悬吊运动训练对慢性非特异性腰痛的疗效观察

目的观察悬吊运动训练技术治疗社区慢性非特异性腰痛的效果。方法 35例成人慢性非特异性腰痛患者分成治疗组(n=18)和对照组(n=17),分别采用电疗+悬吊运动训练和单纯电疗治疗4周。使用疼痛数字评分(NRS)、Oswestry腰痛功能障碍问卷,分别在治疗开始前、治疗4周后进行评估。结果治疗后与对照组比较,治疗组NRS、Oswestry腰痛功能障碍问卷评分改善(P<0.05)。结论悬吊运动训练可以有效减轻社区慢性非特异性腰痛患者的疼痛及功能障碍。     

悬吊运动疗法治疗慢性非特异性腰痛的研究

目的研究悬吊运动疗法对慢性非特异性腰痛患者的治疗效果。 方法26例慢性非特异性腰痛患者接受6周的悬吊运动治疗。在患者初次就诊、治疗6周后以及治疗结束3个月后分别用目测类比评分（VAS）和Roland-Morris功能障碍问卷（RMDQ）评价其疼痛程度和功能障碍程度。 结果和初诊时相比,治疗6周及治疗结束3个月后随访时,患者疼痛程度明显减轻(P＜0.05);患者功能障碍得到明显改善(P＜0.05)。 结论悬吊运动疗法是一种有效减轻慢性非特异性腰痛患者疼痛程度并改善其功能障碍的疗法。     

腰椎稳定性训练治疗慢性非特异性腰痛的研究

目的:研究腰椎稳定性训练对慢性非特异性腰痛患者的治疗效果.方法:91名慢性非特异性腰痛患者随机分为治疗组(46人)和对照组(45人).两组患者均接受6周共18次治疗,治疗组患者进行腰椎稳定性训练,对照组患者接受磁热治疗.在患者治疗前、治疗6周后以及随访1年后分别评价其疼痛和功能障碍程度.结果:治疗6周后,治疗组较对照组患者在疼痛和功能障碍方面具有更显著的改善(P<0.05),治疗组疗效在随访1年后仍然得到维持(P<0.05).结论:腰椎稳定性训练是一种有效减轻慢性非特异性腰痛患者疼痛程度并改善其功能障碍的疗法.     

悬吊训练技术对肩周炎的疗效观察

目的:观察悬吊训练技术(SET)与常规疗法治疗肩周炎的临床疗效。方法:将43例肩周炎患者随机分为对照组和治疗组,治疗组21例,对照组22例,对照组采用常规训练技术,治疗组使用悬吊训练技术。每组患者每周接受5次治疗,持续4周,患者治疗前、治疗4周后采用肩功能评定法(CMS)进行评估。结果:研究显示,两组患者经过治疗后各项评分均有显著提高;治疗前两组患者之间差异无显著性意义(P0.05),治疗4周后,治疗组与对照组的差异均具有显著性意义(P0.05),且治疗组显著优于对照组。结论:对于肩周炎患者,应用悬吊训练技术比常规训练技术能更好的减轻疼痛、增加肩关节活动度、改善肌力和提高上肢运动功能。     

悬吊训练对产后腰痛的效果

目的探讨悬吊训练对产后腰痛的临床疗效。方法 2017年2月至2018年2月,产后腰痛的患者66例随机分为对照组(n=33)和观察组(n=33)。对照组给予常规康复理疗和美式脊椎矫正,观察组在对照组基础上辅以悬吊训练。治疗前和治疗6周后采用疼痛数字评分、Oswestry功能障碍指数和腹横肌厚度进行评价。结果治疗前,两组疼痛数字评分、Oswestry功能障碍指数评分和腹横肌厚度均无显著性差异(P 0.05)。治疗6周后,两组疼痛数字评分、Oswestry功能障碍指数评分较治疗前均显著降低(t 14.579, P 0.001);两组腹横肌厚度较治疗前均显著增加(t 15.855, P 0.001);且观察组上述指标均显著优于对照组(t 4.818,P 0.001)。结论在常规康复理疗和美式脊椎矫正治疗基础上再辅以悬吊训练,可进一步减轻产后腰痛患者的疼痛,改善功能,提高生活质量。     

五禽戏配合控力抗阻康复运动治疗慢性下腰痛的临床研究

目的观察五禽戏配合控力抗阻康复运动治疗慢性下腰痛的临床疗效。方法按入院日期尾号的单双号将76例患者分为对照组和观察组各38例。对照组给予优化的腰背肌康复运动方案。观察组给予五禽戏运动方案和智能化运动控制训练系统下的控力抗阻康复运动方案。两组患者均每天训练,3周为1个疗程,共进行3个疗程。采用视觉模拟评分法和Oswestry腰痛残疾指数对患者腰背部功能进行评分。结果干预3周、6周、9周后,两组患者视觉模拟评分法和Oswestry腰痛残疾指数评分均低于训练前,且观察组评分更低于对照组,差异有统计学意义(P0.05)。结论五禽戏配合控力抗阻康复运动治疗对慢性下腰痛具有较好的临床疗效。     

悬吊训练治疗青少年特发性非双弯型脊柱侧弯疗效观察

目的:观察悬吊训练对青少年特发性非双弯型脊柱侧弯(AIS)的影响。方法:选择2019年6—12月在东南大学附属中大医院康复医学科治疗的AIS患者42例,采用随机数字表法分为对照组和观察组,每组21例。2组均给予常规康复训练,常规康复训练主要包括凹侧脊柱肌筋膜放松治疗(5 min/次)、呼吸治疗(每组6次,共3组,组间休息40 s)、牵引治疗(30 min/次)。对照组在常规康复训练基础上给予垫上训练,主要包括双桥训练、卷腹训练、左或右侧平板训练,每个动作训练8～10次,共训练4～6组,组间休息40～60 s。观察组在常规康复训练基础上给予悬吊训练。主要包括仰卧位、侧卧位、俯卧位下的中立位控制训练(记录训练维持时间,出现疼痛或者疲劳即终止此次训练,每个动作训练8～10次,共训练4～6组,组间休息40～60 s)。以上项目训练隔日1次,3次/周,持续训练6个月。在治疗前及治疗6个月后分别采用Cobb角评估患者脊柱侧弯严重程度;采用锁骨角(CA)评估肩部失衡程度;采用骨盆倾斜角(PO)评估骨盆失衡程度;采用脊柱侧弯研究协会22项问卷表(SRS-22)评估患者的自我形象满意度。结果:治疗前,2组Cobb角、CA、PO、SRS-22评分差异无统计学意义(P0.05)。与治疗前比较,2组Cobb角、CA、PO均明显减小,SRS-22评分明显增加,差异具有统计学意义(P0.05)。与对照组比较,观察组Cobb角、CA、PO均明显更低,SRS-22评分明显更高,差异具有统计学意义(P0.05)。结论:悬吊训练可有效改善AIS患者脊柱侧弯、肩部失衡、骨盆失衡及自我形象满意度,值得临床推广。     

悬吊运动训练对恢复期脑卒中患者上肢功能的影响

目的:观察悬吊运动训练对恢复期脑卒中患者上肢功能改善的效果。方法:将脑卒中偏瘫患者32例随机分为观察组和对照组各16例,对照组采用常规偏瘫上肢康复训练,观察组在此基础上增加悬吊运动训练,分别于治疗前后采用Fugl-Meyer上肢运动功能(FMA-UE)和Barthel指数(BI)进行评定。结果:治疗4周后,2组FMAUE和BI评分均较治疗前有明显提高(P0.05),且观察组FMA-UE和BI评分明显高于对照组(P0.05)。结论:悬吊运动训练可以改善恢复期脑卒中患者上肢的运动功能,提高日常生活活动能力。     

核心肌力训练对轻中度青少年特发性脊柱侧弯患儿肌群肌力改善及Cobb角的影响

目的探讨核心肌力训练对轻中度青少年特发性脊柱侧弯(AIS)患儿肌群肌力改善及Cobb角的影响。方法选取2018年1月—2019年12月于医院接受治疗的青少年特发性脊柱侧弯(AIS)患儿98例,按照组间基本特征匹配的原则分为对照组与观察组,各49例。对照组采用常规支具治疗与护理,观察组在此基础上采用核心肌力训练干预,比较两组患儿肌群肌力改善情况、Cobb角、视觉模拟疼痛评分(VAS)及肢体运动功能评分(FMA)。结果观察组肌群肌力优于对照组(P<0.05);Cobb角、VAS评分均低于对照组(P<0.05),FMA评分高于对照组(P<0.05)。结论青少年特发性脊柱侧弯(AIS)患儿采用核心肌力训练干预效果明显,可有效提升患儿肌群肌力水平,改善Cobb角,降低疼痛感,促进患儿运动功能恢复。     

悬吊运动疗法治疗腰椎间盘突出症患者的疗效观察

目的观察悬吊运动疗法（SET）治疗腰椎间盘突出症(LDH)的疗效。 方法采用随机数字表法将62例LDH患者分为治疗组及对照组,其中对照组给予干扰电、超短波及湿热敷治疗,治疗组在上述基础上同时辅以SET训练。于治疗前、治疗4周后分别采用疼痛VAS评分、腰椎疾患治疗成绩评分表对2组患者腰痛及腰椎功能改善情况进行评定。 结果2组患者分别经4周治疗后,发现治疗组疼痛VAS评分［(3.22±0.94)分］、腰椎功能评分［(23.6±5.8)分］、对照组疼痛VAS评分［(4.66±0.92)分］、腰椎功能评分［(15.4±6.5)分］均较治疗前明显改善（P<0.05）,并且上述指标均以治疗组患者的改善幅度较显著,与对照组间差异均具有统计学意义（P<0.05）;另外治疗组患者腰椎功能评分改善率［（90.3±16.5）% vs（79.3±24.9）%］及治愈显效率（87.5% vs 73.3%）亦显著优于对照组水平,组间差异均具有统计学意义（P<0.05）。 结论SET训练可显著减轻LDH患者腰痛症状,促其腰椎功能改善,该疗法值得临床推广、应用。     

216例慢性非特异性腰痛患者的康复疗效观察

目的观察不同治疗手段对慢性非特异性腰痛的临床疗效。方法对246例慢性非特异性腰痛患者随机分成对照组(n=82)、家庭指导组(n=82)和强化治疗组(n=82)进行治疗,使用数字类比疼痛评分法、改良Oswestry腰痛调查表,分别在治疗开始前、治疗后1个月、3个月和6个月进行评估。结果家庭指导组和强化治疗组均能减轻腰痛,且强化治疗组疗效更好。结论以主动运动训练为核心的现代康复治疗技术可有效改善慢性非特异性腰痛患者的症状。     

Effectiveness of an extension-oriented treatment approach in a subgroup of subjects with low back pain: a randomized clinical trial

BACKGROUND AND PURPOSE: The purpose of this multicenter randomized clinical trial was to examine the effectiveness of an extension-oriented treatment approach (EOTA) in a subgroup of subjects with low back pain (LBP) who were hypothesized to benefit from the treatment compared with similar subjects who received a lumbar spine strengthening exercise program. METHODS: Subjects with LBP and symptoms distal to the buttocks that centralized with extension movements were included. Forty-eight subjects were randomly assigned to groups that received an EOTA (n=26) or a strengthening exercise program (n=22). Subjects attended 8 physical therapy sessions and completed a home exercise program. Follow-up data were obtained at 1 week, 4 weeks, and 6 months after randomization. Primary outcome measures were disability (modified Oswestry Low Back Pain Disability Questionnaire) and pain (Numeric Pain Rating Scale). RESULTS: Subjects in the EOTA group experienced greater improvements in disability compared with subjects who received trunk strengthening exercises at 1 week (mean difference between groups from baseline=8.9, 95% confidence interval [CI]=2.0, 15.9), 4 weeks, (mean difference=14.4, 95% CI=4.8, 23.9), and 6 months (mean difference=14.6, 95% CI=4.6, 24.6). The EOTA group demonstrated greater change in pain at the 1-week follow-up only. DISCUSSION AND CONCLUSION: An EOTA was more effective than trunk strengthening exercise in a subgroup of subjects hypothesized to benefit from this treatment approach. Additional research is needed to explore whether an EOTA may benefit other subgroups of patients.     

MULTIDISCIPLINARY PAIN ABSTRACTS: 49

The purpose of this multicenter, randomized, controlled trial was to compare the effect of manual therapy to exercise therapy in sick-listed patients with chronic low back pain. The effects of exercise therapy and manual therapy on chronic low back pain with respect to pain, function, and sick leave have been investigated in a number of studies. The results are, however, conflicting. Patients with chronic low back pain or radicular pain sick-listed for more than 8 weeks and less than 6 months were included. A total of 49 patients were randomized to either manual therapy (n=27) or to exercise therapy (n=22). Sixteen treatments were given over the course of 2 months. Pain intensity, functional disability (Oswestry disability index), general health (Dartmouth Care Cooperative function charts), and return to work were recorded before, immediately after, at 4 weeks, 6 months, and 12 months after the treatment period. Spinal range of motion (Schober test) was measured before and immediately after the treatment period only. Although significant improvements were observed in both groups, the manual therapy group showed significantly larger improvements than the exercise therapy group on all outcome variables throughout the entire experimental period. Immediately after the 2-month treatment period, 67% in the manual therapy and 27% in the exercise therapy group had returned to work. It was concluded that improvements were found in both intervention groups, but manual therapy showed significantly greater improvement than exercise therapy in patients with chronic low back pain. The effects were reflected on all outcome measures, both on short- and long-term follow-up.     

Trunk muscle stabilization training plus general exercise versus general exercise only: randomized controlled trial of patients with recurrent low back pain

BACKGROUND AND PURPOSE: The purpose of this randomized controlled trial was to examine the usefulness of the addition of specific stabilization exercises to a general back and abdominal muscle exercise approach for patients with subacute or chronic nonspecific back pain by comparing a specific muscle stabilization-enhanced general exercise approach with a general exercise-only approach. SUBJECTS: Fifty-five patients with recurrent, nonspecific back pain (stabilization-enhanced exercise group: n=29, general exercise-only group: n=26) and no clinical signs suggesting spinal instability were recruited. METHODS: Both groups received an 8-week exercise intervention and written advice (The Back Book). Outcome was based on self-reported pain (Short-Form McGill Pain Questionnaire), disability (Roland-Morris Disability Questionnaire), and cognitive status (Pain Self-Efficacy Questionnaire, Tampa Scale of Kinesiophobia, Pain Locus of Control Scale) measured immediately before and after intervention and 3 months after the end of the intervention period. RESULTS: Outcome measures for both groups improved. Furthermore, self-reported disability improved more in the general exercise-only group immediately after intervention but not at the 3-month follow-up. There were generally no differences between the 2 exercise approaches for any of the other outcomes. DISCUSSION AND CONCLUSION: A general exercise program reduced disability in the short term to a greater extent than a stabilization-enhanced exercise approach in patients with recurrent nonspecific low back pain. Stabilization exercises do not appear to provide additional benefit to patients with subacute or chronic low back pain who have no clinical signs suggesting the presence of spinal instability.     

Continuous low-level heat wrap therapy for the prevention and early phase treatment of delayed-onset muscle soreness of the low back: a randomized controlled trial

OBJECTIVE: To evaluate the effects of continuous low-level heat wrap therapy for the prevention and early phase treatment (ie, 0-48 h postexercise) of delayed-onset muscle soreness (DOMS) of the low back. DESIGN: Two prospective randomized controlled trials. SETTING: Outpatient medical facility. PARTICIPANTS: Sixty-seven subjects asymptomatic of back pain and in good general health (mean age, 23.5+/-6.6 y). INTERVENTIONS: Participants performed vigorous eccentric exercise to experimentally induce low back DOMS. Participants were assigned to 1 of 2 substudies (prevention and treatment) and randomized to 1 of 2 treatment groups within each substudy: prevention study (heat wrap, n=17; control [nontarget muscle stretch], n=18) and treatment study (heat wrap, n=16; cold pack, n=16). Interventions were administered 4 hours before and 4 hours after exercise in the prevention study and between hours 18 to 42 postexercise in the treatment study. MAIN OUTCOME MEASURES: To coincide with the expected occurrence of peak symptoms related to exercise-induced low back DOMS, hour 24 postexercise was considered primary. Pain intensity (prevention) and pain relief (treatment) were primary measures, and self-reported physical function and disability were secondary measures. RESULTS: In the prevention study, at hour 24 postexercise, pain intensity, disability, and deficits in self-reported physical function in subjects with the heat wrap were reduced by 47% (P<.001), 52.3% (P=.029), and 45% (P=.013), respectively, compared with the control group. At hour 24 in the treatment study, postexercise, pain relief with the heat wrap was 138% greater (P=.026) than with the cold pack; there were no differences between the groups in changes in self-reported physical function and disability. CONCLUSIONS: In this small study, continuous low-level heat wrap therapy was of significant benefit in the prevention and early phase treatment of low back DOMS.     

Long-term exercise adherence in the elderly with chronic low back pain

OBJECTIVE: Chronic back pain is common in the elderly population and can be treated with exercise. Long-term adherence to exercise recommendations has been documented in adults of <65 yrs of age but not for elderly adults. This study explored exercise behaviors of elderly adults with a history of chronic back pain before and 2 yrs after treatment in an exercise-oriented rehabilitation program. DESIGN: This study utilized a case series design to survey 126 subjects >65 yrs old who underwent physical therapy during the year 2000 for complaints of chronic low back pain. Of these, 89 (70%) responded to the 2-yr questionnaire. Outcome measures included visual analog scale for pain, Oswestry disability questionnaires, back flexibility and strength, and a questionnaire exploring exercise behaviors. All subjects underwent a 6-wk physical therapy program that consisted of exercise coupled with advice to remain active. RESULTS: Improvements in flexibility and strength occurred during treatment. Mean Oswestry disability scores (0-100 scale) improved from 32 to 20, and pain scores (0-10 scale) from 5.0 to 3.0 during treatment (P < 0.001) and were maintained at the 2-yr follow-up, regardless of exercise adherence. The percentage of patients who performed at least some exercise increased from 49% before treatment to 72% at the 2-yr follow-up. The changes in disability or pain observed during treatment did not influence exercise compliance. The most frequently stated reasons for nonadherence was that exercise did not help or aggravated pain (33%). For those who exercised regularly, 80% did so because of the health benefits from exercise. CONCLUSIONS: The exercise behaviors of many elderly adults with chronic low back pain can increase after an exercise-oriented spine physical therapy program.     

Osteopathic manipulative treatment combined with exercise improves pain and disability in individuals with non-specific chronic neck pain: A pragmatic randomized controlled trial

PurposeTo determine effectiveness of osteopathic manipulative treatment combined with stretching and strengthening exercises in the cervical region on pain and disability in individuals with non-specific chronic neck pain.Methods90 adults with non-specific chronic neck pain were randomized to either exercises group (EG, n = 45) or osteopathic manipulative treatment associated with exercises group (OMT/EG, n = 45). The primary outcomes were obtained by the use of Numeric Pain-Rating Scale (NPRS), Pressure Pain Threshold (PPT) and Neck Disability Index (NDI). Secondary outcomes included range of motion (ROM) for cervical spine rotation, Fear-Avoidance Beliefs Questionnaire Work/Physical Activity (FABQ-W/PA) and Pain-self efficacy at two different moments: baseline and 4 weeks after the first treatment. Techniques and dosages of OMT were selected pragmatically by a registered osteopath. Generalized Estimating Equations model (GEE), complemented by the Least Significant Difference (LSD) and the intention-to-treat analysis, was used to assess the clinical outcomes.ResultsAnalysis with GEE indicated that OMT/EG reduced pain and disability more than the EG alone after 4 weeks of treatment with statistically significant difference (p < 0,05), as well as cervical active rotation was significantly improved (p = 0.03). There were no between-group differences observed in Pressure Pain Threshold (PPT) measure, Fear-Avoidance Beliefs Questionnaire and Pain-self efficacy.ConclusionThe association between OMT and exercises reduces pain and improves functional disability more than only exercise for individuals with non-specific chronic neck pain.     

平衡罐疗法对非特异性下腰痛的疗效观察

目的观察平衡罐疗法对非特异性下腰痛的疗效。方法75例非特异性下腰痛患者随机分为对照组、拔罐组与平衡罐组,分别采用双氯芬酸钠肠溶胶囊口服、拔罐与平衡罐治疗,观察治疗3周后的疼痛视觉模拟评分与Oswestry指数的变化。结果治疗3周后,平衡罐治疗组的疼痛视觉模拟评分与Oswestry指数均低于拔罐疗法组与对照组(P<0.05),而拔罐疗法组与对照组之间无显著性差异。结论平衡罐疗法是治疗非特异性下腰痛的有效方法。     

Effect of an exercise program for posture correction on musculoskeletal pain

[Purpose] The present study investigated the effect of an exercise program for posture correction on musculoskeletal pain. [Subjects] Between September 2, 2013 and November 3, 2013, an exercise program was performed in 88 students from S University in K city (male students, n = 34; female students, n = 54). [Methods] The exercise program for posture correction was performed for 20 minutes per session, 3 times a week for 8 weeks. Pain levels were measured using a pain scale, and pain levels before and after the exercise program were compared. [Results] Overall, pain levels of the participants were lower after the exercise program than before the program, and significant differences in pain levels were noted in the shoulders, middle back, and lower back. [Conclusion] In conclusion, shoulder pain, mid back pain, and low back pain were relieved with the exercise program for posture correction. Therefore, the findings of this study can be used to improve the work efficiency of students as well as people engaged in sedentary work.Key words: Posture correction exercise, Posture, Pain