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椎间盘突出症伴根性病变患者的运动控制训练与经皮神经电刺激比较:一项随机对照试验。

Motor Control Training Compared With Transcutaneous Electrical Nerve Stimulation in Patients With Disc Herniation With Associated Radiculopathy: A Randomized Controlled Trial.

机构信息

From the Department of Speech, Physical and Occupational Therapy, School of Medicine, University of São Paulo, São Paulo, Brazil (FJRF, LAVR, TNB, MOM, JC, APMCC, GPLA, APM); Laboratory of Human Motricity Studies, Federal University of Pará, Belém, Brazil (BC); Federal University Amapá, Campus Binacional of Oiapoque, Amapá, Brazil (LAVR); and Federal University of Ceará, Ceará, Brazil (GPLA).

出版信息

Am J Phys Med Rehabil. 2019 Mar;98(3):207-214. doi: 10.1097/PHM.0000000000001048.

Abstract

OBJECTIVE

The aim of the study was to compare the effectiveness of motor control training and transcutaneous electrical nerve stimulation in relieving pain, reducing functional disability, and improving transversus abdominis activation in patients with lumbar disc herniation with associated radiculopathy.

DESIGN

This is a randomized controlled trial.

METHODS

Forty patients diagnosed with lumbar disc herniation were randomly divided into two groups: motor control training group (n = 20) and transcutaneous electrical nerve stimulation group (n = 20).

INTERVENTIONS

The motor control training group and transcutaneous electrical nerve stimulation group attended 60 mini sessions twice a week for 8 wks, totaling to 16 sessions.

MAIN OUTCOME MEASURES

The main outcome measures are pain, functional disability, and transversus abdominis activation capacity.

RESULTS

Differences between both groups were observed after 8 wks, favoring the motor control training group. Motor control training was more effective than transcutaneous electrical nerve stimulation in relieving pain (mean difference = 3.3 points, 95% confidence interval = 2.12-4.48), reducing functional disability (mean difference = 8.4 points, 95% confidence interval = 5.44-11.36), improving the quality of pain (mean difference = 17 points, 95% confidence interval = 7.93-26.07), sensory quality of pain (mean difference = 10.3 points, 95% confidence interval = 5.55-15.05), and transversus abdominis activation (mean difference = 1.5 points, 95% confidence interval = 0.90-2.10).

CONCLUSIONS

The results suggest that motor control training is more effective than transcutaneous electrical nerve stimulation with respect to relieving pain, reducing functional disability, and improving transversus abdominis activation in patients with lumbar disc herniation.

摘要

目的

本研究旨在比较运动控制训练和经皮神经电刺激在缓解腰椎间盘突出症伴根性病变患者疼痛、减少功能障碍和改善腹横肌激活方面的效果。

设计

这是一项随机对照试验。

方法

将 40 名诊断为腰椎间盘突出症的患者随机分为两组:运动控制训练组(n = 20)和经皮神经电刺激组(n = 20)。

干预措施

运动控制训练组和经皮神经电刺激组每周接受 60 分钟的治疗,每周 2 次,共 8 周,总计 16 次。

主要观察指标

主要观察指标为疼痛、功能障碍和腹横肌激活能力。

结果

经过 8 周的治疗,两组之间出现了差异,运动控制训练组效果更好。运动控制训练在缓解疼痛方面比经皮神经电刺激更有效(平均差异=3.3 分,95%置信区间=2.12-4.48),减少功能障碍(平均差异=8.4 分,95%置信区间=5.44-11.36),改善疼痛质量(平均差异=17 分,95%置信区间=7.93-26.07),疼痛感觉质量(平均差异=10.3 分,95%置信区间=5.55-15.05),以及腹横肌激活(平均差异=1.5 分,95%置信区间=0.90-2.10)。

结论

结果表明,与经皮神经电刺激相比,运动控制训练在缓解疼痛、减少功能障碍和改善腰椎间盘突出症患者腹横肌激活方面更有效。

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