| 李秀明,纵亚,谢青,张伟明,计海彪,化龙昂.脊柱核心稳定性训练对单侧慢性非特异性腰痛远期治疗效果的研究[J].中国康复,2020,35(7):357-361 |
| 脊柱核心稳定性训练对单侧慢性非特异性腰痛远期治疗效果的研究 |
| Long-term efficacy of spinal core stability training for unilateral chronic nonspecific low back pain |
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| DOI： |
| 中文关键词: 慢性非特异性腰痛 核心稳定性训练 多裂肌 脂肪浸润 |
| 英文关键词: chronic non-specific low back pain core stability training multifidus muscle fat infiltration |
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| 中文摘要: |
| 目的：探讨脊柱核心稳定性训练对单侧慢性非特异性腰痛(CLBP)的远期治疗效果。方法：选取单侧CLBP患者42例，随机分为训练组和对照组各21例。2组在初次就诊期间均接受常规康复治疗，训练组在此基础上同时进行腰部核心稳定性训练治疗。于康复治疗前及康复1年后进行VAS评分、简明健康状况调查问卷（SF-36）评分及腰椎MRI检查，使用Image J软件检测MRI图像L3/L4及L5/S1节段多裂肌的脂肪浸润率（FSF）。结果：治疗1年后，较治疗前及对照组治疗后，训练组VAS评分明显降低，SF-36评分均明显提高（P<0.01），而对照组治疗前后评分对比差异无统计学意义。L3/L4及L5/S1节段MRI检查结果显示，治疗后训练组L3/L4、L5/S1节段双侧FSF明显低于对照组（P＜0.05）。治疗前，2组L3/L4、L5/S1节段患侧FSF明显高于健侧（P＜0.05）。治疗1年后，训练组L3/L4、L5/S1节段患侧FSF与健侧FSF对比均无统计学差异，对照组L3/L4、L5/S1节段患侧FSF明显高于健侧（P＜0.05）。结论：对CLBP患者行核心稳定性训练，可以减轻患者的疼痛，改善其生活质量，这可能与降低多裂肌的脂肪浸润程度有关。 |
| 英文摘要: |
| Objective: To explore the long-term efficacy of spinal core stability training on chronic non-specific low back pain (CLBP). Methods: A total of 42 subjects with unilateral CLBP were randomly divided into the training group (n=21) and the control group (n=21). Both groups received conventional rehabilitation treatment after the first visit, 3 times a week for 4 weeks. Besides, the training group was treated with the lumbar core stability training at the same period. All subjects were observed for one following year after the initial visit. VAS score, SF-36 score and lumbar spine MRI examination were performed before and 1 year after the treatment in each group. In analyzing the MRI results, total cross-sectional area (tCSA), muscle cross-sectional area (mCSA) and fat cross-sectional area (fCSA) of L3/L4 and L5/S1 segments were measured by Image J. Accordingly, fat signal fraction (FSF) was also calculated as fCSA/tCSA. Results: One year after the treatment, VAS scores in the training group were significantly reduced and SF 36 scores were significantly increased as compared with those before and after treatment in the control group (P<0.01). However, there was no statistically significant difference in scores before and after treatment in the control group. The MRI results of L3/L4 and L5/S1 segments showed that there was no statistically significant difference in FSF between the two groups before treatment, while the bilateral FSF of L3/L4 and L5/S1 segments in the training group after treatment was significantly lower than that in the control group (P<0.05). Before treatment, FSF of the affected side of L3/L4 and L5/S1 was significantly higher than that of the healthy side in the two groups (P<0.05). After 1 year of treatment, there was no statistically significant difference in the FSF between the affected side and the healthy side of L3/L4 and L5/S1 segments in the training group, while the FSF of the affected side in the L3/L4 and L5/S1 segments in the control group was significantly higher than that in the healthy side (P<0.05). Conclusion: Core stability training for CLBP patients can reduce the pain and improve the quality of life of patients, which may be related to the reduction in the degree of fat infiltration of the multifidus muscle. |
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