G D.The effect of complex rehabilitation training for 12 weeks on trunk muscle function and spine deformation of patients with SCI[J].J Phys Ther Sci,2015,27(3):951-954.
[8]Trampas A,Mpeneka A,Malliou V,et al.Immediate effects of core-stability exercises and clinical massage on dynamic-balance performance of patients with chronic specific low back pain[J].J Sport Rehabil,2014,12(4):373-383.
[9]胡鹫,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.
[10]Mannion A F,Helbling D,Pulkovski N,et al.Spinal segmental stabilisation exercises for chronic low back pain:programme adherence and its influence on clinical outcome[J]Eur Spine J,2009,18(12):1881-1891.
[11]屠建莹,任筱舒,陆博逊.核心力量训练对脑干卒中患者的影响[J].中华物理医学与康复杂志,2013,35(9):747-749.
[12]曾勇,邹佳华,邓光锐,等.核心肌群训练对慢性非特异性下腰痛的疗效观察[J].中国实用医药,2013,8(10):252-253.
[13]Ren D J,Liu X M,Du S Y,et al.Percutaneous nucleoplasty using coblation technique for the treatment of chronic nonspecific low back pain:5-year follow-up results[J].Chin Med J(Engl),2015,128(14):1893-1897.
[14]李祖虹,刘琦.核心稳定性训练治疗腰椎病患者的疗效观察[J].中华物理医学与康复杂志,2014,36(11):864-866.
[15]刘洪举,朱思刚,丘云锋,等.腰椎核心稳定性训练结合电针治疗慢性非特异性腰痛的疗效观察[J].中国康复,2015,30(4):296-297.
[16]于瑞,王楚怀,潘翠环,等.悬吊运动疗法治疗慢性非特异性下腰痛后站立位腰屈伸运动表面肌电信号的变化[J].中国康复理论与实践,2015,21(8):943-946.
[17]朱雯丽,徐道明,刘静,等.电针结合核心肌群训练治疗非特异性下腰痛的疗效观察[J].中国康复,2016,31(4):283-285.
[18]Lee N K,Kwon J W,Son S M,et al.Changes of plantar pressure distributions following open and closed kinetic chain exercise in patients with stroke[J].NeuroRehabilitation,2013,32(2):385-390.
[19]孙戴,林德快,蔡涵,等.推拿结合悬吊运动训练对慢性非特异性腰痛的临床疗效观察[J].颈腰痛杂志,2014,35(2)134-136.
[20]Prieske O,Muehlbauer T,Borde R,et al.Neuromuscular and athletic performance following core strength training in elite youth soccer:role of instability[J].Scand J Med Sci Sports2016,26(1):48-56.
[21]高琼璧.针刺治疗腰痛分子机制的探讨[D].广州:广州中医药大学,2000.
[22]王华,杜元灏.针灸学[M].北京:中国中医药出版社,2014232-233.
[23]金鑫,朱荣光.电针结合推拿治疗腰椎间盘突出症31例临床观察[J].江苏中医药,2014,46(11):53-54.
[24]张梦丽.电针配合中频治疗腰椎间盘突出症疗效观察[J]中医临床研究,2015,32(7):28-30.
[25]王轩,程为平,于致顺,等.电针配合电鍉针罐治疗腰背筋膜疼痛症候群疗效观察[J].上海针灸杂志,2016,35(1):63-65.