核心稳定性训练对慢性下腰痛患者腰椎不稳的影响：一项随机临床试验。
Influence of core stability exercise on lumbar vertebral instability in patients presented with chronic low back pain: A randomized clinical trial.
作者信息
Javadian Yahya, Akbari Mohammad, Talebi Ghoadamali, Taghipour-Darzi Mohammad, Janmohammadi Naser
机构信息
Department of Physiotherapy, Babol University of Medical Sciences, Babol, Iran.
Department of Physiotherapy, Iran University of Medical Sciences, Tehran, Iran.
出版信息
Caspian J Intern Med. 2015 Spring;6(2):98-102.
BACKGROUND
Excessive lumbar vertebrae translation and rotation in sagittal plane has been attributed as an associated factor of lumbar segmental instability (LSI) and low back pain (LBP). Reduction of these abnormalities improves back pain. The aim of this study was to investigate the effect of core stability exercise on the translation and rotation of lumbar vertebrae in sagittal plane in patients with nonspecific chronic LBP (NSCLBP).
METHODS
In this randomized clinical trial, 30 patients with NSCLBP due to LSI were included. The participants were randomly divided into two groups of treatment and control. The treatment group received general exercises plus core stability exercise for 8 weeks whereas; the control group received only general exercises. The magnitude of translation (mm) and rotation (deg) of lumbar vertebrae in the sagittal plane was determined by radiography in flexion and extension at baseline and after intervention. The primary outcome measures were to determine the mean changes from baseline in translation and rotation of the lumbar vertebrae in the sagittal plane after 8 weeks of intervention in each group. The secondary outcome was to compare the two groups in regard to translation and rotation of the lumbar vertebrae at the end of the study period. Data were analyzed using paired t-test and independent t-test.
RESULTS
Thirty patients aged 18-40 years old with clinical diagnosis of NSCLBP entered the study. Compared with baseline values, mean value of translation and rotation of the lumbar vertebra reduced significantly in both groups (P<0.05), except L3 translation in the control group. At the endpoint, mean translation value of L4 (P=0.04) and L5 (P=0.001) and rotation of the L5 (P=0.01) in the treatment group was significantly lower than the control group.
CONCLUSION
These findings indicate that in patients presented with NSCLBP due to lumbar segmental instability, core stability exercises plus general exercises are more efficient than general exercises alone in the improvement of excessive lumbar vertebrae translation and rotation.
背景
腰椎在矢状面的过度平移和旋转被认为是腰椎节段性不稳定（LSI）和下腰痛（LBP）的相关因素。减少这些异常可改善背痛。本研究的目的是调查核心稳定性训练对非特异性慢性下腰痛（NSCLBP）患者腰椎在矢状面的平移和旋转的影响。
方法
在这项随机临床试验中，纳入了30例因LSI导致NSCLBP的患者。参与者被随机分为治疗组和对照组。治疗组接受常规锻炼加核心稳定性训练，为期8周；对照组仅接受常规锻炼。通过影像学检查在基线时和干预后测定腰椎在矢状面的平移幅度（mm）和旋转角度（度）。主要结局指标是确定每组干预8周后腰椎在矢状面的平移和旋转相对于基线的平均变化。次要结局是在研究期末比较两组在腰椎平移和旋转方面的情况。数据采用配对t检验和独立t检验进行分析。
结果
30例年龄在18至40岁之间、临床诊断为NSCLBP的患者进入研究。与基线值相比，两组腰椎的平移和旋转平均值均显著降低（P<0.05），对照组L3的平移除外。在终点时，治疗组L4（P=0.04）和L5（P=0.001）的平均平移值以及L5的旋转（P=0.01）均显著低于对照组。
结论
这些发现表明，对于因腰椎节段性不稳定而出现NSCLBP的患者，核心稳定性训练加常规锻炼在改善腰椎过度平移和旋转方面比单纯常规锻炼更有效。
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