摘要
背景:研究发现机械性腰痛与某些姿势、肌肉和活动度特性有关。与病源学因素有关的情况包括腰椎前凸下降或过度、腹肌肌力下降、躯干屈肌和伸肌肌力失衡、腰部活动度下降等,而脊椎矫正,或称为整脊术是国外作为脊柱功能障碍和疼痛的一种保守治疗方法。目的:评价机械脉冲力脊椎矫正和常规物理因子治疗对于机械性腰痛患者主观疼痛和功能障碍指标以及腰部活动范围和躯干肌肌力的影响。方法:采用随机对照前瞻性临床研究方法,入选60例年龄18-65岁、病程在6周以上、伴有或不伴有下肢放射痛的机械性腰痛患者,随机分配到试验组(机械脉冲力脊椎矫正)和对照组(常规物理因子治疗)。2组治疗均为每周2次,共4周。在治疗前和治疗后1个月评估患者的目测类比评分、Roland-Morris功能障碍问卷评分、腰部活动范围和躯干肌肌力。结果与结论:(1)与治疗前相比,2组腰痛患者在治疗后1个月的疼痛和功能障碍均显著下降(P <0.05),试验组治疗后1个月目测类比评分显著低于对照组(P <0.05);(2)与治疗前相比,试验组治疗后1个月显示屈曲和伸展活动范围均显著改善(P <0.05);治疗后1个月试验组腰部屈曲活动范围优于对照组(P <0.05);(3)与治疗前相比,2组患者治疗后的躯干屈肌和伸肌肌力均有显著改善(P <0.05);治疗后1个月试验组的躯干伸肌肌力改善优于对照组(P <0.05);(4)提示相比于常规物理因子治疗,机械脉冲力脊椎矫正法治疗机械性腰痛在缓解疼痛以及改善腰部活动范围和躯干肌肌力方面更加有效。
BACKGROUND:Chronic low back pain has been shown to be related to gestures,muscle and activity characteristics.Etiological factors include decreased or excessive lumbar lordosis,decreased abdominal muscle strength,imbalance of trunk flexors and extensors,and decreased lumbar mobility.Spinal manipulation or chiropractic surgery is a conservative treatment for spinal dysfunction and pain at abroad.OBJECTIVE:To assess the efficacy of spinal mechanical impulsive manipulation and conventional physiotherapy by subjective pain and dysfunction as well as range of motion and trunk muscle strength in the patients with chronic low back pain.METHODS:This was a prospective,randomized controlled clinical trial.Sixty subjects with an age of 18 to 65 years,who had a primary complaint of low back pain at least 6-week duration with or without radiating pain to the lower extremity were included,and randomized into trial(spinal mechanical impulsive manipulation)and control(conventional physiotherapy)groups.Treatment programs were performed twice weekly,for 4 weeks.The Visual Analogue Scale scores,Roland-Morris dysfunction questionnaire,lumbar spinal range of motion and trunk muscle strength before and 1 month after treatment were detected.RESULTS AND CONCLUSION:(1)All subjects had a significant decrease in pain and disability after intervention(P<0.05).The Visual Analogue Scale score at 1 month after treatment in the trial group was significantly lower than those in the control group(P<0.05).(2)Both groups showed significant improvements in lumbar flexion,extension,flexor and extensor strength after treatment(P<0.05).The lumbar flexion range of motion and extensor muscle strength at 1 month after treatment were increased significantly in the trial group compared with the control group(P<0.05).(3)Both groups showed significant improvements in trunk extensor strength after treatment(P<0.05).The trunk extensor strength improvement at 1 month after treatment in the trial group was significantly superior to that in the control group(P<0.0
作者
朱中亮
俞晓杰
刘邦忠
朱民
赵莉亚
闫冬冬
Zhu Zhongliang;Yu Xiaojie;Liu Bangzhong;Zhu Min;Zhao Liya;Yan Dongdong(Department of Rehabilitation,Zhujiajiao People’s Hospital of Qingpu District,Shanghai 201713,China;Department of Pain,South Branch of Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 201112,China;Department of Rehabilitation Medicine,Zhongshan Hospital of Fudan University,Shanghai 200031,China)
出处
《中国组织工程研究》
CAS
北大核心
2018年第35期5637-5641,共5页
Chinese Journal of Tissue Engineering Research
基金
上海市青浦区科技发展基金项目(青科发2016-05)
上海市青浦区卫生计生系统重点学科项目(WZ2015-04)~~
