Pagé Isabelle, Marchand Andrée-Anne, Nougarou François, O'Shaughnessy Julie, Descarreaux Martin
Doctoral Student, Département d'Anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.
Postdoctoral Fellowship, Département des Sciences de l'Activité Physique, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada.
J Manipulative Physiol Ther. 2015 Sep;38(7):449-57. doi: 10.1016/j.jmpt.2015.08.005. Epub 2015 Sep 26.
The objective of this study was to evaluate changes in neuromechanical responses and clinical outcomes in chronic low back pain participants after 4 sessions of biofeedback training.
Twenty-one participants took part in an electromyography biofeedback 4-session training program aimed at reducing lumbar paraspinal muscle activity during full trunk flexion. The sessions consisted of ~46 trunk flexion-extension divided into 5 blocks. The effects of training blocks and sessions on lumbar flexion-relaxation ratio and lumbopelvic ranges of motion were assessed. Changes in disability (Oswestry Disability Index), pain intensity (numerical rating scale), and fear of movement (Tampa Scale for Kinesiophobia) were also evaluated.
Analyses of variance revealed a significant block effect for which an increase in the flexion-relaxation ratio and the lumbar range of motion between block 1 and the other blocks for sessions 1 and 2 (P < .0001) was observed. However, no significant session or interaction effect was observed. Among clinical outcomes, only fear of movement significantly decreased between the baseline (mean [SD], 33.05 [7.18]) and the fourth session (29.80 [9.88]) (P = .02). There was no significant correlation between clinical outcomes and neuromechanical variables.
Biofeedback training led to decreases in lumbar paraspinal muscle activity in full trunk flexion and increases in lumbopelvic range of motion in participants with chronic nonspecific low back pain. Although the neuromechanical changes were mostly observed at the early stage of the program, the presence of a decrease in the fear of movement suggests that the participants' initially limited ROMs may have been modulated by fear avoidance behaviors.
本研究的目的是评估慢性下腰痛参与者在接受4次生物反馈训练后的神经力学反应变化和临床结果。
21名参与者参加了一项肌电图生物反馈4次训练计划，旨在减少全躯干屈曲时腰椎旁肌肉的活动。训练课程包括约46次躯干屈伸，分为5个组块。评估了训练组块和课程对腰椎屈伸放松比率和腰骶部活动范围的影响。还评估了残疾程度（奥斯威斯利残疾指数）、疼痛强度（数字评分量表）和运动恐惧（坦帕运动恐惧量表）的变化。
方差分析显示存在显著的组块效应，观察到第1组块与第1和第2次课程的其他组块之间的屈伸放松比率和腰椎活动范围增加（P <.0001）。然而，未观察到显著的课程或交互效应。在临床结果中，仅运动恐惧在基线时（均值[标准差]，33.05[7.18]）和第4次课程时（29.80[9.88]）之间显著降低（P =.02）。临床结果与神经力学变量之间无显著相关性。
生物反馈训练导致慢性非特异性下腰痛参与者在全躯干屈曲时腰椎旁肌肉活动减少，腰骶部活动范围增加。尽管神经力学变化大多在训练计划的早期阶段观察到，但运动恐惧的降低表明参与者最初有限的活动范围可能受到恐惧回避行为的调节。
