腰椎间盘突出症康复治疗中腰部核心肌力训练的临床评估
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摘要
为了系统评估腰椎间盘突出症患者康复治疗中腰部核心肌力训练治疗的临床疗效,本研究选取2012年1月至2014年1月研究者所在医院就诊的150例腰椎间盘突出症腰肌锻炼康复治疗患者,随机分成A、B两组。A组患者进行腰部核心肌力训练治疗,即核心肌力组;B组患者给予传统腰肌功能锻炼治疗,即传统腰肌锻炼组;康复治疗均在医生指导下进行,所有患者每天早晚各锻炼1次,每次持续15 min,共训练治疗12周。所有患者均定期随访,治疗后6周和12周分别通过VAS疼痛评分、JOA腰椎功能评分和ODI腰椎功能评分变化进行效果评价。治疗后6周,核心训练组VAS评分平均(5.0±1.5)分,JOA评分平均(21.4±2.6)分,ODI评分平均(29.5±8.0)分;但与传统腰肌训练组比较无明显差别(p>0.05);治疗后12周核心肌力锻炼组疼痛症状缓解明显,VAS平均(2.9±1.2)分;腰椎功能改善明显JOA评分平均(25.2±3.2)分,ODI评分平均(38.8±9.4)分;与传统腰肌训练组比较差异具有统计意义(p<0.05)。本研究说明腰肌核心肌力训练长期锻炼效果好于传统腰肌训练。
In this study, in order to systematically evaluate the clinical efficacy of lumbar core muscle strength training in the rehabilitation treatment of lumbar disc herniation, we selected 150 patients with lumbar disc herniation treated by lumbar core muscle strength training in our hospital from January 2012 to January 2014 and randomly divided them into group A and group B. Group A patients were treated with lumbar core muscle training, so that was the core muscle strength group, and group B patients were given traditional lumbar muscle functional exercise, so that was the traditional lumbar muscle exercise group. The rehabilitation treatment was all conducted under the guidance of doctor, and all the patients exercised once a day in the morning evening, lasting 15 min for each time, and for 12 weeks in total. All patients were followed up regularly and at the time of 6 weeks and 12 weeks post-treatment, the clinical effect was evaluated by VAS pain score, JOA lumbar function score and ODI lumbar function score. 6 weeks after treatment, the average scores of VAS, JOA and ODI of the core muscle group were 5.0 ±1.5, 21.4±2.6, and29.5±8.0, respectively, which were not significantly difference from those of the traditional lumbar muscle exercise group(p>0.05). 12 weeks after treatment, the pain symptoms of core muscle strength exercise group were relieved obviously, and the average VAS score was 2.9±1.2; lumbar function was improved significantly and the average JOA score was 25.2±3.2, and average ODI score was 38.8±9.4; compared with the traditional lumbar muscle exercise group, the difference was statistically significant(p<0.05). The results of this study showed that long-term exercise effect of strength lumbar core muscle exercise might be better than that of traditional lumbar muscle exercise.
In this study, in order to systematically evaluate the clinical efficacy of lumbar core muscle strength training in the rehabilitation treatment of lumbar disc herniation, we selected 150 patients with lumbar disc herniation treated by lumbar core muscle strength training in our hospital from January 2012 to January 2014 and randomly divided them into group A and group B. Group A patients were treated with lumbar core muscle training, so that was the core muscle strength group, and group B patients were given traditional lumbar muscle functional exercise, so that was the traditional lumbar muscle exercise group. The rehabilitation treatment was all conducted under the guidance of doctor, and all the patients exercised once a day in the morning evening, lasting 15 min for each time, and for 12 weeks in total. All patients were followed up regularly and at the time of 6 weeks and 12 weeks post-treatment, the clinical effect was evaluated by VAS pain score, JOA lumbar function score and ODI lumbar function score. 6 weeks after treatment, the average scores of VAS, JOA and ODI of the core muscle group were 5.0 ±1.5, 21.4±2.6, and29.5±8.0, respectively, which were not significantly difference from those of the traditional lumbar muscle exercise group(p>0.05). 12 weeks after treatment, the pain symptoms of core muscle strength exercise group were relieved obviously, and the average VAS score was 2.9±1.2; lumbar function was improved significantly and the average JOA score was 25.2±3.2, and average ODI score was 38.8±9.4; compared with the traditional lumbar muscle exercise group, the difference was statistically significant(p<0.05). The results of this study showed that long-term exercise effect of strength lumbar core muscle exercise might be better than that of traditional lumbar muscle exercise.
引文
Akuthota V.,and Nadler S.F.,2004,Core strengthening,Arch.Phys.Med.Rehabil.,85(1):86-92
Anderson K.,and Beam D.G.,2005,Trunk muscle activity increases with unstable squat movements,Canadian Journal of Applied Physiolngy,30(1):33-45
Anderson K.G.,and Beam D.G.,2004,Maintenanee of EMG activity and loss of force output with instability,J.Strength.Cond.Res.,18(3):637-640
Chaléat-Valayer E.,Denis A.,Abelin-Genevois K.,Zelmar A.,Siani-Trebern F.,Touzet S.,Bergeret A.,Colin C.,and Fassier J.B.,2016,Long-term effectiveness of an educational and physical intervention for preventing low-back pain recurrence:a randomized controlled trial,Scand.J.Work Environ.Health,42(6):510-519
Hart L.,2006,Exercise therapy for nonspecific low back pain:a meta-analysis,Clin.J.Sport Med.,16(2):189-190
Hodges P.W.,and Richardson C.A.,1997,Contraction of the abdominal muscles associated with movement of the lower limb,Physical Therapy,77(2):132-144
King M.A.,2000,Core stability:creating a foundation for functional rehabilitation,Athl.Therapy Today,5(2):6-13
Kirkaldy-Willis W.H.,Burns S.H.,and Aker P.D.,1993,Elastic supports and body suits effective energy-storing garments,J.Back Musculoskelet.Rehabil.,3(3):12-20
Ma L.,Zhang Y.,Wang D.,and Xue W.,2006,Clinical curative effect analysis of waist core strength training in the rehabilitation treatment of patients with lumbar disc herniation,Zhongguo Shequ Yishi(Chinese Community Doctors),31(25):179-181(马磊,张焱,王丹,薛薇,2006,腰部核心肌力训练在腰椎间盘突出症康复治疗中的临床疗效分析,中国社区医师,31(25):179-181)
Newcomer K.L.,Jacobson T.D.,Gabriel D.A.,Larson D.R.,Brey R.H.,and An K.N.,2002,Muscle aetiration patterns in subjcts with and without low back pain,Archives of Physteal Medicine and Rehabilitation,83(6):816-821
Panjabi M.M.,2003,Clinical spinal instability and low back pain,J.Electromyogr.Kinesiol.,13(4):371-379
Tschugg A.,Loseher W.N.,Hartmann S.,Neururer S.,Wildauer M.,and ThoméC.,2015,Gender influences radicularpain perception in patients with lumbar disc herniation,J.Womens Health.,24(9):771-776
Willardson J.M.,2007,Core stability training:applications to sports conditioning programs,J.Strength Condit.Res.,21(3):979-985
Willson J.D.,Dougherty C.P.,Ireland M.L.,and Davis I.M.,2005,Core stability and its relationship to lower extremity function and injury,J.Am.Arad.Orthop.Surg.,l3(5):316-325
Anderson K.,and Beam D.G.,2005,Trunk muscle activity increases with unstable squat movements,Canadian Journal of Applied Physiolngy,30(1):33-45
Anderson K.G.,and Beam D.G.,2004,Maintenanee of EMG activity and loss of force output with instability,J.Strength.Cond.Res.,18(3):637-640
Chaléat-Valayer E.,Denis A.,Abelin-Genevois K.,Zelmar A.,Siani-Trebern F.,Touzet S.,Bergeret A.,Colin C.,and Fassier J.B.,2016,Long-term effectiveness of an educational and physical intervention for preventing low-back pain recurrence:a randomized controlled trial,Scand.J.Work Environ.Health,42(6):510-519
Hart L.,2006,Exercise therapy for nonspecific low back pain:a meta-analysis,Clin.J.Sport Med.,16(2):189-190
Hodges P.W.,and Richardson C.A.,1997,Contraction of the abdominal muscles associated with movement of the lower limb,Physical Therapy,77(2):132-144
King M.A.,2000,Core stability:creating a foundation for functional rehabilitation,Athl.Therapy Today,5(2):6-13
Kirkaldy-Willis W.H.,Burns S.H.,and Aker P.D.,1993,Elastic supports and body suits effective energy-storing garments,J.Back Musculoskelet.Rehabil.,3(3):12-20
Ma L.,Zhang Y.,Wang D.,and Xue W.,2006,Clinical curative effect analysis of waist core strength training in the rehabilitation treatment of patients with lumbar disc herniation,Zhongguo Shequ Yishi(Chinese Community Doctors),31(25):179-181(马磊,张焱,王丹,薛薇,2006,腰部核心肌力训练在腰椎间盘突出症康复治疗中的临床疗效分析,中国社区医师,31(25):179-181)
Newcomer K.L.,Jacobson T.D.,Gabriel D.A.,Larson D.R.,Brey R.H.,and An K.N.,2002,Muscle aetiration patterns in subjcts with and without low back pain,Archives of Physteal Medicine and Rehabilitation,83(6):816-821
Panjabi M.M.,2003,Clinical spinal instability and low back pain,J.Electromyogr.Kinesiol.,13(4):371-379
Tschugg A.,Loseher W.N.,Hartmann S.,Neururer S.,Wildauer M.,and ThoméC.,2015,Gender influences radicularpain perception in patients with lumbar disc herniation,J.Womens Health.,24(9):771-776
Willardson J.M.,2007,Core stability training:applications to sports conditioning programs,J.Strength Condit.Res.,21(3):979-985
Willson J.D.,Dougherty C.P.,Ireland M.L.,and Davis I.M.,2005,Core stability and its relationship to lower extremity function and injury,J.Am.Arad.Orthop.Surg.,l3(5):316-325
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