França Fábio Renovato, Burke Thomaz Nogueira, Caffaro Renê Rogieri, Ramos Luiz Armando, Marques Amélia Pasqual
Department of Physical Therapy, Communication Science & Disorders, Occupational Therapy, University of São Paulo, São Paulo, Brazil.
J Manipulative Physiol Ther. 2012 May;35(4):279-85. doi: 10.1016/j.jmpt.2012.04.012.
The purpose of this study was to compare the effects of 2 exercise programs, segmental stabilization exercises (SSEs) and stretching of trunk and hamstrings muscles, on functional disability, pain, and activation of the transversus abdominis muscle (TrA), in individuals with chronic low back pain.
A total of 30 participants were enrolled in this study and randomly assigned to 1 of 2 groups as a function of intervention. In the segmental stabilization group (SS), exercises focused on the TrA and lumbar multifidus muscles, whereas in the stretching group (ST), exercises focused on stretching the erector spinae, hamstrings, and triceps surae. Severity of pain (visual analog scale and McGill pain questionnaire) and functional disability (Oswestry disability questionnaire) and TrA muscle activation capacity (Pressure Biofeedback Unit, or PBU) were compared as a function of intervention. Interventions lasted 6 weeks, and sessions happened twice a week (30 minutes each). Analysis of variance was used for intergroup and intragroup comparisons.
As compared with baseline, both treatments were effective in relieving pain and improving disability (P < .001). Those in the SS group had significantly higher gains for all variables. The stretching group did not effectively activate the TrA (P = .94).
Both techniques improved pain and reduced disability. In this study, SS was superior to muscular stretching for the measured variables associated with chronic low back pain.
本研究旨在比较两种运动方案，即节段性稳定训练（SSEs）和躯干与腘绳肌拉伸，对慢性下腰痛患者功能障碍、疼痛及腹横肌（TrA）激活的影响。
本研究共纳入30名参与者，并根据干预措施将其随机分为两组。在节段性稳定训练组（SS组），训练重点是TrA和腰多裂肌，而在拉伸组（ST组），训练重点是竖脊肌、腘绳肌和小腿三头肌的拉伸。比较干预前后疼痛严重程度（视觉模拟评分和麦吉尔疼痛问卷）、功能障碍（奥斯威斯利功能障碍问卷）及TrA肌肉激活能力（压力生物反馈仪，或PBU）。干预持续6周，每周进行两次（每次30分钟）。采用方差分析进行组间和组内比较。
与基线相比，两种治疗方法均能有效缓解疼痛并改善功能障碍（P <.001）。SS组所有变量的改善幅度均显著更高。拉伸组未能有效激活TrA（P = 0.94）。
两种技术均能改善疼痛并减轻功能障碍。在本研究中，对于与慢性下腰痛相关的测量变量，节段性稳定训练优于肌肉拉伸。
