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牵引对处于不同阶段退行性椎间盘疾病的年轻患者的有效性。

Effectiveness of Traction in Young Patients Representing Different Stages of Degenerative Disc Disease.

作者信息

Kuligowski Tomasz, Dębiec-Bąk Agnieszka, Skrzek Anna

机构信息

Akademia Wychowania Fizycznego we Wrocławiu Polska / University School of Physical Education in Wrocław, Poland Wydział Fizjoterapii; Katedra Fizjoterapii w Dysfunkcjach Narządu Ruchu / Faculty of Physiotherapy; Department of Physiotherapy in Musculoskeletal Dysfunctions.

出版信息

Ortop Traumatol Rehabil. 2019 Jun 30;21(3):187-195. doi: 10.5604/01.3001.0013.2925.

Abstract

BACKGROUND

Low back pain (LBP) currently ranks among the most frequent musculoskeletal pathologies, and the average age of those affected is constantly decreasing. One of the causes of LBP is lumbar disc herniation (LDH). If untreated, it causes disability and leads to socio-economic problems. Traction techniques are a popular method of treating this condition. The stage of LDH (protrusion, extrusion) in young people appears to determine patients' clinical status, necessitating diversification of treatment methods with regard to the type of damage.

MATERIAL AND METHODS

The study enrolled 37 people aged 22-35. The subjects underwent radiological evalu-ation (MRI), which constituted the basis for assigning them to one of two groups: a protrusion group (PRO) or an extrusion group (EXT). During the experiment, the patient was in the supine position while the therapist administered three-dimensional traction using a manual therapy belt. The Oswestry questionnaire, MRC scale, NRS, SLR test, PLE test and measurements of lumbar segment mobility were used for clinical evaluation. Statistica 12.5 was used to perform statistical calculations.

RESULTS

An analgesic effect was noted with regard to the following two parameters in both groups: ODI (PRO 28 → 14 and EXT 30 → 28, p <0.01) and NRS (PRO 6 → 2 and EXT 6 → 3, p <0.01). The subjects improved clinically, with regard to PLE (EXT 22% → 0%, p <0.04) and SLR (PRO 100% → 29%, p <0.01, and EXT 100% → 57%, p <0.01).

CONCLUSIONS

  1. The type of intervertebral disc damage determines the functional status of young people with degenerative disc disease. 2. The study demonstrated and confirmed a positive effect of traction on the functional status of subjects with lumbar disc herniation. 3. Traction techniques are safe and can be successfully used in the treatment of LDH.
摘要

背景

下背痛(LBP)目前是最常见的肌肉骨骼疾病之一,且受影响人群的平均年龄在不断下降。腰椎间盘突出症(LDH)是LBP的病因之一。若不治疗,会导致残疾并引发社会经济问题。牵引技术是治疗这种疾病的常用方法。年轻人的LDH阶段(突出、脱出)似乎决定了患者的临床状况,因此有必要根据损伤类型使治疗方法多样化。

材料与方法

该研究纳入了37名年龄在22 - 35岁之间的人。受试者接受了放射学评估(MRI),这构成了将他们分为两组之一的依据:突出组(PRO)或脱出组(EXT)。在实验过程中,患者仰卧,治疗师使用手动治疗带进行三维牵引。采用Oswestry问卷、MRC量表、NRS、直腿抬高试验(SLR)、股神经牵拉试验(PLE)以及腰椎节段活动度测量进行临床评估。使用Statistica 12.5进行统计计算。

结果

两组在以下两个参数方面均显示出镇痛效果:Oswestry功能障碍指数(ODI)(PRO组从28降至14,EXT组从30降至28,p <0.01)和数字疼痛评分法(NRS)(PRO组从6降至2,EXT组从6降至3,p <0.01)。受试者在临床方面有所改善,在股神经牵拉试验(PLE)(EXT组从22%降至0%,p <0.04)和直腿抬高试验(SLR)方面(PRO组从100%降至29%,p <0.01,EXT组从1

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