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肌内效贴布对磁共振成像确诊的腰椎间盘退变所致下腰痛患者疼痛、功能障碍及腰背伸肌耐力的急性影响

Acute effects of Kinesio taping on pain, disability and back extensor muscle endurance in patients with low back pain caused by magnetic resonance imaging-confirmed lumbar disc degeneration.

作者信息

Chang Nai-Jen, Chou Willy, Hsiao Pei-Chi, Chang Wen-Dien, Lo Yi-Ming

机构信息

Department of Sports Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

Department of Physical Medicine and Rehabilitation, Chi Mei Medical Center, Tainan, Taiwan.

出版信息

J Back Musculoskelet Rehabil. 2018 Feb 6;31(1):85-93. doi: 10.3233/BMR-169681.

Abstract

BACKGROUND

Individuals with disc degeneration experience associated pain and disability. Considering its safety and affordability, Kinesio tape (KT) may be a viable treatment. However, most KT studies have demonstrated its effects in healthy adults and patients with nonspecific low back pain. The efficacy of KT in patients with disc degeneration is yet to be investigated.

OBJECTIVES

To examine the acute effects of KT on patients with lumbar disc degeneration confirmed through magnetic resonance imaging.

METHODS

A total of 31 eligible patients (aged 25-64 years) with low back pain caused by lumbar disc degeneration were divided into mild and moderate-to-severe pain groups. KT was applied to the painful lumbar region in a lumbar brace-like pattern for 1 day. A visual analogue scale for pain and the Oswestry disability index were analysed before and after 1 day of taping. The Biering-Sorensen test for trunk muscle endurance was performed before, immediately after, and 1 day after taping as well as immediately after tape removal.

RESULTS

After taping, both groups showed significant pain reduction (p< 0.001), but the reduction was of minimal clinical importance in the moderate-to-severe pain group. The magnitude of treatment (i.e. effect size) was higher in the moderate-to-severe pain group. Disability significantly decreased in both groups, particularly in the moderate-to-severe pain group, but the improvement was not clinically worthwhile. Trunk muscle endurance significantly improved in both groups with in situ taping, but it decreased after tape removal.

CONCLUSIONS

KT may be adopted as an assistive aid for immediate pain reduction, particularly in lumbar disc degeneration patients with moderate-to-severe pain; however, its effects on disability and trunk muscle endurance are not clinically worthwhile. The long-term effects of KT, with or without active exercise, warrant further assessment.

摘要

背景

椎间盘退变患者会经历相关疼痛和功能障碍。考虑到其安全性和可承受性,肌内效贴布(KT)可能是一种可行的治疗方法。然而,大多数KT研究已证明其对健康成年人和非特异性下背痛患者的效果。KT对椎间盘退变患者的疗效尚待研究。

目的

研究KT对经磁共振成像确诊的腰椎间盘退变患者的急性影响。

方法

总共31名符合条件的因腰椎间盘退变导致下背痛的患者(年龄25 - 64岁)被分为轻度疼痛组和中重度疼痛组。KT以类似腰托的方式贴于疼痛的腰部区域,持续1天。在贴布1天前后分析疼痛视觉模拟量表和Oswestry功能障碍指数。在贴布前、贴布后即刻、贴布1天后以及去除贴布后即刻进行躯干肌肉耐力的 Biering-Sorensen 试验。

结果

贴布后,两组疼痛均显著减轻(p < 0.001),但在中重度疼痛组中这种减轻的临床意义极小。中重度疼痛组的治疗幅度(即效应量)更高。两组功能障碍均显著降低,尤其是中重度疼痛组,但改善情况在临床上并不值得。两组在原位贴布时躯干肌肉耐力均显著提高,但去除贴布后降低。

结论

KT可作为一种辅助手段用于即刻减轻疼痛,特别是对中重度疼痛的腰椎间盘退变患者;然而,其对功能障碍和躯干肌肉耐力的影响在临床上并不值得。无论有无主动运动,KT的长期效果都需要进一步评估。

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