美式整脊技术对非特异性腰痛的疗效

doi:10.3969/j.issn.1006-9771.2019.04.005

《中国康复理论与实践》 ›› 2019, Vol. 25 ›› Issue (4): 390-395.doi: 10.3969/j.issn.1006-9771.2019.04.005

美式整脊技术对非特异性腰痛的疗效

张立强, 马跃文

中国医科大学附属第一医院康复医学科，辽宁沈阳市 110001

收稿日期:2018-09-12 修回日期:2018-10-15 出版日期:2019-04-20 发布日期:2019-04-24
通讯作者: 马跃文，E-mail: yuewen_m@sina.com
作者简介:张立强(1986-)，男，满族，辽宁本溪市人，技师，主要研究方向：骨科疾病的物理治疗。

Effect of Chiropractic on Nonspecific Low Back Pain

ZHANG Li-qiang, MA Yue-wen

Department of Rehabilitation Medicine, the First Affiliated Hospital of China Medical University, Shenyang, Liaoning 110001, China

Received:2018-09-12 Revised:2018-10-15 Published:2019-04-20 Online:2019-04-24
Contact: MA Yue-wen, E-mail: yuewen_m@sina.com

摘要/Abstract

摘要： 目的探讨美式整脊技术对非特异性腰痛的疗效。方法 2016年7月至2018年1月，选取90例非特异性腰痛患者，随机分为对照组(n = 45)和观察组(n = 45)。两组均给予核心稳定性训练和常规物理治疗，观察组在此基础上辅以美式整脊技术，治疗4周，随访半年。治疗前，治疗2周、4周后和随访半年后分别采用疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、腹背肌耐力测试、腰部主动关节活动度(AROM)进行评价。结果治疗2周、4周时，两组VAS评分，ODI评分，腹、背肌耐力测试和腰部AROM均较治疗前改善(P < 0.05)。观察组在治疗2周、4周时，所有指标均较对照组显著改善(t > 0.263, P < 0.001)。半年后随访，两组VAS、ODI均较治疗前改善(P < 0.05)，且观察组较对照组显著改善(t > 5.911, P < 0.001)。结论核心稳定性训练和常规物理治疗配合美式整脊技术可以更有效减轻非特异性腰痛患者痛疼程度，改善功能障碍，同时提高脊柱稳定性，对患者的恢复有较好的长期疗效和预防作用。

关键词: 非特异性腰痛, 美式整脊, 核心稳定性训练, 疼痛

Abstract: Objective To observe the clinical effect of chiropractic on nonspecific low back pain (NLBP). Methods From July, 2016 to January, 2018, 90 patients with NLBP were randomly divided into control group (n = 45) and observation group (n = 45). Both groups accepted core stabilization exercises (CSE) and routine physical therapy, and the observation group received chiropractic additionally. They were treated for four weeks and followed up for six months. Before, and two and four weeks after treatment, and at six-month follow-up, they were evaluated with Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), abdominal and dorsal muscle endurance test (AMET) and waist active range of motion (AROM). Results Two and four weeks after treatment, the result of VAS, ODI, AMET, and waist AROM improved significantly in both groups (P < 0.05), and they were better in the observation group than in the control group (t > 0.263, P < 0.001). At six-month follow-up, the scores of VAS and ODI improved significantly (P < 0.05), and were better in the observation group than in the control group (t > 5.911, P < 0.001). Conclusion CSE and routine physical therapy combined with chiropractic could better reduce the pain, improve the dysfunction, and increase the spinal stability for patients with NLBP.

Key words: nonspecific low back pain, chiropractic, core stabilization exercises, pain

中图分类号:

R681.5

张立强, 马跃文. 美式整脊技术对非特异性腰痛的疗效[J]. 《中国康复理论与实践》, 2019, 25(4): 390-395.

ZHANG Li-qiang, MA Yue-wen. Effect of Chiropractic on Nonspecific Low Back Pain[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2019, 25(4): 390-395.

参考文献

[1] BermanB M, LangevinH M, WittC M, et al. Acupuncture for chronic low back pain [J]. N Engl J Med, 2010, 363(18): 454-461.
[2] FourneyD R, AnderssonG, ArnoldP M, et al. Chronic low back pain: a heterogeneous condition with challenges for an evidence-based approach [J]. Spine(Phila Pa1976), 2011, 36(21 Suppl): S1-S9.
[3] KaptchukT J, EisenbergD M. Chiropractic: origins, controversies, and contributions [J]. Arch Intern Med, 1998, 58(20): 2215-2224.
[4] DelittoA, GeorgeS Z, Van DillenL R, et al. Low back pain [J]. J Orthop Sports Phys Ther, 2012, 42(4): A1-A57.
[5] 王宁华,顾新,谢欲晓. 腰部疾患——循证预防与康复[M]. 北京:北京大学医学出版社, 2017, 6: 282-309.
[6] HawkC, SchneiderM, M W JrEvans, et al. Consensus process to develop a best-practice document on the role of chiropractic care in health promotion, disease prevention, and wellness [J]. J Manipulative Physiol Ther, 2012, 35(7): 556-567.
[7] FauconnierA, DallongevilleE, HuchonC, et al. Measurement of acute pelvic pain intensity in gynecology: a comparison of five methods [J]. Obstet Gynecol, 2009, 113(2 Pt1): 260-269.
[8] LeeD Y, ShimC S, AhnY, et al. Comparison of percutaneous endoscopic lumbar discectomy and open lumbar microdiscectomy for recurrent disc herniation [J]. J Korean Neurosurg Soc, 2009, 46(6): 515-521.
[9] 王玉龙. 康复功能评定学[M]. 2版. 北京:人民卫生出版社, 2013, 3: 342-344.
[10] van DieënJ H, KuijerP P, BurdorfA, et al. Non-specific low back pain [J]. Lancet, 2012, 379(9814): 482-491.
[11] YangH, HaldemanS, LuM L, et al. Low back pain prevalence and related workplace psychosocial risk factors: a study using data from the 2010 National Health Interview Survey [J]. J Manipulative Physiol Ther, 2016, 39(7): 459-472.
[12] FroudR, BjørkliT, BrightP, et al. The effect of journal impact factor, reporting conflicts, and reporting funding sources, on standardized effect sizes in back pain trials: a systematic review and meta-regression [J]. BMC Musculoskelet Disord, 2015, 16: 370.
[13] 郭湄. 核心稳定性训练对非特异性腰痛疗效的影响[J]. 中国康复医学杂志, 2016, 31(1): 88-90.
[14] PanjabiM M. The stabilizing system of the spine. Part I. Function, dysfunction, adaptation, and enhancement [J]. J Spinal Disord, 1992, 5(4): 383-389.
[15] PanjabiM M. Clinical spinal instability and low back pain [J]. J Electromyogr Kinesiol, 2003, 13(4): 371-379.
[16] AiraksinenO, BroxJ I, CedraschiC, et al. European guidelines for the management of chronic nonspecific low back pain [J]. Eur Spine J, 2006, 15(Suppl 2): S192-S300.
[17] LiebensonC. Spinal stabilization training: the transverse abdominus [J]. J Bodyw Mov Ther, 1998, 2(4): 218-223.
[18] McGillS M. Low Back stability: from formal description to issues for performance and rehabilitation [J]. Exerc Sport Sci Rev, 2001, 29(1): 26-31.
[19] 唐宏亮,王雄将,卢栋明,等. 推拿干预慢性疲劳综合征研究的系统评价[J]. 中华中医药学刊, 2018, 36(6): 1363-1368.
[20] 燕铁斌. 物理治疗学[M]. 北京:人民卫生出版社, 2013: 8.
[21] 张月兰,代名彩. 中药熏蒸联合超短波治疗腰椎间盘突出症的疗效观察[J]. 中华物理医学与康复杂志, 2015, 37(2): 122-124.
[22] 李宏彦,宋俊. 核心稳定性训练治疗椎间盘源性下背痛的疗效观察[J]. 中华物理医学与康复杂志, 2018, 40(7): 535-537.
[23] 刘庆. 美式整脊技术：原理与操作[M]. 天津:天津科技翻译出版有限公司, 2013: 4.
[24] BialoskyJ E, SimonC B, BishopM D, et al. Basis for spinal manipulative therapy: a physical therapist perspective [J]. J Electromyogr Kinesiol, 2012, 22(5): 643-647.
[25] ClarkB C, D A JrGoss, WalkowskiS, et al. Neurophysiologic effects of spinal manipulation in patients with chronic low back pain [J]. BMC Musculoskelet Disord, 2011, 12: 170.
[26] AlukoA, DesouzaL, PeacockJ. The effect of core stability exercises on variations in acceleration of trunk movement, pain, and disability during an episode of acute nonspecific low back pain: a pilot clinical trial [J]. J Manipulative Physiol Ther, 2013, 36(8): 497-504. e1-3.
[27] AhmedR, Shakil-Ur-RehmanS, SibtainF. Comparison between specific lumber mobilization and core-stability exercises with core-stability exercises alone in mechanical low back pain [J]. Pak J Med Sci, 2014, 30(1): 157-160.

美式整脊技术对非特异性腰痛的疗效

Effect of Chiropractic on Nonspecific Low Back Pain

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 15

Metrics

本文评价

推荐阅读 0

[1]	刘冬, 徐子涵, 李江, 鞠萍. M1区联合背外侧前额叶高频重复经颅磁刺激对脊髓损伤后神经病理性疼痛患者脑电图θ振幅的效果[J]. 《中国康复理论与实践》, 2024, 30(1): 87-94.
[2]	张冠聪, 黄秋晨, 顾蕊, 刘四海, 胡春英, 刘克敏. 不同神经肌肉训练方法对早期膝骨关节炎患者疼痛和运动功能效果的比较[J]. 《中国康复理论与实践》, 2023, 29(9): 1090-1097.
[3]	马圣楠, 柯竟悦, 董洪铭, 李建萍, 张洪浩, 刘超, 沈双, 李古强. 核心稳定性训练干预前交叉韧带重建术后动态平衡及表面肌电的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 882-889.
[4]	王钊, 贾凡, 赵莹, 徐付国, 朱伟伟, 厉航, 张明. 坐位压力生物反馈疗法联合Flexi-bar对慢性非特异性腰痛的效果[J]. 《中国康复理论与实践》, 2023, 29(1): 110-118.
[5]	解焕鑫,刘晓磊,李强,章耀华,张鸿悦,郭峰,张耀国,杨华清. 不稳定坐位躯干控制训练对髌股疼痛综合征的疗效[J]. 《中国康复理论与实践》, 2022, 28(7): 770-775.
[6]	蔡桂燕,陈瑞琳,徐姝蕊,陶静,刘娇. 膝骨关节炎和腰痛患者的脑低频振幅影像学特征比较[J]. 《中国康复理论与实践》, 2022, 28(5): 602-608.
[7]	李冉, 杜巨豹, 曹光磊, 李征, 李子怡, 葛亚丽, 钱龙. 骨科康复一体化模式对全膝关节置换术患者运动功能的效果[J]. 《中国康复理论与实践》, 2022, 28(2): 144-149.
[8]	张晓倓,李军,张玲玲,谢惠敏,孙丽君,潘昱,李春宝,贾子善,张立宁. 慢性髋关节疼痛患者的功能障碍及相关心理因素分析[J]. 《中国康复理论与实践》, 2022, 28(12): 1484-1488.
[9]	李绪,许子琢,鲁俊,保沁彤,刘欣荣,赵若欣,许光旭. 基于肌张力描记技术测量的慢性非特异性腰痛竖脊肌收缩特性分析[J]. 《中国康复理论与实践》, 2021, 27(4): 450-455.
[10]	李向哲,丁洁,王庆华,董传明,王彤,吴勤峰. 减重平板训练对脊髓损伤大鼠神经病理性疼痛及脊髓后角谷氨酸脱羧酶-65/67表达的影响[J]. 《中国康复理论与实践》, 2021, 27(2): 131-136.
[11]	黄武杰,刘红,李雅萍,江征. 疼痛缓解对慢性非特异性腰痛患者步态特征的影响[J]. 《中国康复理论与实践》, 2021, 27(2): 197-202.
[12]	黄娜,张慧鑫,任浩,郭昱琪. 基于移动互联网的虚拟无痛病房对开颅手术后患者疼痛管理的效果[J]. 《中国康复理论与实践》, 2021, 27(2): 222-229.
[13]	刘晓磊,李强,章耀华,张鸿悦,刘文辉,李佳,董明,杨云,杨华清. 离心运动训练对髌股疼痛综合征患者膝关节功能和神经肌肉控制的效果[J]. 《中国康复理论与实践》, 2021, 27(11): 1334-1339.
[14]	孙悦梅,裴倩,黄秋晨,栗亮,刘克敏. Flexi-bar训练对非特异性腰痛的治疗效果[J]. 《中国康复理论与实践》, 2021, 27(10): 1205-1210.
[15]	何佩珏, 黄敏, 王谦, 刘韬, 王清. 涡流浴缓解疼痛的疗效与机制研究进展[J]. 《中国康复理论与实践》, 2021, 27(1): 93-96.