Flexi-bar训练对非特异性腰痛的治疗效果

doi:10.3969/j.issn.1006-9771.2021.10.011

摘要/Abstract

摘要：

目的探索核心稳定性训练联合Flexi-bar对非特异性腰痛患者核心肌群的肌电活动、厚度的影响及对腰痛的疗效。方法选择2020年6月至2021年1月北京博爱医院非特异性腰痛患者30例。试验一：测量用与不用Flexi-bar进行核心稳定性训练(仰卧桥式、卷腹、四点支撑)时腹横肌、多裂肌的肌电均方根值差异。试验二：将患者随机分为两组,每组15例,对照组单独进行传统核心稳定性训练;试验组在此基础上增加Flexi-bar训练。每次30 min,每周3次,共6周。治疗前后分别采用视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)进行评定,超声测量腹横肌厚度和多裂肌横截面积。结果试验一：除仰卧桥式动作下,腹横肌在用与不用Flexi-bar时的肌电活动无显著性差异(|t| < 2.029, P > 0.05)外,其余动作中两组间腹横肌和多裂肌均存在显著性差异(|t| > 2.468, P < 0.05)。试验二：训练前,两组间各项指标比较均无显著性差异(|t| < 1.944, P > 0.05);训练后,两组VAS和ODI均较训练前显著降低(|t| > 6.808, P < 0.001),腹横肌厚度、多裂肌面积均显著增加(|t| > 5.937, P < 0.001);除腹横肌厚度外(t = -1.431, P > 0.05),试验组各项指标均优于对照组(|t| > 2.411, P < 0.05)。结论 Flexi-bar训练可以改善非特异性腰痛患者疼痛及功能。

关键词: 非特异性腰痛, 核心稳定性训练, Flexi-bar

Abstract:

Objective To investigate the effects of Flexi-bar on nonspecific low back pain.Methods From June, 2020 to January, 2021, 30 patients with nonspecific low back pain were enrolled. Firstly, all the patients performed core stabilization exercise (supine bridge, curl-up and four-point support) using Flexi-bar or not, respectively. And the difference of electromyography (EMG) root mean square (RMS) value of transversus abdominis and multifidus was observed. Secondly, they were randomly divided into control group (n = 15) and experimental group (n = 15). The control group performed core stabilization exercise, and the experimental group received Flexi-bar training in addition, 30 minutes a time, three times a week, for six weeks. They were evaluated with Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), and measured the thickness of transversus abdominis and the area of multifidus before and after training.Results Firstly, there was significant difference in RMS of transversus abdominis and multifidus between using Flexi-bar or not (|t| > 2.468, P < 0.05), except the RMS of transversus in supine bridge (|t| < 2.029, P > 0.05). Secondly, before training, there was no significant difference between the control group and the experimental group (|t| < 1.944, P > 0.05); after training, the scores of VAS and ODI significantly decreased (|t| > 6.808, P < 0.001), the thickness of transversus abdominis and the area of multifidus significantly increased (|t| > 5.937, P < 0.001), and all the indexes were better in the experimental group than in the control group (|t| > 2.411, P < 0.05), except the thickness of transverse abdominis (t = -1.431, P > 0.05).Conclusion Flexi-bar could facilitate to reduce pain and improve the function of patients with nonspecific low back pain.

Key words: nonspecific low back pain, core stabilization exercise, Flexi-bar

中图分类号:

R681.5

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.

SUN Yue-mei,PEI Qian,HUANG Qiu-chen,LI Liang,LIU Ke-min. Effects of Flexi-bar on Nonspecific Low Back Pain[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(10): 1205-1210.

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项目	对照组 (n = 15)	试验组 (n = 15)	χ²/t值	P值
年龄(岁)	37±9.50	36.13±8.60	0.347	0.561
性别(男/女, n)	9/6	8/7	0.136	0.713
身高(cm)	168.80±5.76	167.47±6.25	1.199	0.283
体质量(kg)	61.80±8.18	61.27±7.49	0.634	0.432
病程(月)	9.67±6.00	8.67±5.34	0.806	0.377

运动方式	肌肉	CSE		CSE+Flexi-bar		左侧比较		右侧比较
运动方式	肌肉	左	右	左	右	t值	P值	t值	P值
仰卧桥式	腹横肌	81.40±23.03	74.67±24.63	82.87±22.21	79.53±26.70	-0.644	0.530	-2.029	0.062
	多裂肌	142.13±19.83	163.53±25.49	178.67±26.77	180.20±32.56	-3.360	0.005	-2.468	0.027
卷腹	腹横肌	212.80±37.58	208.20±30.28	234.53±40.37	237.60±27.24	-4.059	0.001	-4.666	< 0.001
卷腹	多裂肌	75.40±21.23	78.13±15.07	84.60±21.29	90.27±17.21	-7.770	< 0.001	-4.549	< 0.001
四点支撑	腹横肌	148.20±23.87	156.87±23.78	192.40±44.71	209.60±51.25	-5.141	< 0.001	-3.554	0.003
四点支撑	多裂肌	130.20±22.53	146.80±27.44	178.67±26.77	169.13±17.25	-4.225	< 0.001	-4.112	< 0.001

组别	n	治疗前	治疗后	t值	P值
对照组	15	5.20±0.77	3.80±0.86	8.573	< 0.001
试验组	15	4.60±0.91	2.67±1.05	6.808	< 0.001
t值		1.944	3.238
P值		0.062	0.003

组别	n	治疗前	治疗后	t值	P值
对照组	15	20.76±3.62	12.45±2.78	7.803	< 0.001
试验组	15	20.40±3.70	9.80±3.30	25.051	< 0.001
t值		0.269	2.381
P值		0.790	0.024

组别	n	治疗前	治疗后	t值	P值
对照组	15	0.46±0.064	0.49±0.063	-6.029	< 0.001
试验组	15	0.47±0.06	0.53±0.06	-5.937	< 0.001
t值		-0.206	-1.431
P值		0.838	0.164