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慢性非特异性下腰痛患者的腰骶骨盆核心稳定训练与疼痛调节

Lumbopelvic Core Stabilization Exercise and Pain Modulation Among Individuals with Chronic Nonspecific Low Back Pain.

作者信息

Paungmali Aatit, Joseph Leonard H, Sitilertpisan Patraporn, Pirunsan Ubon, Uthaikhup Sureeporn

机构信息

Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.

Physiotherapy Programme, School of Rehabilitation Sciences, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia.

出版信息

Pain Pract. 2017 Nov;17(8):1008-1014. doi: 10.1111/papr.12552. Epub 2017 Feb 25.

Abstract

BACKGROUND

Lumbopelvic stabilization training (LPST) may provide therapeutic benefits on pain modulation in chronic nonspecific low back pain conditions. This study aimed to examine the effects of LPST on pain threshold and pain intensity in comparison with the passive automated cycling intervention and control intervention among patients with chronic nonspecific low back pain.

METHODS

A within-subject, repeated-measures, crossover randomized controlled design was conducted among 25 participants (7 males and 18 females) with chronic nonspecific low back pain. All the participants received 3 different types of experimental interventions, which included LPST, the passive automated cycling intervention, and the control intervention randomly, with 48 hours between the sessions. The pressure pain threshold (PPT), hot-cold pain threshold, and pain intensity were estimated before and after the interventions.

RESULTS

Repeated-measures analysis of variance showed that LPST provided therapeutic effects as it improved the PPT beyond the placebo and control interventions (P < 0.01). The pain intensity under the LPST condition was significantly better than that under the passive automated cycling intervention and controlled intervention (P < 0.001). Heat pain threshold under the LPST condition also showed a significant trend of improvement beyond the control (P < 0.05), but no significant effects on cold pain threshold were evident.

CONCLUSIONS

Lumbopelvic stabilization training may provide therapeutic effects by inducing pain modulation through an improvement in the pain threshold and reduction in pain intensity. LPST may be considered as part of the management programs for treatment of chronic low back pain.

摘要

背景

腰骶部稳定训练(LPST)可能对慢性非特异性下腰痛患者的疼痛调节具有治疗益处。本研究旨在比较LPST与被动自动循环干预及对照干预对慢性非特异性下腰痛患者疼痛阈值和疼痛强度的影响。

方法

对25名慢性非特异性下腰痛患者(7名男性和18名女性)进行了一项受试者内重复测量交叉随机对照设计。所有参与者随机接受3种不同类型的实验干预,包括LPST、被动自动循环干预和对照干预,各干预之间间隔48小时。在干预前后评估压力疼痛阈值(PPT)、冷热疼痛阈值和疼痛强度。

结果

重复测量方差分析显示,LPST具有治疗效果,因为它提高了PPT,超过了安慰剂和对照干预(P<0.01)。LPST条件下的疼痛强度明显优于被动自动循环干预和对照干预条件下的疼痛强度(P<0.001)。LPST条件下的热痛阈值也显示出超过对照的显著改善趋势(P<0.05),但对冷痛阈值没有明显影响。

结论

腰骶部稳定训练可能通过提高疼痛阈值和降低疼痛强度来诱导疼痛调节,从而提供治疗效果。LPST可被视为慢性下腰痛治疗管理方案的一部分。

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