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慢性机械性下腰痛的腰椎前凸康复对疼痛和腰椎节段运动的影响:一项随机试验

Lumbar lordosis rehabilitation for pain and lumbar segmental motion in chronic mechanical low back pain: a randomized trial.

作者信息

Diab Aliaa A, Moustafa Ibrahim M

机构信息

Basic Science Department, Faculty of Physical Therapy, Cairo University, Cairo, Egypt.

出版信息

J Manipulative Physiol Ther. 2012 May;35(4):246-53. doi: 10.1016/j.jmpt.2012.04.021.

Abstract

OBJECTIVE

The purpose of this study was to investigate the effects of lumbar extension traction with stretching and infrared radiation compared with stretching and infrared radiation alone on the lumbar curve, pain, and intervertebral movements of patients with chronic mechanical low back pain (CMLBP).

METHODS

This randomized clinical study with 3-month follow-up was completed at the Cairo University research laboratory. Eighty patients (age ranged from 40 to 50 years) with CMLBP and a hypolordotic lumbar spine were randomly assigned to traction or a comparison group. The comparison group (n = 40) received stretching exercises and infrared radiation, whereas the traction group (n = 40) received lumbar extension traction in addition to stretching exercises and infrared radiation. The absolute rotatory angle, intervertebral movements, and visual analog scale were measured for all patients at 3 intervals.

RESULTS

The results revealed a statistically significant difference between the groups at 2 follow-up time points compared with the baseline values for the translational and sagittal rotational movements of L3-L4, L4-L5, L5-S1, and L2-L3 (posttreatment) and absolute rotatory angle (P < .01). There were no statistically significant changes in pain (P = .1 and .3) and L1-L2 (P = .072 and .076) or L2-L3 (at follow-up; P = .3), and there was no significant difference between all the previous variables adjusted to the groups' baseline outcome interaction (P > .01).

CONCLUSION

Lumbar extension traction with stretching exercises and infrared radiation was superior to stretching exercises and infrared radiation alone for improving the sagittal lumbar curve, pain, and intervertebral movement in CMLBP.

摘要

目的

本研究旨在探讨与单纯拉伸和红外线辐射相比,拉伸、红外线辐射联合腰椎后伸牵引对慢性机械性下腰痛(CMLBP)患者腰椎曲度、疼痛及椎间运动的影响。

方法

这项为期3个月随访的随机临床研究在开罗大学研究实验室完成。80例年龄在40至50岁之间、患有CMLBP且腰椎前凸减小的患者被随机分为牵引组或对照组。对照组(n = 40)接受拉伸锻炼和红外线辐射,而牵引组(n = 40)除拉伸锻炼和红外线辐射外,还接受腰椎后伸牵引。在3个时间点对所有患者测量绝对旋转角度、椎间运动和视觉模拟评分。

结果

结果显示,与L3-L4、L4-L5、L5-S1和L2-L3(治疗后)的平移和矢状面旋转运动以及绝对旋转角度的基线值相比,两组在2个随访时间点存在统计学显著差异(P < .01)。疼痛(P = .1和.3)以及L1-L2(P = .072和.076)或L2-L3(随访时;P = .3)无统计学显著变化,并且在根据各组基线结果相互作用调整后的所有先前变量之间无显著差异(P > .01)。

结论

对于改善CMLBP患者的腰椎矢状面曲度、疼痛及椎间运动,拉伸锻炼、红外线辐射联合腰椎后伸牵引优于单纯的拉伸锻炼和红外线辐射。

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