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采用运动控制训练方案治疗慢性非特异性下腰痛患者的腰骨盆运动恢复和肌肉募集模式:一项前瞻性研究。

Recovery of the lumbopelvic movement and muscle recruitment patterns using motor control exercise program in people with chronic nonspecific low back pain: A prospective study.

机构信息

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China.

Department of Physiotherapy, Prince of Wales Hospital, Hong Kong SAR, China.

出版信息

PLoS One. 2021 Nov 18;16(11):e0259440. doi: 10.1371/journal.pone.0259440. eCollection 2021.

Abstract

This study aims to investigate the dysfunction and recovery of the lumbopelvic movement and motor control of people with chronic nonspecific low back pain after a structured rehabilitation which emphasizes on re-education and training of movement and motor control. The lumbopelvic movement and motor control pattern of 30 adults (15 with chronic low back pain, 15 healthy controls) were assessed using 3D motion and electromyographic analysis during the repeated forward bending test, in additional to the clinical outcome measures. Regional kinematics and muscle recruitment pattern of the symptomatic group was analysed before and after the 6-week rehabilitation, and compared to healthy controls. Significant improvement in back pain, functional capacity and self-efficacy of the symptomatic group was found after the rehabilitation. Patients with chronic nonspecific low back pain were capable to recover to a comparable level of the healthy controls in terms of their lumbopelvic movement and motor control pattern upon completion of a 6-week rehabilitation program, despite their dysfunction displayed at baseline. Phase specific motor control reorganization in which more profound and positive changes shown during the flexion phase. Our findings indicate that the recovery of the movement and motor control pattern in patients with chronic low back pain achieved to a comparable level of the healthy able-bodies. The improvement of both the physical outcome measures suggest that specific rehabilitation program which emphasizes on optimizing motor control during movements would help promoting the functional recovery of this specific low back pain subgroup.

摘要

本研究旨在探讨慢性非特异性下腰痛患者在强调运动再教育和运动控制训练的结构化康复后,其腰骶部运动和运动控制的功能障碍和恢复情况。在重复前屈测试中,使用 3D 运动和肌电图分析评估了 30 名成年人(15 名慢性腰痛,15 名健康对照组)的腰骶部运动和运动控制模式,此外还评估了临床结果测量。对症状组的局部运动学和肌肉募集模式进行了分析,分别在 6 周康复前后,并与健康对照组进行了比较。康复后,症状组的腰痛、功能能力和自我效能感显著改善。尽管在基线时表现出功能障碍,但慢性非特异性下腰痛患者在完成 6 周康复计划后,在腰骶部运动和运动控制模式方面能够恢复到与健康对照组相当的水平。在特定的运动控制再组织中,在屈曲阶段表现出更深刻和积极的变化。我们的研究结果表明,慢性腰痛患者的运动和运动控制模式的恢复达到了与健康人群相当的水平。物理结果测量的改善表明,强调在运动中优化运动控制的特定康复方案将有助于促进这一特定下腰痛亚组的功能恢复。

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