Marshall Paul W M, Murphy Bernadette A
Exercise Rehabilitation Clinic, Department of Sport and Exercise Science, University of Auckland, Auckland, New Zealand.
J Manipulative Physiol Ther. 2006 Sep;29(7):550-60. doi: 10.1016/j.jmpt.2006.06.025.
The purpose of this pilot study was to use a multidimensional model to evaluate deficits in patients with low back pain (LBP) over the course of a 12-week rehabilitation program using the Swiss ball.
A within-subjects, repeated-measures design based at the University exercise training clinic was used. Twenty patients with chronic nonspecific LBP (12 men, 8 women; symptom duration, 4.8 years; 38.8 +/- 12.1 years old; height, 1.76 +/- 0.06 m; weight, 76.15 +/- 7.21 kg) participated in this study. Self-report measures were the Oswestry Disability Index, Visual Analog Scale, Medical Outcomes 12-Item Short Form Health Survey, and Self-Efficacy For Exercise Scale. Physiologic measures were electromyography measurement of feedforward muscle activation, flexion relaxation phenomenon, myoelectric fatigue, endurance capacity measured by the Sorenson test, and a modified sit-up test. Individuals performed 12 weeks of progressive exercise periodized every 4 weeks using a Swiss ball. Outcome measures were assessed at baseline, 4 weeks, 8 weeks, 12 weeks, and at a 3-month follow-up. Repeated-measures analysis for variance for time differences and regression analysis for variance in Oswestry scores were performed.
The Oswestry score for self-reported disability significantly decreased over the intervention (F(4,14) = 19.456, P < .001). Significant improvements in pain and disability maintained to the 3 months of follow-up. There were significant changes in perceptions of physical and mental well-being, erector spinae fatigue, and flexion relaxation measures. Change in flexion relaxation explained 38% of the improvement in Oswestry scores at the 12-week measurement.
This study showed that the Swiss ball may be successfully used in a rehabilitation context for patients with LBP. This pilot study has used a novel approach to assess improvements during a rehabilitation program, which may be used in the future to explain differences between different treatment modalities.
本初步研究的目的是使用多维模型，通过为期12周的瑞士球康复计划，评估腰痛（LBP）患者的功能缺陷。
采用基于大学运动训练诊所的受试者内重复测量设计。20例慢性非特异性LBP患者（12例男性，8例女性；症状持续时间4.8年；年龄38.8±12.1岁；身高1.76±0.06米；体重76.15±7.21千克）参与本研究。自我报告测量指标包括奥斯威斯利功能障碍指数、视觉模拟量表、医学结局简表12项健康调查和运动自我效能量表。生理测量指标包括前馈肌肉激活的肌电图测量、屈曲放松现象、肌电疲劳、通过索伦森试验测量的耐力能力以及改良仰卧起坐试验。个体使用瑞士球进行为期12周的渐进性运动，每4周进行一次周期调整。在基线、4周、8周、12周以及3个月随访时评估结局指标。进行时间差异的重复测量方差分析以及奥斯威斯利评分方差的回归分析。
自我报告的功能障碍的奥斯威斯利评分在干预期间显著降低（F(4,14)=19.456，P<.001）。疼痛和功能障碍的显著改善持续到3个月随访时。在身心健康感知、竖脊肌疲劳和屈曲放松测量方面有显著变化。屈曲放松的变化在12周测量时解释了奥斯威斯利评分改善的38%。
本研究表明，瑞士球可成功用于LBP患者的康复治疗。这项初步研究采用了一种新颖的方法来评估康复计划期间的改善情况，未来可用于解释不同治疗方式之间的差异。
