基于平均频率变化的腰椎间盘突出症患者核心稳定性训练的康复价值探讨

目的 通过观察腰椎间盘突出症患者两种体位下核心肌表面肌电图的平均功率值变化探讨核心稳定性训练疗法在临床腰痛康复中的价值。 方法 选取2016年1月-2017年6月绍兴市人民医院符合入选标准的腰椎间盘突出症患者57例,采用随机数字表法分为训练组(29例)和对照组(28例),训练组给予核心稳定性训练疗法联合常规理疗(中频脉冲和超短波治疗);对照组仅接受常规理疗,总疗程8周。在治疗前、治疗后4周和8周时分别进行JOA下背痛评定量表、ODI评估和平均频率(mean frequency,MNF)值提取,选取腹直肌、竖脊肌和多裂肌为MNF提取肌肉,进行数据分析。 结果 提取肌肉接受核心肌治疗后在最大前屈位、后伸位上,上述值均较治疗前改善,组内比较:相比治疗前差异均有统计学意义(均P<0.05);其中训练组内治疗后4周和8周时比较,差异有统计学意义(均P<0.05),而对照组差异无统计学意义(均P>0.05)。组间比较:治疗后8周时,ODI百分比、JOA评分及MNF值差异均有统计学意义(均P<0.05),4周时差异无统计学意义(均P>0.05)。 结论 核心稳定性训练在短期内与常规理疗效果相近,但延长疗程后在减轻腰痛、改善功能障碍及增加核心肌效能方面较一般理疗更为有效,且简便易行,值得临床推广。 

The value of core stability training in lumbar disc herniation on mean frequency

Objective To explore the effects of core stability training in lumbar disc herniation with the change of mean frequency (MNF) signals under different position on core muscles. Methods From January 2016 to June 2017, fifty-seven patients with lumbar disc herniation were randomly divided into the experimental group (core stability training plus regular physical therapy, n=29) and the control group (regular physical therapy only, n=28). The total course of treatment was 8 weeks. All patients were assessed three times (before, after 4 and 8 weeks) using Japanese orthopaedic association (JOA), oswestry disability index (ODI) and MNF of rectus abdominis, erector spinae and lumbar multifidus. Results Two therapies were both effective. The improvements on all above indexes at 4 weeks and 8 weeks after treatment were both statistically significant (all P<0.05) under different position in two groups. There was statistically significant (all P<0.05) in experimental group, but no statistically significant (all P>0.05) in control group between 4 weeks and 8 weeks. Between two groups, no significant difference (all P>0.05) was found at 4 weeks and significant difference (all P<0.05) was found at 8 weeks. Conclusion There are similar effects on patients with lumbar disc herniation between core stability training and regular physical therapy during a short time. While continuing core stability training can further improve the ability of core muscles and relieve pain and dysfunction. It should be better than the regular physical therapy and be worthy of clinical promotion.