Otadi Khadijeh, Nakhostin Ansari Noureddin, Sharify Shahriar, Fakhari Zahra, Sarafraz Hadi, Aria Amir, Rasouli Omid
Department of Physiotherapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Occupational Medicine Department, Hormozgan University of Medical Sciences, Bandar Abbas, Iran.
BMC Sports Sci Med Rehabil. 2021 Mar 4;13(1):20. doi: 10.1186/s13102-021-00250-y.
It is unknown how diaphragm training combined with electrical stimulation affects pain, function, static stability, and balance in athletes with chronic low back pain (CLBP). This study aimed to explore the effects of combining diaphragm training with electrical stimulation on pain, function, static stability, and dynamic balance in athletes with nonspecific CLBP.
The design was a randomized clinical trial. A total of 24 amateur athletes (12 women, 12 men, mean age: 35.2 ± 9.8) with nonspecific CLBP were randomly allocated into two groups. The experimental group (n = 12) received diaphragm training plus Transcutaneous Electrical Nerve Stimulation (TENS), while the control group (n = 12) received TENS alone. Both groups underwent 12 sessions over a four-week period. Static stability, dynamic balance, pain, and function were measured pre- and post-intervention.
Analysis of variance 2 × 2 revealed greater improvements in pain (p < 0.001), static stability (p < 0.001), and dynamic balance (p < 0.01) in the experimental group compared to the control group. Function was improved in both groups following the interventions (p < 0.001), and there was a trend of a larger improvement in the experimental group than the control group (p = 0.09). Fisher's exact test showed that the experimental group reported ≥50% improvement only in the pain score, not function, compared to the group that received TENS alone (p = 0.005).
Pain, function, static stability, and dynamic balance were improved in both groups following 12 intervention sessions. However, pain, static stability, and dynamic balance were improved to a greater extent in diaphragm training plus TENS than TENS alone in amateur athletes with CLBP. Therefore, it seems beneficial to add diaphragm training to the rehabilitation program for athletes with nonspecific CLBP.
The trial was retrospectively registered in the Iranian Registry of Clinical Trials ( www.irct.ir ) on September 10, 2020 as IRCT20090228001719N8 .
尚不清楚膈肌训练结合电刺激对慢性下腰痛（CLBP）运动员的疼痛、功能、静态稳定性和平衡有何影响。本研究旨在探讨膈肌训练与电刺激相结合对非特异性CLBP运动员的疼痛、功能、静态稳定性和动态平衡的影响。
采用随机临床试验设计。共有24名患有非特异性CLBP的业余运动员（12名女性，12名男性，平均年龄：35.2±9.8岁）被随机分为两组。实验组（n = 12）接受膈肌训练加经皮神经电刺激（TENS），而对照组（n = 12）仅接受TENS。两组均在四周内进行12次训练。在干预前后测量静态稳定性、动态平衡、疼痛和功能。
2×2方差分析显示，与对照组相比，实验组在疼痛（p < 0.001）、静态稳定性（p < 0.001）和动态平衡（p < 0.01）方面有更大改善。干预后两组功能均得到改善（p < 0.001），且实验组改善幅度有大于对照组的趋势（p = 0.09）。Fisher精确检验显示，与仅接受TENS的组相比，实验组仅在疼痛评分上报告有≥50%的改善，功能方面则没有（p = 0.005）。
经过12次干预训练后，两组的疼痛、功能、静态稳定性和动态平衡均得到改善。然而，在患有CLBP的业余运动员中，膈肌训练加TENS比单独使用TENS在疼痛、静态稳定性和动态平衡方面改善程度更大。因此，在非特异性CLBP运动员的康复计划中增加膈肌训练似乎是有益的。
该试验于2020年9月10日在伊朗临床试验注册中心（www.irct.ir）进行回顾性注册，注册号为IRCT20090228001719N8。
