节段性稳定训练对机械性下背痛患者腰椎节段性不稳定的疗效：一项随机安慰剂对照交叉研究。
Efficacy of segmental stabilization exercise for lumbar segmental instability in patients with mechanical low back pain: A randomized placebo controlled crossover study.
作者信息
Kumar Senthil P
机构信息
Department of Physiotherapy, Kasturba Medical College, Manipal University, Mangalore, India.
出版信息
N Am J Med Sci. 2011 Oct;3(10):456-61. doi: 10.4297/najms.2011.3456.
BACKGROUND
Lumbar segmental stability is an important biomechanical component that influences symptoms amongst patients with Mechanical low back pain.
AIMS
To compare the efficacy of segmental stabilization exercises utilizing multifidus and transversus abdominis muscles versus a placebo treatment in patients with lumbar segmental instability.
MATERIALS AND METHODS
The study was an observer-blinded randomized placebo-controlled cross-over study of 18 adults (12 men, 6 women), of mean age 22.5 ± 1.09 yrs who scored 7/13 in subjective aspects and 8/14 in objective aspects of Delphi criteria for lumbar segmental instability. The selected subjects were then randomized to receive either placebo-control (prone lying) or experimental (lumbar segmental stabilization) as a first treatment. Each treatment was followed by a wash-out period of 24 hours. Outcomes were measured four times- pre- and post- first intervention, pre- and post- second intervention. The outcome measures used were pain on Visual analogue scale, Pressure pain threshold and Joint play grading scale (0-6 scale) on that level.
RESULTS
Two-way analysis of variance and post-hoc analysis using Bonferonni test were used with level of significance set at p<.05 using Statistical package for social sciences version 12.0.1 for Windows. Visual analogue scale changed significantly in both the periods of intervention- in control (P =.016) and experimental (P =.000) periods. However this improvement was more significant in the experimental period. The Joint play grading scale scores improved only in the experimental condition compared to the control condition significantly. The Pressure pain threshold also improved significantly in the experimental condition (P =.000) while the changes in control condition was not statistically significant (P=.816).
CONCLUSION
Segmental stabilization exercise was more effective than placebo intervention in symptomatic lumbar segmental instability.
背景
腰椎节段稳定性是影响机械性下腰痛患者症状的重要生物力学因素。
目的
比较多裂肌和腹横肌节段性稳定训练与安慰剂治疗对腰椎节段性不稳定患者的疗效。
材料与方法
本研究为观察者盲法随机安慰剂对照交叉研究，纳入18名成年人（12名男性，6名女性），平均年龄22.5±1.09岁，他们在腰椎节段性不稳定的德尔菲标准主观方面得分为7/13分，客观方面得分为8/14分。然后将选定的受试者随机分为接受安慰剂对照（俯卧位）或实验性治疗（腰椎节段性稳定训练）作为首次治疗。每次治疗后有24小时的洗脱期。在首次干预前和后、第二次干预前和后进行四次结果测量。使用的结果测量指标为视觉模拟量表上的疼痛、压力疼痛阈值和该节段的关节活动分级量表（0 - 6级）。
结果
使用社会科学统计软件包Windows版12.0.1进行双向方差分析和使用Bonferonni检验的事后分析，显著性水平设定为p <.05。视觉模拟量表在两个干预阶段均有显著变化——对照阶段（P =.016）和实验阶段（P =.000）。然而，这种改善在实验阶段更为显著。与对照条件相比，关节活动分级量表评分仅在实验条件下有显著改善。实验条件下压力疼痛阈值也有显著改善（P =.000），而对照条件下的变化无统计学意义（P =.816）。
结论
节段性稳定训练在有症状的腰椎节段性不稳定方面比安慰剂干预更有效。
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