Marugán-Rubio Daniel, Chicharro J L, Becerro-de-Bengoa-Vallejo Ricardo, Losa-Iglesias Marta Elena, Rodríguez-Sanz David, Vicente-Campos Davinia, Molina-Hernández Nerea, Calvo-Lobo César
Faculty of Nursing, Physiotherapy and Podiatry, Universidad Complutense de Madrid, 28040 Madrid, Spain.
Department of Physiotherapy, Centro Superior de Estudios Universitarios La Salle, 28023 Madrid, Spain.
J Clin Med. 2022 Jul 25;11(15):4318. doi: 10.3390/jcm11154318.
Diaphragmatic weakness and thickness reduction have been detected in athletes with lumbopelvic pain (LPP). Strength training of inspiratory muscles may be necessary for athletes with LPP. Inspiratory muscle training (IMT) and visual biofeedback by rehabilitative ultrasound imaging (RUSI) have been proposed as possible interventions. Here, we determine the effectiveness of visual biofeedback by RUSI with a proposed novel thoracic orthotic device to facilitate diaphragmatic contraction in conjunction with high-intensity IMT in athletes with non-specific LPP. A single-blinded, parallel-group, randomized clinical trial was performed (NCT04097873). Of 86 participants assessed for eligibility, 64 athletes with non-specific LPP (39 males and 25 females; mean age, 33.15 ± 7.79 years) were recruited, randomized, analyzed and received diaphragm visual biofeedback by RUSI in conjunction with high-intensity IMT (RUSI+IMT; n = 32) or isolated high-intensity IMT (IMT; n = 32) interventions for 8 weeks. Diaphragmatic thickness during normal breathing, maximum respiratory pressures, pain intensity, pressure pain threshold on lumbar musculature, disability by the Roland−Morris questionnaire, quality of life by the SF-12 questionnaire and spirometry respiratory parameters were assessed at baseline and after the 8-week intervention. There were significant differences (p = 0.015), within a medium effect size (Cohen’s d = 0.62) for the forced expiratory volume in 1-s (FEV1), which was increased in the RUSI+IMT intervention group relative to the IMT alone group. Adverse effects were not observed. The rest of the outcomes did not show significant differences (p > 0.05). Diaphragm visual biofeedback by RUSI with the proposed novel thoracic orthotic device in conjunction with high-intensity IMT improved lung function by increasing FEV1 in athletes with non-specific LPP.
在患有腰骶部疼痛（LPP）的运动员中已检测到膈肌无力和厚度减小。对于患有LPP的运动员，吸气肌的力量训练可能是必要的。吸气肌训练（IMT）和通过康复超声成像（RUSI）进行的视觉生物反馈已被提议作为可能的干预措施。在此，我们确定通过RUSI进行视觉生物反馈与一种新型胸段矫形器相结合，在患有非特异性LPP的运动员中与高强度IMT联合使用以促进膈肌收缩的有效性。进行了一项单盲、平行组、随机临床试验（NCT04097873）。在86名评估合格的参与者中，招募了64名患有非特异性LPP的运动员（39名男性和25名女性；平均年龄33.15±7.79岁），进行随机分组、分析，并接受通过RUSI进行膈肌视觉生物反馈与高强度IMT联合干预（RUSI + IMT；n = 32）或单独的高强度IMT（IMT；n = 32）干预，为期8周。在基线和8周干预后，评估了正常呼吸时的膈肌厚度、最大呼吸压力、疼痛强度、腰部肌肉的压痛阈值、罗兰 - 莫里斯问卷评估的残疾程度、SF - 12问卷评估的生活质量以及肺功能仪呼吸参数。在1秒用力呼气量（FEV1）方面存在显著差异（p = 0.015），效应量中等（科恩d = 0.62），RUSI + IMT干预组相对于仅IMT组FEV1增加。未观察到不良反应。其余结果未显示出显著差异（p>0.05）。通过RUSI进行膈肌视觉生物反馈与新型胸段矫形器相结合并与高强度IMT联合使用，可通过增加非特异性LPP运动员的FEV1来改善肺功能。
