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运动再训练和腰椎稳定练习对机械性下背痛的影响:一项初步研究。

Effects of Movement Retraining and Lumbar Stabilization Exercises in Mechanical Low Back Pain: A Pilot Study.

作者信息

Desai Roopa, Rathi Manisha, Palekar Tushar J

机构信息

Musculoskeletal Sciences, Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pune, IND.

Physiotherapy, Dr. D. Y. Patil College of Physiotherapy, Dr. D. Y. Patil Vidyapeeth, Pune, IND.

出版信息

Cureus. 2024 Feb 16;16(2):e54291. doi: 10.7759/cureus.54291. eCollection 2024 Feb.

Abstract

Objective To determine and compare the effects of movement retraining (MR), lumbar stabilization exercises (LSE), and a combination of both these exercises on pain, flexibility, strength, and functional disability in chronic mechanical low back pain (CMLBP) patients. Materials and methods Fifteen CMLBP participants, aged 20-40 years, were randomly allocated into three groups. Group A (n=5) received MR, group B (n=5), LSE, and group C (n=5), a combination of MR and CSE, along with hot packs for eight weeks, thrice a week on alternate days. Outcomes used were the Numerical Pain Rating Scale (NPRS), Modified Modified Schober's Test (MMST), Pressure Biofeedback (PBU), Roland Morris Disability Questionnaire (RMDQ), and Movement Control (MC) dissociation tests to identify MC impairments and were assessed at pre-intervention, post-four weeks, and post-eight weeks. The data were analyzed using repeated measures ANOVA. The level of significance was considered at p-value<0.05. Results Participants with CMLBP significantly improved in all variables in all three groups (p-value≤0.05). On inter-group comparison, group A showed better improvement in lumbar extension range of motion than the other two groups, with a mean difference of MMST in group A of 0.62±0.30, group B of 0.52±0.22, and group C of 0.36±0.02, with a p-value ≤0.002. Group C showed more improvement in core strength, with a mean difference of 5.0±0.25 in group A, 3.2±0.56 in group B, and 5.2±0.57 in group C, with a p-value ≤0.03. A significant improvement was observed in NPRS, MMST flexion, RMDQ, and uncontrolled movements (UCMs). Conclusion All three methods of treatment are effective in the management of CMLBP. Clinically, kinetic control showed better improvement in reducing pain and improving lumbar flexion and extension range of motion. Functional disability was better improved with lumbar stabilization exercises, and core strength was improved with a combination of KC and LSE. However, a combination of MR and LSE helps improve core strength, and movement retraining improves lumbar extension.

摘要

目的 确定并比较运动再训练(MR)、腰椎稳定训练(LSE)以及这两种训练的联合应用对慢性机械性下腰痛(CMLBP)患者疼痛、灵活性、力量和功能障碍的影响。材料与方法 15名年龄在20 - 40岁的CMLBP参与者被随机分为三组。A组(n = 5)接受MR训练,B组(n = 5)接受LSE训练,C组(n = 5)接受MR和LSE的联合训练,同时使用热敷袋,为期八周,每周三次,隔日进行。使用的评估指标包括数字疼痛评分量表(NPRS)、改良Schober试验(MMST)、压力生物反馈(PBU)、罗兰·莫里斯残疾问卷(RMDQ)以及运动控制(MC)解离测试以识别MC损伤,并在干预前、四周后和八周后进行评估。数据采用重复测量方差分析进行分析。显著性水平设定为p值<0.05。结果 所有三组中CMLBP参与者的所有变量均有显著改善(p值≤0.05)。组间比较时,A组在腰椎后伸活动度方面的改善优于其他两组,A组MMST的平均差值为0.62±0.30,B组为0.52±0.22,C组为0.36±0.02,p值≤0.002。C组在核心力量方面的改善更为明显,A组的平均差值为5.0±0.25,B组为3.2±0.56,C组为5.2±0.57,p值≤0.03。在NPRS、MMST前屈、RMDQ和非控制运动(UCMs)方面观察到显著改善。结论 所有三种治疗方法对CMLBP的管理均有效。临床上,动力学控制在减轻疼痛和改善腰椎屈伸活动度方面显示出更好的效果。腰椎稳定训练在改善功能障碍方面效果更佳,而核心力量通过动力学控制和LSE的联合应用得到改善。然而,MR和LSE的联合应用有助于提高核心力量,运动再训练可改善腰椎后伸。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cef8/10944583/dee84a1c9410/cureus-0016-00000054291-i01.jpg

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