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骨盆本体感觉神经肌肉促进技术对骶髂关节功能障碍患者的影响:一项随机对照研究。

The effect of pelvic proprioceptive neuromuscular facilitation techniques in patients with sacroiliac joint dysfunction: A randomized controlled study.

作者信息

Ucgun Hikmet, Kaya Meltem, Kulli Hilal Denizoglu

机构信息

Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Istanbul Atlas University, Istanbul, Turkey.

出版信息

J Back Musculoskelet Rehabil. 2025 Mar;38(2):229-240. doi: 10.1177/10538127241298537. Epub 2024 Dec 11.

DOI:10.1177/10538127241298537
PMID:40084572
Abstract

BackgroundDespite the widespread presence of sacroiliac joint dysfunction (SIJD) among causes of low back pain, SIJD is still overlooked.ObjectiveThis study aimed to investigate the effect of pelvic proprioceptive neuromuscular facilitation techniques (PNF) in patients with SIJD. MethodsThis prospective, single-blinded, randomized controlled study was conducted between December 2023 and March 2024. Fourty patients diagnosed with SIJD, with pain for at least 4 weeks initially, aged between 18 and 40, were randomly allocated into experimental group (EG, n = 20) and control group (CG, n = 20) using a computer-based randomised numbered list. The CG received patient education consisting of basic lumbar stabilization exercises (LSE); the EG received exercise training consisting of pelvic PNF techniques in addition to patient education. The interventions of both groups were applied 3 days a week for 6 weeks. Pain, mobility, flexibility, lumbar range of motion, posture, trunk flexor muscle endurance, and trunk extensor muscle endurance were assessed by VAS, Modified Schober's test, sit-and-reach test, goniometer, New York Posture Rating Chart, flexor endurance test, ve Biering-Sørensen test, respectively, before and after interventions. The Shapiro-Wilk test was used to assess normality, while intra-group and inter-group comparisons were conducted using either the Paired sample T-test or the Independent samples T-test.ResultsOf the EG (n = 20, 30,88 ± 14,23 years), 82.35% (n = 14) were female, while the CG (n = 20, 27,18 ± 7,58 years) comprised 76.47% (n = 13) females. The mean body mass index for the EG was 23.71 ± 3.68 kg/m², compared to 23.51 ± 3.68 kg/m² in the CG. Baseline values of pain (p = 0.152, 95% CI [-0.342-2.107]), mobility (p = 0.407, 95% CI [-12.699-5.405]), flexibility (p = 0.758, 95% CI [-2.293-3.116]), posture (p = 0.913, [-2.422-3.613]), trunk flexor muscle endurance (p = 0.336, 95% CI [-3.213-5.955]), and trunk extensor muscle endurance (p = 0.405, 95% CI [-2.927-4.842]) of the groups were similar. Both the EG and CG achieved significant improvements in reducing pain (p < 0.001). The improvement in the pain was significantly higher in the EG compared to the CG (p < 0.001, dcohen = -1.030). There were significantly change in the scores of mobility, flexibility, and lumbar range of motion only in the EG. All changes had a medium or high effect size (p < 0.001, dcohen = 0.631; p = 0.011, dcohen = 0.417; p < 0.05, dcohen = 0.649, respectively).ConclusionIncorporating the pelvic proprioceptive neuromuscular facilitation techniques into the rehabilitation protocols for patients with sacroiliac joint dysfunction may prove beneficial, potentially enhancing pain relief while also improving mobility, flexibility, and lumbar range of motion.

摘要

背景

尽管骶髂关节功能障碍(SIJD)在腰痛病因中广泛存在,但仍被忽视。

目的

本研究旨在探讨骨盆本体感觉神经肌肉促进技术(PNF)对SIJD患者的影响。

方法

本前瞻性、单盲、随机对照研究于2023年12月至2024年3月进行。40例诊断为SIJD的患者,最初疼痛至少4周,年龄在18至40岁之间,使用基于计算机的随机编号列表随机分为实验组(EG,n = 20)和对照组(CG,n = 20)。CG接受包括基本腰椎稳定练习(LSE)的患者教育;EG除患者教育外,还接受包括骨盆PNF技术的运动训练。两组干预均每周进行3天,共6周。在干预前后,分别通过视觉模拟评分法(VAS)、改良Schober试验、坐立位体前屈试验、量角器、纽约姿势评定表、屈肌耐力试验、 Biering-Sørensen试验评估疼痛、活动度、柔韧性、腰椎活动范围、姿势、躯干屈肌耐力和躯干伸肌耐力。使用Shapiro-Wilk检验评估正态性,组内和组间比较分别使用配对样本T检验或独立样本T检验。

结果

EG组(n = 20,年龄30.88 ± 14.23岁)中,82.35%(n = 14)为女性,而CG组(n = 20,年龄27.18 ± 7.58岁)中76.47%(n = 13)为女性。EG组的平均体重指数为23.71 ± 3.68 kg/m²,CG组为23.51 ± 3.68 kg/m²。两组的疼痛(p = 0.152,95%CI[-0.342 - 2.107])、活动度(p = 0.407,95%CI[-12.699 - 5.405])、柔韧性(p = 0.758,95%CI[-2.293 - 3.116])、姿势(p = 0.913,[-2.422 - 3.613])、躯干屈肌耐力(p = 0.336,95%CI[-3.213 - 5.955])和躯干伸肌耐力(p = 0.405,95%CI[-2.927 - 4.842])的基线值相似。EG组和CG组在减轻疼痛方面均取得了显著改善(p < 0.001)。与CG组相比,EG组疼痛改善更为显著(p < 0.001,Cohen's d = -1.030)。仅EG组的活动度、柔韧性和腰椎活动范围得分有显著变化。所有变化均具有中等或高效应量(分别为p < 0.001,Cohen's d = 0.631;p = 0.011,Cohen's d = 0.417;p < 0.05,Cohen's d = 0.649)。

结论

将骨盆本体感觉神经肌肉促进技术纳入骶髂关节功能障碍患者的康复方案可能有益,可能增强疼痛缓解,同时改善活动度、柔韧性和腰椎活动范围。

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