本体感觉神经肌肉促进技术治疗慢性非特异性腰痛的疗效观察

目的：观察本体感觉神经肌肉促进技术（PNF）对慢性非特异性腰痛（CNLBP）的影响。方法：选取CNLBP患者41例,随机分为观察组21例和对照组20例,2组患者均采用常规康复治疗,观察组在此基础上增加PNF训练。于治疗前后采用视觉模拟评分法（VAS）、Oswestry功能障碍指数问卷表（ODI）和健康状况调查简表（SF-36）对患者的疗效及功能进行评估,表面肌电图仪采集竖脊肌、腹直肌和腹外斜肌的肌电信号,分析均方根值（RMS）和平均肌电值（AEMG）,并计算屈曲-放松比值（FRR）。结果：治疗4周后,2组患者的VAS评分及ODI指数均较治疗前明显下降（均P＜0.05）,且观察组均低于对照组（均P＜0.05）;SF-36评分和竖脊肌、腹直肌、腹外斜肌的RMS值及竖脊肌FRR值均较治疗前明显提高（均P＜0.05）,且观察组均高于对照组（均P＜0.05）。结论：在常规康复治疗的基础上增加PNF训练可显著改善CNLBP患者的功能,并提高疗效。     

慢性腰痛患者站立位躯干屈伸运动时腰背肌的功能变化研究

目的:研究慢性腰痛(CLBP)患者在站立位矢状面屈伸运动时腰背肌功能状况的变化,揭示其改变的可能机制及临床意义。方法:慢性非特异性腰痛患者25例和健康人25例,在站立位进行躯干的屈曲伸展运动,运用表面肌电图(sEMG)仪和摄像系统同步采集记录双侧L2/3、L4/5水平最长肌、多裂肌在站立位、前屈运动、完全屈曲及回到直立位不同运动时相的sEMG值。结果:两组受试对象站立位时,最长肌及多裂肌均方根(RMS)值差异无显著性意义(P>0.05);前屈运动时,最长肌及多裂肌RMS值增大,完全屈曲时,最长肌及多裂肌RMS值减小,腰痛组在前屈运动和完全屈曲时,最长肌和多裂肌RMS值较健康对照组增大,差异具有显著性意义(P<0.05);由屈曲位回至直立位时,腰痛组最长肌和多裂肌的RMS值明显小于健康对照组,差异具有显著性意义(P<0.05);腰痛组最长肌和多裂肌的屈曲-放松比较健康对照组降低,差异具有显著性意义(P<0.05);运动时相对两组受试对象的最长肌和多裂肌RMS值影响均有显著性意义(P<0.05)。结论:在躯干屈伸运动中,健康人腰背肌存在屈曲-放松现象(FRP),腰痛患者腰背肌功能发生疼痛适应性改变,表现为屈曲-放松反应缺如和主动活动机能不足。     

曲安奈德治疗慢性腰痛12例疗效观察

1 引言 慢性腰痛是多发病、常见病,笔者采用曲安奈德(痛息通,昆明积大制药有限公司生产)穴位注射治疗本病12例,取得了显著疗效,现报告如下.     

健身气功八段锦锻炼治疗大学生慢性颈痛患者的疗效观察

目的 观察健身气功八段锦锻炼治疗大学生慢性颈痛患者的疗效。 方法 采用随机数字表法将72例大学生慢性颈痛患者分为观察组及对照组,指导观察组患者习练健身气功八段锦一、二、四式,指导对照组患者进行颈部肌肉康复训练操练习。2组患者每天早、晚各练习1次,共治疗30 d。于入选时、治疗30 d及6个月后随访时采用颈痛量表(NPQ）对2组患者进行疗效评定,同时采用肌骨超声检查2组患者头半棘肌厚度及弹性变化情况。 结果 治疗30 d后发现2组患者NPQ评分及头半棘肌弹性、厚度均较治疗前明显改善（P<0.05）,并且观察组患者上述指标均显著优于对照组水平（P<0.05）;6个月后随访时发现2组患者NPQ评分、头半棘肌厚度无明显改变,但头半棘肌弹性较治疗结束时明显增加。 结论 八段锦锻炼能有效改善慢性颈痛大学生患者症状,提高生活质量,同时还能促进患者头半棘肌功能恢复,是治疗慢性颈痛的有效手段。     

运动控制训练治疗慢性腰痛的临床疗效研究

目的：探讨运动控制训练(motor control exercise,MCE)对慢性腰痛(chronic low back pain,CLBP)的临床治疗效果。方法：选择2021年1—8月CLBP患者37例,并随机分为试验组(n=18)和对照组(n=19)。两组训练均为每周3天,每天1次,每次60min。对照组均进行核心肌力训练(2组),试验组核心肌力训练(1组)后进行运动控制训练(1组)。共6周。分别在两组患者训练前、训练6周后进行疼痛视觉模拟评分(visual analogue scale,VAS)、Roland-Morris功能障碍调查表(Roland-Morris disability questionnaire,RMDQ)、静态平衡测试评估。结果：治疗6周后,两组患者VAS、RMDQ治疗前后均有显著性差异(P<0.05),试验组睁眼运动椭圆面、闭眼静态平衡指标、睁眼/闭眼长度较治疗前有显著差异(P<0.05);治疗6周后,试验组VAS、RMDQ、睁眼静态平衡指标、闭眼左右方向平均运动速度、运动椭圆面积较对照组显著改善(P<0.05)。结论：MCE对CLBP患...     

腰椎核心稳定性训练结合电针治疗慢性非特异性腰痛的疗效观察

目的：观察腰椎核心稳定性训练结合电针治疗慢性非特异性腰痛（CNLBP）的临床疗效。方法：CNLBP患者64例随机分为2组各32例,对照组给予电针治疗,观察组在此基础上增加腰椎核心稳定性训练。治疗前后采用Oswestry功能障碍指数(ODI)和视觉模拟评分法(VAS)对2组疼痛程度和功能水平进行评价。结果：治疗1个月后,2组ODI及VAS评分均较治疗前明显下降（P<0.05）;随访1个月后,观察组ODI及VAS评分与治疗1个月后比较差异无统计学意义,对照组ODI及VAS评分与治疗1个月后比较明显升高（P<0.05）;观察组治疗后各时间点ODI及VAS评分均更低于对照组（P<0.05）。结论：腰椎核心稳定性训练结合电针治疗慢性非特异性腰痛疗效优于单纯电针治疗,且短期内不易复发。     

四位一体推拿疗法治疗慢性非特异性腰痛的近期疗效观察

目的 比较四位一体推拿疗法与传统推拿疗法治疗慢性非特异性腰痛的近期疗效。方法 慢性非特异性腰痛患者60例,采用随机数字表法分为四位一体推拿疗法组和传统推拿组各30例,分别采用传统推拿和四位一体推拿,每周治疗2次,每次40 min,连续治疗4周。比较两组患者治疗前和治疗结束后1个月的腰部疼痛视觉模拟量表(VAS)评分、Roland腰椎功能障碍评分和Oswestry功能障碍指数(ODI)评分。结果 治疗后1月,两组患者VAS评分、Roland评分、ODI评分均低于治疗前,且四位一体推拿疗法组评分低于单纯推拿组,好转率优于单纯推拿组,差异有统计学意义(P<0.05)。结论 采用四位一体推拿疗法和传统推拿法治疗慢性非特异性腰痛均能使腰部疼痛得到缓解,改善腰部活动功能,四位一体推拿疗法近期临床疗效更佳。     

悬吊训练治疗慢性非特异性腰痛的疗效观察

慢性腰痛是指疼痛局限于肋以下、下臀纹以上的疼痛、肌肉紧张或僵硬,可能伴有下肢疼痛(坐骨神经痛)且持续12周及以上。非特异性腰痛是指不能归因于可辨认的病理学(如感染、肿瘤、骨质疏松风湿性关节炎、骨折或炎症)的     

四维疗法治疗飞行人员慢性下腰痛临床疗效观察

目的 探讨四维疗法治疗飞行人员慢性下腰痛临床疗效.方法 选取全军软组织伤病康复中心康复疗养的96例飞行人员慢性下腰痛患者按就诊顺序,使用随机数字表分为两组,观察组48例,采用四维疗法治疗;对照组48例,采用按摩、针灸、中频传统方法治疗.两组每个疗程均为10 d,2个疗程后观察疗效、VAS评分、JOA评分分值变化.结果 ...     

八段锦锻炼对慢性心力衰竭患者疗效的Meta分析

目的：对八段锦锻炼治疗慢性心力衰竭（CHF）患者的有效性及安全性进行系统评价。方法：检索Web of Science、Pubmed、Embase、Cochrane Library、维普数据库、中国知网、万方数据库,检索八段锦对慢性心力衰竭疗效的随机对照试验,按照纳入标准与排除标准筛选文献,根据Cochrane Reviews Handbook进行文献质量评价,采用RevMan 5.4软件对数据进行Meta分析。结果：共纳入8篇随机对照实验,治疗组共343例患者,对照组共313例患者。Meta分析结果显示：与对照组比较,联合八段锦治疗在6 min步行距离测试（WMD 102.8m;95%CI:70.76 to 134.83;P<0.05）、生活质量评分（MLFHQ scores）(WMD-10.77points;95%CI：-13.19 to-8.34;P<0.05)、左心室射血分数（LEVF）(WMD 3.62%;95%CI:2.05 to 5.19;P<0.05)上均有显著改善;与对照组比较,可降低CHF患者血清脑利钠肽水平（BNP）(WMD-76.2 pg/ml;...     

Analyzing chronic low back pain: the relative contribution of pain coping strategies

Sixty-two chronic low back pain patients were administered the Coping Strategies Questionnaire (CSQ) to assess the frequency of use and perceived effectiveness of a variety of cognitive and behavioral pain coping strategies. Analysis of individual variables revealed that CSQ factors, gender, physical examination findings, and chronicity of pain had significant effects on one or more of a series of pain, psychological distress or behavioral measures. To assess the relative contribution of each of these variables hierarchical stepwise regression analyses were carried out. These analyses revealed that the Helplessness factor of the CSQ explained 50% of the variance in psychological distress (Global Severity Index of the SCL-90R), and 46% of the variance in depression (Beck Depression Inventory). Patients scoring high on this CSQ factor had significantly higher levels of psychological distress. None of the demographic or medical status variables explained a significant proportion of variance in the psychological distress measures. The Diverting Attention and Praying factor of the CSQ explained a moderate (9%), but significant amount of variance in pain report. Patients scoring high on this factor had higher scores on the McGill Pain Questionnaire. Coping strategies were not strongly related to pain behavior measures such as guarding or uptime. A consideration of pain coping strategies may allow one to design pain coping skills training interventions so as to fit the needs of the individual low back pain patient.     

Electromyography-biofeedback for chronic low back pain: A qualitative cohort study

Background and AimsSurface electromyography-biofeedback (sEMG-BF) may reduce the burden of CLBP by improving physical functioning, sleep, pain catastrophizing, anxiety, and depression. This qualitative study investigated the impact of weekly EMG-BF sessions on adults with CLBP.MethodsTwenty-six individuals with CLBP participated in telephone interviews after completing an 8-week virtual sEMG-BF intervention. Trained interviewers conducted the 10-to-15-minute semi-structured interviews to understand participants’ experience with the intervention. Common themes and subthemes were identified and analyzed using MAXQDA 2022 software.ResultsParticipants were predominantly middle-aged females (M = 45, range of 19 – 66) who have had exposure to utilizing conventional therapies such as physical therapy, chiropractor, and massage for the treatment of CLBP. This study focused on participants who reported their experience of the main outcome study which included perceived reductions in CLBP symptoms, including pain and stress, and positive effects on self-awareness and sleep. Three overarching themes emerged and were further divided into subthemes: participants’ involvement (virtual experience, accessibility of device, and future recommendations) perceived benefits (participants gained awareness, recommendations for future treatment, met expectations, and implementation), and desire for flexibility (obstacles and COVID-19 Impact). No adverse effects were reported by any of the participants within the study.ConclusionsBoth physical and psychological improvements were reported by participants following an sEMG-BF intervention. Specific implementation procedures and critical barriers were identified. In particular, the ability to receive care for CLBP during the COVID-19 pandemic was important to participants.     

The influence of non-specific low back pain on pressure pain thresholds and disability.

The purpose of this study was to investigate the pressure pain thresholds (PPTs) with respect to the Erector spinae and the hip muscles in 87 patients with subacute non-specific low back pain (LBP) and to evaluate the relationship between the PPTs and disability. In order to establish reference values, 64 healthy subjects were examined with respect to PPTs and used as a control group against the group of LBP patients. The mean PPT values of the Erector spinae and the hip at all examined points of the LBP group were significantly lower (p<0.001) in comparison to the PPT values of the healthy group. An exceptionally high difference (2.7 kg/cm2) was found at the L3 Erector spinae level. The correlation between having LBP or not in the whole group (n=151) and PPT, was highest at the L3 level of the Erector spinae (r=-0.710, p<0.001). When the group of patients with LBP was divided into two subgroups in terms of having an Oswestry disability index (ODI) lower than 40 ("moderate LBP disability") or an ODI higher than 40 ("severe LBP disability") it was surprising to notice that there was no significant difference between the PPTs of the Erector spinae and the hip musculature. This study has shown the possibility of the existence of muscular disorder in the lumbar part of the Erector spinae in patients with non-specific low back pain, but also reveals the strong inter-individual differences in muscular fibrosis sensitivity and pain behaviour related to gender.     

The disabling role of fluctuations in physical activity in patients with chronic low back pain

Patients with chronic low back pain (CLBP) often report a disabling decrease in their activity level due to pain. The nature of the association between disability, activity, and pain over time is however, unclear. An intriguing issue here is whether a high level of pain-related disability is associated with a low activity level or are changes in the level of activity over time pain provoking and thus more disabling? The objectives of this study were to investigate associations between disability, pain intensity, pain-related fear, and characteristics of physical activity in patients with CLBP. A total of 42 patients with CLBP were recruited from the Pain Clinic of the Maastricht University Hospital. Each pain patient carried an electronic diary for one week, in which questions about current pain intensity, and the level of physical activity were completed at 8 moments a day. Disability was scored by the Quebec Back Pain Disability Scale (QBPDS), Fear of movement by the Tampa Scale for Kinesiophobia (TSK). To explain the level of disability regression analyses were performed with disability as dependent variable and pain intensity, pain-related fear, and consecutively the level of physical activity in daily life and fluctuations in physical activity as independent variables. Results, based on 34 patients, showed that activity fluctuations (β = 0.373, p < 0.05) rather than the mean activity level over time (β = ?0.052, ns) contributed significantly in explaining disability. The results are discussed in the light of current theories, previous research, and clinical implications.     

核心稳定性训练联合认知行为疗法对慢性非特异性腰痛患者疗效观察

目的研究核心稳定性训练联合认知行为疗法(CBT)对慢性非特异性腰痛(CNLBP)患者的疗效。方法选取首都医科大学附属北京康复医院住院部收治的60例CNLBP患者,按照随机数字表法分为治疗组和对照组各30例,两组均接受核心稳定性训练,治疗组在此基础上行CBT干预。比较两组功能障碍指数(ODI)、疼痛视觉模拟评分(VAS)、精神状况自评量表(SCL-90)、腰部活动度及临床疗效,不良反应及复发情况。结果治疗后,治疗组总有效率高于对照组(P<0.05);两组VAS、ODI评分均低于治疗前,治疗组下降程度大于对照组(P<0.05);治疗组躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐惧、偏执的评分低于对照组,前屈、后伸和侧弯的活动度高于对照组(P<0.05);两组不良反应发生率及复发率比较差异无统计学意义(P>0.05)。结论核心稳定性训练联合CBT治疗CNLBP,临床疗效良好,有效改善患者心理状况和腰部活动度。     

The effect of the Alexander Technique on pain intensity in patients with chronic low back pain: A randomized controlled trial

ObjectiveThe present study was performed to determine the effect of the Alexander Technique on the intensity of pain in patients with chronic low back pain (LBP).MethodsThis study is a clinical trial that was performed on 80 patients with chronic LBP in Kashan, Iran. Participants were randomly assigned in control and intervention groups. To assess the participants’ LBP, a visual analog scale of pain (VAS-Pain) was completed by both groups. In the intervention group, in addition to routine care for LBP patients, the Alexander Technique was performed in three 60-min sessions per week for 12 weeks. The control group participants received routine care for LBP patients. The two groups completed the VAS-Pain scale immediately after and one month after the intervention.ResultsThe results showed that there was no statistically significant difference between the two groups in terms of demographic characteristics and mean pain intensity score before the intervention (p > 0.05). Immediately after and then one month after the intervention, there was statistically significant differences between the two groups regarding the mean scores of pain (p < 0.05). The results of repeated measures ANOVA showed that, in the intervention group, the mean score of pain had decreased over time (p < 0.05).ConclusionThe results of the present study showed that the Alexander Technique was effective in reducing the intensity of pain among the participants. We recommend the Alexander Technique as a useful and effective intervention for reducing chronic LBP.     

Effects of Qigong practice in office workers with chronic non-specific low back pain: A randomized control trial

ObjectiveTo investigate the effects of Qigong practice, Guan Yin Zi Zai Gong level 1, compared with a waiting list control group among office workers with chronic nonspecific low back pain (CNLBP).MethodsA randomized controlled trial was conducted at offices in the Bangkok Metropolitan Region. Seventy-two office workers with CNLBP were screened for inclusion/exclusion criteria (age 20–40 years; sitting period more than 4 h per day) and were allocated randomly into two groups: the Qigong and waiting list groups (n = 36 each). The participants in the Qigong group took a Qigong practice class (Guan Yin Zi Zai Gong level 1) for one hour per week for six weeks at their workstation. The participants were encouraged to conduct the Qigong exercise at home every day. The waiting list group received general advice regarding low back pain management. The primary outcomes were pain intensity, measured by the visual analog scale, and back functional disability, measured by the Roland and Morris Disability Questionnaire. The secondary outcomes were back range of motion, core stability performance index, heart rate, respiratory rate, the Srithanya Stress Scale (ST-5), and the global perceived effect (GPE) questionnaire.ResultsCompared to the baseline, participants in the Qigong group experienced significantly decreased pain intensity and back functional disability. No statistically significant difference in these parameters was found in the waiting list group. Comparing the two groups, Qigong exercise significantly improved pain intensity, back functional impairment, range of motion, core muscle strength, heart rate, respiratory rate, and mental status. The Qigong group also had a significantly higher global outcome satisfaction than the waiting list group.ConclusionQigong practice is an option for treatment of CNLBP in office workers.