摘要
目的 分析探讨腰椎间盘突出症患者核心稳定性训练治疗前后腰部肌肉表面肌电信号变化特征及其疗效.方法 邵逸夫医院康复医学科收集38例诊断明确且符合纳入排除标准的腰椎间盘突出症患者,采用随机数字表法将患者分为训练组和对照组,每组19例,对照组仅接受2周常规牵引理疗治疗,训练组在接受2周常规牵引理疗治疗后,再进行2周腰背肌核心稳定性训练.所有患者均在治疗前和治疗4周时（治疗后）进行VAS评分、JOA下背痛评分及表面肌电图（sEMG）检测,并进行统计学分析比较.结果 治疗后,对照组VAS评分[（1.11±0.74）分]和JOA评分[（21.05±3.08）分]及训练组VAS评分[（0.95±0.62）分]和JOA评分[（23.47±2.04）分]较组内治疗前改善（P＜0.01）,组间对比,治疗后,训练组JOA评分高于对照组（P＜0.01）.治疗后,训练组患侧竖脊肌中位频率值[（84.84土12.78）分]、患侧竖脊肌平均振幅值[（108.94±24.70）分]和患侧多裂肌的中位频率值[（95.63±16.35）分]均较组内治疗前提高（P＜0.05）,健患侧对比差异无统计学意义（P＞0.05）;组间对比,训练组患侧竖脊肌[（84.84±12.78）分]与多裂肌[（95.63±16.35）分]中位频率值均高于对照组（P＜0.05）,但治疗前后2组平均振幅值比较,除患侧竖脊肌[（108.94±24.70）分]差异有统计学意义外（P＜0.05）,余均无统计学意义（P＞0.05）.结论 核心稳定性训练可进一步减轻腰椎间盘突出症患者腰部症状、改善腰背部核心肌群耐疲劳性和两侧多裂肌肌功能不平衡性,但训练对于腰部整体肌肉力量的改善程度有待于进一步延长治疗时间后的研究观察.
Objective To analyze the surface-electromyography （sEMG） signals of patients with lumbar disc herniation before and after core stability exercise therapy.Methods Thirty-eight cases diagnosed with lumbar disc herniation were randomly divided into a control group （n =19） and an experimental group （n =19） using a random number table.The former was given two weeks＇ conventional traction physiotherapy,while the latter was given another two weeks of core stability exercise of lumbar and dorsal muscles after the conventional treatment.All of the patients were assessed using a visual analogue scale （VAS） and each was given a Japanese orthopedic association （JOA） score,sEMGs were recorded before and after 4 weeks of treatment.Results After treatment,average VAS scores[（1.11 ±0.74） and （0.95 ±0.62） respectively] and JOA scores[（21.05 ±3.08） and （23.47 ±2.04） respectively] in the control and experimental group both had improved significantly compared to that before treatment （P ＜ 0.01）.The average JOA score in the experimental group was significantly higher than that in the control group （P ＜ 0.01） after the treatment.After treatment of 4 weeks,erector spinae median frequency （MF） values（84.84 ± 12.78） and erector spinae average amplitude （AEMG） value （108.94 ± 24.70） in the experimental group were significantly improved（P ＜ 0.05）,so did the multifidus muscles MF value（95.63 ± 16.35） of affected side.There was no significant difference between the affected and unaffected side （P ＞ 0.05）.Moreover,the MF values of the experimental group were significantly higher than that the control group （P ＜ 0.05） after treatment.There was significant difference between the average AEMG values of erector spinae of affected side before and after treatment （P ＜ 0.05）.Conclusions Core stability exercise can further alleviate the symptoms of lumbar disc herniation after conventional traction physiotherapy.It improves the fatigue tolerance of th
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2014年第11期859-863,共5页
Chinese Journal of Physical Medicine and Rehabilitation
关键词
腰椎间盘突出症
腰部肌肉
核心稳定性训练
表面肌电图
Lumbar disc herniation
Lumbar muscles
Core stability exercise
Surface electromyography
