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双侧非对称肢体本体感觉神经肌肉促进对腰痛的疼痛、多裂肌活动、活动范围和残疾的影响:一项随机对照试验。

Bilateral Asymmetrical Limb Proprioceptive Neuromuscular Facilitation Effects on Pain, Multifidus Activity, Range of Motion, and Disability in Low Back Pain: A Randomized Controlled Trial.

机构信息

Department of Physiotherapy, Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Sindh, Pakistan.

Health, Physical Education and Sports Sciences, University of Karachi, Karachi, Sindh, Pakistan.

出版信息

J Manipulative Physiol Ther. 2022 Oct;45(8):604-613. doi: 10.1016/j.jmpt.2023.04.005. Epub 2023 Jun 9.

Abstract

OBJECTIVE

The purpose of this study was to determine the effects of bilateral asymmetrical limb proprioceptive neuromuscular facilitation (PNF) pattern exercises on lumbar multifidus (LM) activity, pain, disability, and lumbar range of motions (ROMs) compared to Swiss ball exercises in patients with chronic low back pain (CLBP).

METHODS

A randomized controlled trial was conducted at the Sindh Institute of Physical Medicine and Rehabilitation, Karachi, Pakistan, between March 2020 and January 2021. A sample size of 150 patients with CLBP was randomized into 2 groups. Participants in the intervention group (n = 75) received bilateral asymmetrical limb PNF, while the comparison group (n = 75) received Swiss ball exercises. The scores of the visual analog scale, Oswestry Disability Index, Modified-Modified Schober's test, and percentage of the maximum voluntary contractions of LM (%MVC LM) through surface electromyography were recorded before and after 15 sessions of exercises. The Wilcoxon signed rank and Mann-Whitney U tests were employed for within-group and between-group comparisons of all outcomes, respectively. The considered level of significance was 0.05. The trial was registered with ClinicalTrials.gov (NCT04206137).

RESULTS

Pain (in sitting, standing, and walking), disability on the Oswestry Disability Index, and left side %MVC LM were significantly improved (P < .001) in the PNF group compared to the comparison group except for right side %MVC LM and ROMs on the Modified-Modified Schober's test (P > .05).

CONCLUSION

Bilateral asymmetrical limb PNF exercises showed improvement in pain, disability, and LM activity of patients with CLBP more than those who used Swiss ball exercises.

摘要

目的

本研究旨在比较双侧非对称肢体本体感觉神经肌肉促进(PNF)模式练习与瑞士球练习对慢性下背痛(CLBP)患者腰椎多裂肌(LM)活动、疼痛、残疾和腰椎活动度(ROM)的影响。

方法

本随机对照试验于 2020 年 3 月至 2021 年 1 月在巴基斯坦卡拉奇的信德物理医学与康复研究所进行。将 150 名 CLBP 患者随机分为 2 组。干预组(n=75)接受双侧非对称肢体 PNF,对照组(n=75)接受瑞士球练习。在 15 次运动后,分别使用视觉模拟评分法、Oswestry 残疾指数、改良改良 Schober 试验和表面肌电图测量 LM 的最大自主收缩百分比(%MVC LM)记录视觉模拟评分法、Oswestry 残疾指数、改良改良 Schober 试验和表面肌电图测量 LM 的最大自主收缩百分比(%MVC LM)的评分。分别采用 Wilcoxon 符号秩和检验和 Mann-Whitney U 检验进行组内和组间比较。考虑的显著性水平为 0.05。该试验在 ClinicalTrials.gov(NCT04206137)注册。

结果

与对照组相比,PNF 组在坐姿、站立位和行走时的疼痛(P<0.001)、Oswestry 残疾指数和左侧 %MVC LM 显著改善(P<0.001),而右侧 %MVC LM 和改良改良 Schober 试验的 ROM 无显著改善(P>0.05)。

结论

与瑞士球练习相比,双侧非对称肢体 PNF 练习能更有效地改善慢性下背痛患者的疼痛、残疾和 LM 活动度。

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