疼痛缓解对慢性非特异性腰痛患者步态特征的影响

doi:10.3969/j.issn.1006-9771.2021.02.013

《中国康复理论与实践》 ›› 2021, Vol. 27 ›› Issue (2): 197-202.doi: 10.3969/j.issn.1006-9771.2021.02.013

疼痛缓解对慢性非特异性腰痛患者步态特征的影响

黄武杰,刘红,李雅萍,江征()

福建中医药大学康复医学院，中医骨伤及运动康复教育部重点实验室，福建福州市 350000

收稿日期:2020-07-17 修回日期:2020-10-26 出版日期:2021-02-25 发布日期:2021-02-26
通讯作者: 江征 E-mail:949273304@qq.com
作者简介:黄武杰(1996-)，男，汉族，广东汕尾市人，硕士研究生，主要研究方向：慢性腰痛康复的基础与临床研究|江征(1975-)，男，汉族，博士，硕士研究生导师，主要研究方向：脊柱疾病康复的基础与临床研究。
基金资助:
福建省康复重点实验室联合福建省康复产业研究院开放课题(2015Y2001-56)

Effect of Pain Relief on Gait Characteristics of Patients with Chronic Nonspecific Low Back Pain

Wu-jie HUANG,Hong LIU,Ya-ping LI,Zheng JIANG()

Rehabilitation Medical College, Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation of Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian 350000, China

Received:2020-07-17 Revised:2020-10-26 Published:2021-02-25 Online:2021-02-26
Contact: Zheng JIANG E-mail:949273304@qq.com
Supported by:
Fujian Rehabilitation Key Laboratory and Fujian Rehabilitation Industry Research Institute Open Project(2015Y2001-56)

摘要/Abstract

摘要： 目的

观察针刺治疗后疼痛缓解对慢性非特异性腰痛(CNLBP)患者的步速、跨步长和地面反作用力(GRF)特征值的影响。

方法

2019年5月至12月，网络招募CNLBP受试者28例，随机分为等待治疗组(n = 14)和针刺治疗组(n = 14)。针刺治疗组接受针刺治疗，每次30 min，每周3次，共4周；等待治疗组入组后仅进行健康宣教，1个月后再接受治疗。所有受试者在入组后及1个月后采用三维运动捕捉系统进行平地步态测试，记录疼痛视觉模拟评分(VAS)及步行过程中的步速、跨步长和GRF特征值，并进行比较。

结果

干预后，两组VAS均降低(t > 2.956, P < 0.05)，针刺治疗组VAS明显低于等待治疗组(t = -2.844, P = 0.004)。两组干预前后步速和跨步长均无显著性差异(P > 0.05)。干预前，两组间GRF特征值比较均无显著性差异(P > 0.05)；干预前后比较，两组内GRF特征值均无显著性差异(P > 0.05)。

结论

针刺治疗1个月可以减轻CNLBP患者疼痛，但未能改善CNLBP患者步行过程中的运动表现。

关键词: 慢性非特异性腰痛, 针刺, 步态测试, 疼痛, 地面反作用力

Abstract: Objective

To observe the effects of pain relief after acupuncture on walking speed, step length and ground reaction force (GRF) of patients with chronic nonspecific low back pain (CNLBP) during walking.

Methods

From May to December, 2019, 28 CNLBP patients were randomly divided into waiting list group (n = 14) and acupuncture group (n = 14). The acupuncture group received acupuncture, 30 minutes a time, three times a week, for four weeks. The waiting list group only received health education after enrollment until four weeks later. Gait analysis was performed with three-dimensional motion system for both groups after enrollment and one month later. The walking speed, step length and GRF characteristic values were recorded and compared, as well as Visual Analogue Score (VAS) for pain.

Results

After intervention, The VAS decreased in both groups (t > 2.956, P < 0.05), and was lower in the acupuncture group than in the waiting list group (t = -2.844, P = 0.004). No significant difference in walking speed, step length and GRF characteristic values was found after intervention in both groups (P > 0.05).

Conclusion

One month-acupuncture could relief the pain of CNLBP patients, however, it could not improve the performance during walking.

Key words: chronic nonspecific low back pain, acupuncture, gait analysis, pain, ground reaction force

中图分类号:

R681.5

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.

Wu-jie HUANG,Hong LIU,Ya-ping LI,Zheng JIANG. Effect of Pain Relief on Gait Characteristics of Patients with Chronic Nonspecific Low Back Pain[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(2): 197-202.

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项目	等待治疗组 (n = 14)	针刺治疗组 (n = 14)	χ²/t值	P值
男/女(n)	6/8	4/10	-0.775	0.439
年龄(岁)	34.07±12.16	30.36±11.38	-0.577	0.564
身高(m)	1.63±0.04	1.64±0.07	-0.046	0.963
体质量(kg)	58.57±6.09	60.93±6.08	-1.025	0.315
体质量指数(kg/m²)	21.91±1.86	24.28±6.67	-1.126	0.260
VAS	6.00±1.52	6.36±0.63	-0.869	0.385
步速(m/s)	1.16±0.11	1.22±0.14	-1.298	0.206
跨步长(m)	1.20±0.08	1.23±0.01	-0.642	0.526

组别	n	干预前	干预后	t值	P值
等待治疗组	14	6.00±1.52	4.43±2.06	2.956	0.011
针刺治疗组	14	6.36±0.63	2.29±1.59	8.586	< 0.001
t/Z		-0.869^a	-2.844
P值		0.385	0.004

组别	n	干预前	干预后	t值	P值
等待治疗组	14	1.16±0.11	1.18±0.11	-0.744	0.470
针刺治疗组	14	1.22±0.14	1.25±0.15	-1.761	0.102

组别	n	干预前	干预后	t值	P值
等待治疗组	14	1.23±0.10	1.25±0.10	-1.525	0.151
针刺治疗组	14	1.20±0.08	1.20±0.07	-0.054	0.958

组别	n		干预前	干预后	t/Z值	P值
等待治疗组	14	左侧F_HS(%体质量)	1.08±0.08	1.11±0.06	-1.194	0.252
		左侧F_MS(%体质量)	0.78±0.05	0.79±0.06	-0.757	0.462
		左侧F_PO(%体质量)	1.34±0.06	1.13±0.07	1.071	0.302
		左侧TTP_HS(%支撑期)	0.25±0.05	0.23±0.04	2.090	0.055
		左侧TTP_MS(%支撑期)	0.46±0.03	0.45±0.03	-0.048	0.962
		左侧TTP_PO(%支撑期)	0.75±0.03	0.76±0.02	-0.639	0.533
		右侧F_HS(%体质量)	1.08±0.07	1.10±0.07	-1.518	0.153
		右侧F_MS(%体质量)	0.79±0.05	0.79±0.07	0.298	0.771
		右侧F_PO(%体质量)	1.13±0.06	1.15±0.07	-0.872	0.299
		右侧TTP_HS(%支撑期)	0.26±0.05	0.23±0.04	1.402	0.178
		右侧TTP_MS(%支撑期)	0.45±0.04	0.47±0.04	-0.136	0.894
		右侧TTP_PO(%支撑期)	0.75±0.02	0.76±0.02	-0.461	0.652
针刺治疗组	14	左侧F_HS(%体质量)	1.14±0.06^a	1.15±0.07	-0.552	0.610
		左侧F_MS(%体质量)	0.78±0.07^b	0.76±0.08	1.049	0.313
		左侧F_PO(%体质量)	1.13±0.04^c	1.14±0.05	-1.393	0.187
		左侧TTP_HS(%支撑期)	0.24±0.04^d	0.25±0.05	-0.518	0.613
		左侧TTP_MS(%支撑期)	0.48±0.04^e	0.46±0.03	1.625	0.128
		左侧TTP_PO(%支撑期)	0.75±0.02^f	0.76±0.02	-1.649	0.123
		右侧F_HS(%体质量)	1.13±0.10^g	1.14±0.08	-0.240	0.814
		右侧F_MS(%体质量)	0.75±0.10^h	0.76±0.07	-0.459^m	0.646
		右侧F_PO (%体质量)	1.11±0.10ⁱ	1.12±0.08	-1.376^m	0.169
		右侧TTP_HS(%支撑期)	0.25±0.04^g	0.24±0.03	1.216	0.246
		右侧TTP_MS(%支撑期)	0.46±0.04^k	0.46±0.03	-0.178	0.861
		右侧TTP_PO(%支撑期)	0.75±0.02^l	0.75±0.02	-0.770	0.455

疼痛缓解对慢性非特异性腰痛患者步态特征的影响

Effect of Pain Relief on Gait Characteristics of Patients with Chronic Nonspecific Low Back Pain

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