School of Physiotherapy, Physiotherapy Research Centre, Curtin Health Innovation Research Institute, Curtin University, Perth, Australia.
J Orthop Sports Phys Ther. 2013 Aug;43(8):542-54. doi: 10.2519/jospt.2013.4699. Epub 2013 Jun 11.
Case report.
Contemporary low back pain models propose that the experience of and responses to pain result from a complex interaction of biopsychosocial factors. This supports the need for a management approach that addresses the biological, psychological, and social components that may be related to the pain disorder. This case report demonstrates the application of, and outcomes associated with, a cognitive functional intervention that considers neurophysiological, physical, psychosocial, cognitive, and lifestyle dimensions for the management of a rower with nonspecific chronic low back pain.
An adolescent male club-level rower with nonspecific chronic low back pain was classified as having a motor control impairment with a lower lumbar compressive-loading pattern in flexion. Evaluation of this patient included ergometer rowing analysis (clinical and laboratory) before and after an 8-week intervention, and outcome measures at a 12-week follow-up. The intervention consisted of a cognitive functional approach that targeted optimization of movement behavior, providing the rower with alternative movement strategies to minimize sustained flexion loading.
Reduced temporal summation of pain while ergometer rowing and reduced functional disability were observed preintervention to 12 weeks postintervention by changes in Roland-Morris Disability Questionnaire score (12/24 to 1/24) and the Patient-Specific Functional Scale (4/30 to 26/30), and associated improvements in lower-limb and back muscle endurance and changes in hip and spinopelvic kinematics during ergometer rowing. In particular, there was a greater use of available range of movement in the lumbar spine postintervention.
The cognitive functional intervention for this patient resulted in reduced pain and functional disability related to ergometer rowing, which was associated with a change in lumbar kinematics and improved lower-limb and back muscle endurance. The results suggest that providing the rower with greater use of his available range of movement may enhance load distribution during the drive phase of rowing. Registered at Australian New Zealand Clinical Trials Registry (ACTRN12609000565246).
Therapy, level 4.
病例报告。
当代腰痛模型提出，疼痛的体验和反应是由生物心理社会因素的复杂相互作用产生的。这支持了一种管理方法的需求，该方法需要解决可能与疼痛障碍相关的生物、心理和社会组成部分。本病例报告展示了一种认知功能干预的应用及其结果，该干预考虑了神经生理、身体、心理社会、认知和生活方式等方面，用于管理患有非特异性慢性腰痛的赛艇运动员。
一名青少年男性赛艇俱乐部级运动员患有非特异性慢性腰痛，被归类为运动控制障碍，在下腰椎弯曲时出现压缩性负荷模式。对该患者的评估包括在 8 周干预前后进行的测功仪划船分析（临床和实验室），以及 12 周随访时的结果测量。干预措施包括认知功能方法，旨在优化运动行为，为运动员提供替代运动策略，以最大限度地减少持续的弯曲负荷。
在测功仪划船过程中观察到疼痛的时间总和减少，并且在干预前至 12 周的 Roland-Morris 残疾问卷评分（12/24 至 1/24）和患者特定功能量表（4/30 至 26/30）的变化，以及相关的下肢和背部肌肉耐力的改善，以及在测功仪划船过程中髋关节和脊柱骨盆运动学的变化，表明运动控制障碍得到改善。特别是，在干预后腰椎的活动范围有了更大的利用。
对该患者的认知功能干预导致与测功仪划船相关的疼痛和功能障碍减少，这与腰椎运动学的变化和下肢和背部肌肉耐力的改善有关。结果表明，为运动员提供更大的可用活动范围可能会增强划桨驱动阶段的负荷分布。在澳大利亚和新西兰临床试验注册中心（ACTRN12609000565246）注册。
治疗，4 级。
