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首页|期刊导航|中国康复理论与实践|在核心稳定训练基础上联合呼吸训练对慢性非特异性腰痛患者前馈控制的效果

在核心稳定训练基础上联合呼吸训练对慢性非特异性腰痛患者前馈控制的效果OA北大核心CSTPCD

Effect of respiratory training based on core stability training on feedforward control in patients with chronic non-specific low back pain

中文摘要英文摘要

目的 探讨在核心稳定训练基础上联合呼吸训练对慢性非特异性腰痛(CNLBP)患者前馈控制的效果. 方法 选取2022年1月至2023年3月嘉兴市第二医院就诊的CNLBP患者60例,随机分为对照组(n=30)和试验组(n=30).两组均进行健康宣教、物理因子治疗和核心稳定训练,试验组在此基础上增加呼吸训练,共4周.治疗前后,比较两组疼痛视觉模拟量表(VAS)评分、日本骨科协会量表(JOA)评分和Oswestry功能障碍指数(ODI)评分;采用表面肌电图检测腹横肌、多裂肌和肱三头肌(运动肌)的均方根植(RMS)和积分肌电值(iEMG),并计算腹横肌、多裂肌与肱三头肌之间的激活顺序、相对激活时间. 结果 治疗后,两组VAS评分、JOA评分和ODI评分均显著改善(|t|>8.515,P<0.001),试验组优于对照组(|t|>2.089,P<0.05);两组腹横肌RMS、多裂肌RMS、腹横肌iEMG、多裂肌iEMG均显著改善(|t|>18.831,P<0.001),试验组明显优于对照组(|t|>3.481,P<0.01);两组腹横肌和多裂肌均在运动肌之前激活,激活时间负值均显著增加(|t|>48.115,P<0.001),试验组明显优于对照组(|t|>3.229,P<0.01). 结论 联合呼吸训练有利于减轻CNLBP患者疼痛程度,降低腰椎功能障碍程度,改善肌肉激活顺序,加强前馈控制.

Objective To investigate the effect of respiratory training based on core stability training on feedforward control in pa-tients with chronic nonspecific low back pain(CNLBP). Methods A total of 60 patients with CNLBP in Jiaxing Second Hospital from January,2022 to March,2023 were ran-domly divided into control group(n=30)and experimental group(n=30).Both groups received health educa-tion,physical factor therapy and core stability training,while the experimental group received respiratory training in addition,for four weeks.Visual Analogue Scale(VAS)score,Japanese Orthopaedic Association low back pain(JOA)score and Oswestry Dysfunction Index(ODI)were compared between two groups before and after treat-ment,while surface electromyography was used to detect the root mean square(RMS)and integrated electromy-ography(iEMG)of transversus abdominis,multifidus and triceps(movement muscles),and the activation se-quence and relative activation time of transversus abdominis,multifidus and triceps were calculated. Results After treatment,the scores of VAS,JOA and ODI improved significantly in both groups(|t|>8.515,P<0.001),and the scores were better in the experimental group than in the control group(|t|>2.089,P<0.05).RMS and iEMG of transversus abdominis and multifidus improved significantly after treatment in both groups(|t|>18.831,P<0.001),and were significantly better in the experimental group(|t|>3.481,P<0.05).The transversus abdominis and multifidus in both groups were activated before the movement muscles,and the relative activation time of transversus abdominis and multifidus increased in negative(|t|>48.115,P<0.001),the experimental group being better(|t|>3.229,P<0.05). Conclusion Combination of core stability training and respiratory training is beneficial in reducing the pain of patients with CNLBP,reducing the lumbar dysfunction,improving the order of muscle activation,and strengthening feed-forward control.

陈灵慧;郑琦;李岩;傅建明;曾明;金鑫;陆晶晶

嘉兴市第二医院康复医学中心,浙江嘉兴市 314000

临床医学

慢性非特异性腰痛呼吸训练前馈控制表面肌电

chronic nonspecific low back painrespiratory trainingfeedforward controlsurface electromyography

《中国康复理论与实践》 2024 (006)

737-744 / 8

浙江省医药卫生科技计划项目(No.2022KY379;No.2023KY1204) Supported by Zhejiang Province Medical and Health Technology Plan(No.2022KY379;No.2023KY1204)

10.3969/j.issn.1006-9771.2024.06.015

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