悬吊推拿运动技术对老年腰椎间盘突出症患者恐动症效果的随机对照试验：基于脑-骨轴理论

doi:10.3969/j.issn.1006-9771.2024.07.016

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (7): 861-868.doi: 10.3969/j.issn.1006-9771.2024.07.016

• 应用研究 • 上一篇

悬吊推拿运动技术对老年腰椎间盘突出症患者恐动症效果的随机对照试验：基于脑-骨轴理论

丹禹钦¹, 苏佳宁¹, 丁懿², 王雪妍³, 许铛瀚⁴, 王菁华⁵, 吴雨静¹, 张梦圆¹, 尹萌⁶, 鹿海峰², 于功昌⁶^,⁷(), 李丽²()

1.山东中医药大学康复医学院，山东济南市 250355
2.山东中医药大学第二附属医院康复医院，山东济南市 250001
3.深圳市中医院，广东深圳市 518033
4.广州中医药大学第一附属医院，广东广州市 510405
5.济宁市中医院，山东济宁市 272100
6.山东第一医科大学附属颈肩腰腿痛医院，山东济南市 250062
7.山东省精神卫生中心，山东济南市 250014

收稿日期:2024-03-05 修回日期:2024-05-15 出版日期:2024-07-25 发布日期:2024-08-07
通讯作者: 于功昌(1981-)，男，汉族，山东济南市人，副教授，主要研究方向：中西医结合康复，E-mail： yugongchang@sdfmu.edu.cn；李丽(1962-)，女，汉族，山东济南市人，教授，主要研究方向：中西医结合身心障碍康复，E-mail： lily.jinan@163.com
作者简介:丹禹钦(1999-)，男，回族，山东冠县人，硕士研究生，主要研究方向：中西医结合康复。
基金资助:
国家自然科学基金面上项目(82374556);国家重点研发计划中医药现代化研究重点专项课题(2018YFC1706005);山东省中医药科技发展项目青年项目(Q-2023067)

Effect of sling exercise with Tuina therapy on kinesiophobia in old patients with lumbar disc herniation: a randomized controlled trial based on concept of brain-bone axis

DAN Yuqin¹, SU Jianing¹, DING Yi², WANG Xueyan³, XU Danghan⁴, WANG Jinghua⁵, WU Yujing¹, ZHANG Mengyuan¹, YIN Meng⁶, LU Haifeng², YU Gongchang⁶^,⁷(), LI Li²()

1. Rehabilitation Medical College, Shandong University of Traditional Chinese Medicine, Ji'nan, Shandong 250355, China
2. the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Ji'nan, Shandong 250001, China
3. Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong 518033, China
4. First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Guangzhou, Guangdong 510405, China
5. Jining Traditional Chinese Medicine Hospital, Jining, Shandong 272100, China
6. Shandong First Medical University Affiliated Neck, Shoulder, Lumbar and Leg Pain Hospital, Ji'nan, Shandong 250062, China
7. Shandong Provincial Mental Health Center, Ji'nan, Shandong 250014, China

Received:2024-03-05 Revised:2024-05-15 Published:2024-07-25 Online:2024-08-07
Contact: YU Gongchang, E-mail: yugongchang@sdfmu.edu.cn; LI Li, E-mail: lily.jinan@163.com
Supported by:
National Natural Science Foundation (General)(82374556);National Key Research and Development Program Key Projects on Modernization of Traditional Chinese Medicine(2018YFC1706005);Shandong Traditional Chinese Medicine Science and Technology Development Project (Youth)(Q-2023067)

摘要/Abstract

摘要：

目的观察悬吊推拿运动技术对老年腰椎间盘突出症患者恐动症的影响，并基于脑-骨轴分析其可能机制。
方法选取2022年9月至2023年12月于山东中医药大学第二附属医院康复医院就诊的56例老年慢性腰椎间盘突出症恐动症患者，随机分为对照组(n = 28)和试验组(n = 28)。对照组采用常规运动疗法，试验组采用悬吊推拿运动技术，共4周。治疗前后，采用Tampa恐动症量表(TSK)、日本骨科协会治疗评估(JOA)和疼痛视觉模拟量表(VAS)进行评定，检查骨密度，测定血清骨保护素(OPG)、去甲肾上腺素(NE)和皮质类固醇(Cor)浓度，表面肌电图测量弱链接侧竖脊肌中值频率(MF)。
结果对照组脱落2例，试验组脱落1例。治疗后两组各项评定评分显著改善(|t| > 14.168, P < 0.001)，血清NE、OPG和Cor水平改善(|t| > 2.103, P < 0.05)，骨密度增加(|t| > 2.726, P < 0.05)，竖脊肌MF显著增加(|t| > 14.736, P < 0.001)；且试验组优于对照组(|t| > 2.154, P < 0.05)。
结论悬吊推拿运动技术可改善老年腰椎间盘突出症患者的疼痛和恐动症，可能通过调节脑-骨轴相关激素和神经递质水平，促进患者身心功能恢复。

关键词: 老年, 腰椎间盘突出症, 恐动症, 悬吊推拿运动技术, 脑-骨轴, 随机对照试验

Abstract:

Objective To explore the effect of sling exercise with Tuina therapy on kinesiophobia in old patients with lumbar disc herniation, and analyze the mechanism based on brain-bone axis.
Methods A total of 56 old patients with chronic lumbar disc herniation and kinesiophobia were selected from the Rehabilitation Hospital of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine from September, 2022 to December, 2023; and randomly divided into control group (n = 28) and experimental group (n = 28). The control group accepted conventional exercise therapy, while the experimental group accepted sling exercise with Tuina therapy, for four weeks. They were assessed with simplified Chinese version of Tampa Scale of Kinesiophobia (TSK), Japanese Orthopaedic Association score (JOA) and Visual Analogue Scale for pain (VAS) before and after treatment, while the bone mineral density (BMD) was tested, the levels of osteoprotegerin (OPG), norepinephrine (NE) and corticosteroids (Cor) in serum were measured, and the median frequency (MF) of weak-link erector spinae was detected with surface electromyography.
Results Two cases dropped off in the control group, and one in the experimental group. The scores of all the assessment improved in both groups after treatment (|t| > 14.168, P < 0.001), as well as the serum levels of OPG, NE and Cor (|t| > 2.103, P < 0.05), BMD (|t| > 2.726, P < 0.05), and MF of erector spinae (|t| > 14.736, P < 0.001); all of them were better in the experimental group than in the control group (|t| > 2.154, P < 0.05).
Conclusion Sling exercise with Tuina therapy can improve the pain and kinesiophobia of lumbar disc herniation in the old adults, which may promote the recovery of physical and mental function through regulating the levels of hormones and neurotransmitters related to the brain-bone axis.

Key words: aged, lumbar disc herniation, kinesiophobia, sling exercise with Tuina therapy, brain-bone axis, randomized controlled trial

中图分类号:

R681.53

丹禹钦, 苏佳宁, 丁懿, 王雪妍, 许铛瀚, 王菁华, 吴雨静, 张梦圆, 尹萌, 鹿海峰, 于功昌, 李丽. 悬吊推拿运动技术对老年腰椎间盘突出症患者恐动症效果的随机对照试验：基于脑-骨轴理论[J]. 《中国康复理论与实践》, 2024, 30(7): 861-868.

DAN Yuqin, SU Jianing, DING Yi, WANG Xueyan, XU Danghan, WANG Jinghua, WU Yujing, ZHANG Mengyuan, YIN Meng, LU Haifeng, YU Gongchang, LI Li. Effect of sling exercise with Tuina therapy on kinesiophobia in old patients with lumbar disc herniation: a randomized controlled trial based on concept of brain-bone axis[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(7): 861-868.

图/表 2

表1

表2

参考文献 50

[1]	中华医学会骨科学分会脊柱外科学组, 中华医学会骨科学分会骨科康复学组. 腰椎间盘突出症诊疗指南[J]. 中华骨科杂志, 2020, 40(8): 477-486.
	Spinal Surgery Group of Orthopedics Branch of Chinese Medical Association, Orthopedic Rehabilitation Group of the Orthopedic Branch of Chinese Medical Association. Clinical Practice Guideline for Diagnosis and Treatment of Lumbar Disc Herniation[J]. Chin J Orthop, 2020, 40(8): 477-486.
[2]	GEERE J H, SWAMY G N, HUNTER P R, et al. Incidence and risk factors for five-year recurrent disc herniation after primary single-level lumbar discectomy[J]. Bone Joint J, 2023, 105-B(3): 315-322. doi: 10.1302/0301-620X.105B3.BJJ-2022-1005.R2 pmid: 36854329
[3]	IONESCU D, IACOB C I, BREHAR F M, et al. The role of catastrophizing and basic psychological needs satisfaction on health-related quality of life and pain in patients with lumbar disc herniation[J]. Front Psychol, 2023, 14: 1147254.
[4]	刘昊为, 黄丽, 杨宗乾, 等. 常用恐动症评估量表的研究进展[J]. 中国康复医学杂志, 2023, 38(9): 1305-1310.
[5]	LUQUE-SUAREZ A, MARTINEZ-CALDERON J, FALLA D. Role of kinesiophobia on pain, disability and quality of life in people suffering from chronic musculoskeletal pain: a systematic review[J]. Br J Sports Med, 2019, 53(9): 554-559.
[6]	KIM Y K, KANG D, LEE I, et al. Differences in the incidence of symptomatic cervical and lumbar disc herniation according to age, sex and national health insurance eligibility: a pilot study on the disease's association with work[J]. Int J Environ Res Public Health, 2018, 15(10): 2094.
[7]	王亚平, 彭文琦. 腰椎间盘突出症恐动症的研究进展[J]. 中国矫形外科杂志, 2019, 27(23): 2170-2173.
	WANG Y P, PENG W Q. Research advance in kinesiophobia secondary to lumbar disc herniation[J]. J Bone Joint Surg, 2019, 27(23): 2170-2173.
[8]	BORDELEAU M, VINCENOT M, LEFEVRE S, et al. Treatments for kinesiophobia in people with chronic pain: a scoping review[J]. Front Behav Neurosci, 2022, 16: 933483.
[9]	PETRUCCI G, PAPALIA G F, RUSSO F, et al. Psychological approaches for the integrative care of chronic low back pain: a systematic review and meta-analysis[J]. Int J Environ Res Public Health, 2021, 19(1): 60.
[10]	POLLER W C, DOWNEY J, MOOSLECHNER A A, et al. Brain motor and fear circuits regulate leukocytes during acute stress[J]. Nature, 2022, 607(7919): 578-584.
[11]	徐帅, 沈飞. 脑-骨交互视阈下应对抑郁症与骨质疏松症的运动调节机制研究进展[J]. 中国体育科技, 2023, 59(1): 51-59.
	XU S, SHEN F. Advances in the study of exercise regulation mechanisms of depression and osteoporosis in the visual threshold of brain-bone interaction[J]. Chin Sports Technol, 2023, 59(1): 51-59.
[12]	李丽, 常光哲, 孙国栋, 等. 中医康复临床实践指南·悬吊推拿运动技术[J]. 康复学报, 2023, 33(6): 486-492.
	LI L, CHANG G Z, SUN G D, et al. Operation Standard for Sling Exercise with Tuina Therapy of Traditional Chinese Medicine Rehabilitation Techniques[J]. Rehabil Med, 2023, 33(6): 486-492.
[13]	张天钰, 刘丽, 丁懿, 等. 悬吊推拿运动技术对颈源性失眠患者睡眠及椎-基底动脉血流动力学的影响[J]. 康复学报, 2023, 33(5): 442-448.
	ZHANG T Y, LIU L, DING Y, et al. Effect of suspension massage exercise technique on cervicogenic insomnia and vertebrobasilar artery hemodynamics[J]. Rehabil Med, 2023, 33(5): 442-448.
[14]	KREINER D S, MATZ P, BONO C M, et al. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of low back pain [published correction appears in Spine J. 2021 Feb 24][J]. Spine J, 2020, 20(7): 998-1024. doi: S1529-9430(20)30141-8 pmid: 32333996
[15]	The Lancet. ICD-11[J]. Lancet, 2019, 393(10188): 2275. doi: S0140-6736(19)31205-X pmid: 31180012
[16]	梁繁荣, 王华. 针灸学[M]. 4版. 北京: 中国中医药出版社, 2016.
	LIANG F R, WANG H. Acupuncture and Moxibustion[M]. 4th ed. Beijing: China Traditional Chinese Medicine Press, 2016.
[17]	胡文. 简体中文版TSK和FABQ量表的文化调适及其在退行性腰腿痛中的应用研究[D]. 上海: 第二军医大学, 2012.
	HU W. Cultural adaptation of simplified Chinese versions of TSK and FABQ scales and their application in degenerative lower back and leg pain[D]. Shanghai: Second Military Medical University, 2012.
[18]	孙兵, 车晓明. 日本骨科协会评估治疗(JOA评分)[J]. 中华神经外科杂志, 2012, 28(6): 623.
	SUN B, CHE X M. The Japanese Orthopedic Association evaluates treatment (JOA score)[J]. Chin J Neurosurg, 2012, 28(6): 623.
[19]	HAWKER G A, MIAN S, KENDZERSKA T, et al. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP)[J]. Arthritis Care Res (Hoboken), 2011, 63(Suppl 11): S240-S252.
[20]	孟丽颖, 高峰, 李和培, 等. 双能X线骨密度仪测定股骨假体周围骨密度水平对患者术后治疗效果的评估[J]. 放射学实践, 2022, 37(6): 764-768.
	MENG L Y, GAO F, LI H P, et al. Evaluation of postoperative outcomes of BMD around femoral prosthesisby dual-energy X-ray absorptiometry[J]. Radiol Prac, 2022, 37(6): 764-768.
[21]	李泽文, 刘丽, 张义, 等. 五音调神法对急性缺血性脑卒中病人创伤后应激障碍及睡眠质量的影响[J]. 护理研究, 2023, 37(4): 577-583.
	LI Z W, LIU L, ZHANG Y, et al. Effect of Wuyintiaoshen therapy on post-traumatic stress disorder and sleep quality in patients with acute ischemic stroke[J]. Nurs Res, 2023, 37(4): 577-583.
[22]	李泽文, 张沛潇, 李丽. 悬吊推拿运动对脑卒中恢复期上肢痉挛的效果[J]. 中国康复理论与实践, 2022, 28(11): 1252-1258. doi: 10.3969/j.issn.1006-9771.2022.11.003
	LI Z W, ZHANG P X, LI L. Effect of sling-massage exercise on upper limb spasticity for stroke patients at recovery stage[J]. Chin J Rehabil Theory Pract, 2022, 28(11): 1252-1258.
[23]	朱慧, 张丹妮, 金孔军, 等. 恐动症成因分析量表的汉化及信效度检验[J]. 解放军护理杂志, 2020, 37(1): 1-4.
	ZHU H, ZHANG D N, JIN K J, et al. The reliability and validity of the Chinese version of Kinesiophobia Causes Scale[J]. PLA Nurs J, 2020, 37(1): 1-4.
[24]	潘丽, 史宝欣. 慢性腰痛患者恐动症现状及其影响因素研究[J]. 中国全科医学, 2019, 22(8): 978-982. doi: 10.12114/j.issn.1007-9572.2019.00.007
	PAN L, SHI B X. Prevalence of kinesiophobia in patients with chronic low back pain and its influential factors[J]. Chin Gen Pract, 2019, 22(8): 978-982.
[25]	杨思睿, 黄正正, 沈绍武. «中医病证分类与代码»与ICD-11传统医学病证模块比较研究[J]. 时珍国医国药, 2021, 32(10): 2555-2557.
	YANG S R, HUANG Z Z, SHEN S W. Comparative study on the Classification and Code of Traditional Chinese Medicine Syndrome and ICD-11 Traditional Medicine Syndrome Module[J]. Lishizhen Med Mat Med Res, 2021, 32(10): 2555-2557.
[26]	YANG F, LIU Y, CHEN S, et al. A GABAergic neural circuit in the ventromedial hypothalamus mediates chronic stress-induced bone loss[J]. J Clin Invest, 2020, 130(12): 6539-6554.
[27]	KYRÖNLAHTI S M, NYGÅRD C H, K C P, et al. Trajectories of low back pain from midlife to retirement and functional ability at old age[J]. Eur J Public Health, 2022, 32(3): 497-503.
[28]	FRANCO D, MAHTABFAR A, HINES K, et al. Neurosurgical evaluation for patients with chronic lower back pain[J]. Curr Pain Headache Rep, 2020, 24(10): 58.
[29]	丁懿, 郭琛琛, 王宁, 等. 肌内效贴结合悬吊推拿运动技术对腰椎间盘突出症的临床疗效观察[J]. 天津中医药, 2019, 36(6): 561-564.
	DING Y, GUO C C, WANG N, et al. Clinical observation of the therapeutic effect of intramuscular patch combined with suspension massage technique on lumbar disc herniation[J]. Tianjin Tradit Chin Med, 2019, 36(6): 561-564.
[30]	陈苑苑. 疼痛相关焦虑和疼痛灾变在抑郁症和慢性疼痛共病中的作用[D]. 合肥: 安徽医科大学, 2023.
	CHEN Y Y. The role of pain related anxiety and pain catastrophes in comorbidity of depression and chronic pain[D]. Hefei: Anhui Medical University, 2023.
[31]	周阳, 刘晓彤, 黄颐殊, 等. 意外创伤疼痛患者恐动症的影响因素及路径分析[J]. 中国护理管理, 2023, 23(10): 1462-1466.
	ZHOU Y, LIU X T, HUANG Y S, et al. Influencing factors and paths of postoperative kinesiophobia in accidentatrauma pain patients[J]. Chin Nurs Manag, 2023, 23(10): 1462-1466.
[32]	陆鹏程, 刘波, 金圣杰, 等. 下丘脑:运动改善骨代谢的关键控制器[J]. 中国组织工程研究, 2022, 26(32): 5201-5208.
	LU P C, LIU B, JIN S J, et al. Hypothalamus: a key controller for improving bone metabolism through exercise[J]. Chin J Tissue Eng Res, 2022, 26(32): 5201-5208.
[33]	丁懿, 郭琛琛, 李丽. 悬吊推拿运动技术治疗腰椎间盘突出症的临床研究[J]. 康复学报, 2019, 29(1): 33-38.
	DING Y, GUO C C, LI L. Clinical study on lumbar disc herniation treated by sling and Tuina exercise technique[J]. Rehabil Med, 2019, 29(1): 33-38.
[34]	刘婷, 马玉容, 秦玉静, 等. 教育-恐惧暴露干预对全髋关节置换术后恐动症患者的影响[J]. 护理学杂志, 2023, 38(10): 22-26.
	LIU T, MA Y R, QIN Y J, et al. The impact of education fear exposure intervention on patients with fear of movement after total hip replacement surgery[J]. J Nurs Sci, 2023, 38(10): 22-26.
[35]	HAN S. Physical activity and self-rated health: role of contexts[J]. Psychol Health Med, 2021, 26(3): 347-358.
[36]	崔银洁, 宋晓娟, 王倩, 等. "截瘫三联针"联合康复训练对脊髓损伤患者心理及日常生活能力的影响[J]. 中国针灸, 2018, 38(5): 483-489.
	CUI Y J, SONG X J, WANG Q, et al. The effect of "paraplegic triple needling" combined with rehabilitation training on psychological and daily living ability of patients with spinal cord injury[J]. Chin Acup Moxib, 2018, 38(5): 483-489.
[37]	TALAEI-KHOEI M, CHEN N, RING D, et al. Satisfaction with life moderates the indirect effect of pain intensity on pain interference through pain catastrophizing[J]. J Consult Clin Psychol, 2018, 86(3): 231-241.
[38]	赵继荣, 张天龙, 朱换平, 等. 腰椎间盘退变与骨质疏松的相关性[J]. 中华骨质疏松和骨矿盐疾病杂志, 2021, 14(3): 302-307.
	ZHAO J R, ZHANG T L, ZHU H P, et al. The correlation between lumbar disc degeneration and osteoporosis[J]. Chin J Osteoporos Bone Miner Res, 2021, 14(3): 302-307.
[39]	许京伟, 吴亚东, 王静, 等. 应用孟德尔随机化探讨骨密度与腰椎间盘突出症的因果关系[J]. 中国医药导报, 2023, 20(21): 92-96.
	XU J W, WU Y D, WANG J, et al. Exploring the causal relationship between bone density and lumbar disc herniation using Mendelian randomization[J]. Chin Med Herald, 2023, 20(21): 92-96.
[40]	张鹏, 罗伟. 老年性骨质疏松症中医证型与骨代谢指标的相关性研究[J]. 山东中医杂志, 2020, 39(3): 265-267, 276.
	ZHANG P, LUO W. Research on the correlation between traditional Chinese medicine syndrome types and bone metabolism indicators in elderly osteoporosis[J]. Shandong J Tradit Chin Med, 2020, 39(3): 265-267, 276.
[41]	董子豪, 郑昱新, 顾新丰, 等. 骨关节炎合并情绪障碍及植物神经功能紊乱的临床研究进展[J]. 国际骨科学杂志, 2022, 43(1): 48-50, 54.
[42]	ZHU J, MA Y, WANG J, et al. The mechanism of osteoprotegerin-induced osteoclast pyroptosis in vitro[J]. Int J Mol Sci, 2023, 24(2): 1518.
[43]	YAN M, TSUKASAKI M, MURO R, et al. Identification of an intronic enhancer regulating RANKL expression in osteocytic cells[J]. Bone Res, 2023, 11(1): 43. doi: 10.1038/s41413-023-00277-6 pmid: 37563119
[44]	MYERS T W. 解剖列车:徒手与动作治疗的肌筋膜经线(第3版)[M]. 关玲,译. 北京: 军事医学科学出版社, 2015: 313-321.
	MYERS T W. Anatomical Train: Muscle and Fascia Meridian in Hand and Movement Therapy (3rd Edition)[M]. GUAN L, trans. Beijing: Military Medical Science Press, 2015: 313-321.
[45]	陈龙豪, 周红海, 李永亮, 等. 国医大师韦贵康以"脊督一体"整体观论治腰椎间盘突出症经验[J]. 中华中医药杂志, 2022, 37(2): 782-785.
	CHEN L H, ZHOU H H, LI Y L, et al. TCM master WEI Gui-kang's experience in treating lumbar disc herniation with the holistic view of 'integration of spine and governor'[J]. J Tradit Chin Med, 2022, 37(2): 782-785.
[46]	KUBO Y, DRESCHER W, FRAGOULIS A, et al. Adverse effects of oxidative stress on bone and vasculature in corticosteroid-associated osteonecrosis: potential role of nuclear factor erythroid 2-related factor 2 in cytoprotection[J]. Antioxid Redox Signal, 2021, 35(5): 357-376.
[47]	ADACHI J D, OLSZYNSKI W P, HANLEY D A, et al. Management of corticosteroid-induced osteoporosis[J]. Semin Arthritis Rheum, 2000, 29(4): 228-251.
[48]	CHANG C, GREENSPAN A, GERSHWIN M E. The pathogenesis, diagnosis and clinical manifestations of steroid-induced osteonecrosis[J]. J Autoimmun, 2020, 110: 102460.
[49]	李婉如, 库逸轩. 急性应激影响工作记忆的生理心理机制[J]. 心理科学进展, 2020, 28(9): 1508-1524. doi: 10.3724/SP.J.1042.2020.01508
	LI W R, KU Y X. The influence of acute stress on working memory: physiological and psychological mechanisms[J]. Adv Psychol Sci, 2020, 28(9): 1508-1524. doi: 10.3724/SP.J.1042.2020.01508
[50]	唐冲, 张克石, 刘正, 等. 肠道菌群与骨质疏松症的发病机制[J]. 中华骨质疏松和骨矿盐疾病杂志, 2021, 14(1): 100-106.
	TANG C, ZHANG K S, LIU Z, et al. Pathogenesis of osteoporosis and gut microbiome[J]. Chin J Osteoporos Bone Miner Res, 2021, 14(1): 100-106.

变量	组别	n	测试	$\bar{x}±s$	t值	P值
TSK评分	对照组	26	前测	51.43±5.02	14.168	< 0.001
			后测	29.13±5.39
	试验组	27	前测	53.78±4.86	22.485	< 0.001
			后测	24.63±4.27
	治疗前两组均值差			2.35±4.94	-1.725	0.091
	治疗后两组均值差			-4.50±4.92	3.368	0.001
JOA评分	对照组	26	前测	12.06±1.57	-20.853	< 0.001
			后测	20.14±1.28
	试验组	27	前测	12.93±1.84	-18.882	< 0.001
			后测	23.72±1.96
	治疗前两组均值差			0.87±1.72	-1.833	0.073
	治疗后两组均值差			3.58±1.72	-7.855	< 0.001
VAS评分	对照组	26	前测	6.12±0.89	15.975	< 0.001
			后测	2.34±0.62
	试验组	27	前测	6.28±0.94	23.006	< 0.001
			后测	2.07±0.18
	治疗前两组均值差			0.16±0.92	-0.674	0.504
	治疗后两组均值差			-0.27±0.55	2.154	0.036

项目	组别	n	测试	$\bar{x}±s$	t值	P值
骨密度/(g·cm^-2)	对照组	26	前测	0.54±0.06	-2.726	0.012
			后测	0.58±0.08
	试验组	27	前测	0.56±0.07	-3.858	0.001
			后测	0.66±0.09
	治疗前两组均值差			0.02±0.06	-1.505	0.139
	治疗后两组均值差			0.08±0.09	-3.180	0.003
OPG/(pg·mL^-1)	对照组	26	前测	2486.23±317.36	-2.507	0.019
			后测	2678.91±307.56
	试验组	27	前测	2480.58±322.19	-4.947	< 0.001
			后测	2857.54±310.68
	治疗前两组均值差			-5.65±319.80	0.064	0.949
	治疗后两组均值差			178.63±309.13	-2.103	0.040
NE/(ng·mL^-1)	对照组	26	前测	8.54±1.03	3.438	0.002
			后测	7.61±0.72
	试验组	27	前测	8.99±0.96	7.546	< 0.001
			后测	7.12±0.58
	治疗前两组均值差			0.45±0.10	-1.653	0.105
	治疗后两组均值差			-0.49±0.66	2.664	0.010
Cor/(ng·mL^-1)	对照组	26	前测	192.67±63.25	2.489	0.020
			后测	156.59±43.72
	试验组	27	前测	196.28±59.43	3.991	< 0.001
			后测	130.25±42.33
	治疗前两组均值差			3.61±61.43	-0.214	0.831
	治疗后两组均值差			-26.34±43.04	2.230	0.030
MF/Hz	对照组	26	前测	81.29±2.01	-14.736	< 0.001
			后测	92.07±3.16	-19.919	< 0.001
	试验组	27	前测	80.84±2.05
			后测	96.58±3.27
	治疗前两组均值差			-0.45±2.03	0.822	0.415
	治疗后两组均值差			4.51±3.22	-5.096	< 0.001

悬吊推拿运动技术对老年腰椎间盘突出症患者恐动症效果的随机对照试验：基于脑-骨轴理论

Effect of sling exercise with Tuina therapy on kinesiophobia in old patients with lumbar disc herniation: a randomized controlled trial based on concept of brain-bone axis

RichHTML

PDF (PC)

可视化

摘要/Abstract

引用本文

使用本文

图/表 2

参考文献 50

相关文章 15

Metrics

本文评价

推荐阅读 0

[1]	井淇, 蔡伟芹, 高倩倩, 嵇丽红, 董志伟, 邢洋, 李伟, 张建华. 基于ICF的社区老年人健康相关康复服务架构与策略探析[J]. 《中国康复理论与实践》, 2024, 30(7): 804-810.
[2]	何爱群, 黎景波, 何茂莉, 叶思媚, 宋秋爽, 刘海鸥, 谢有书. 作业技能再学习策略对脑卒中偏瘫上肢功能效果的随机对照试验[J]. 《中国康复理论与实践》, 2024, 30(7): 823-830.
[3]	陈晨, 孟兆祥, 杨康, 张敏杰, 左亚南, 王奎, 张熙斌, 全逸峰, 金星. 智能镜像手套任务导向性训练联合低频重复经颅磁刺激对脑卒中患者手功能效果的随机对照试验[J]. 《中国康复理论与实践》, 2024, 30(7): 831-838.
[4]	董平, 阚超杰, 郭川, 庄任, 王庆雷, 钱雪. 不同感觉策略下老年人平衡控制的皮质激活特征[J]. 《中国康复理论与实践》, 2024, 30(7): 848-853.
[5]	温娜娜, 张芯慧, 龙清, 王雨豪, 余群萍, 张晗淳, 郑国华. 步态和平衡功能对上海社区老年人衰弱的预测效能[J]. 《中国康复理论与实践》, 2024, 30(6): 731-736.
[6]	粟昭隐, 康巍瀚, 刘亚涛, 吕媛, Michael NERLICH. 中国中老年人身体活动水平与脑卒中发生的相关性：基于CHARLS数据[J]. 《中国康复理论与实践》, 2024, 30(4): 449-453.
[7]	刘辉, 尹航, 胡承红, 贾绍辉, 封叶文哲, 胡庆奎. 基于ICF的老年肌少症功能测量工具的内容和心理测量特性比较[J]. 《中国康复理论与实践》, 2024, 30(3): 273-280.
[8]	王航宇, 葛可可, 范永红, 都丽露, 邹敏, 封磊. 基于ICD-11和ICF主动式音乐疗法改善认知障碍老年人认知功能的系统综述[J]. 《中国康复理论与实践》, 2024, 30(1): 36-43.
[9]	葛可可, 范永红, 王航宇, 都丽露, 李长江, 邹敏. 失眠老年人正念干预健康效益的系统综述[J]. 《中国康复理论与实践》, 2024, 30(1): 54-60.
[10]	沈星星, 陈伟健, 李聪聪, 李俊毅, 王帅, 叶子璇, 向瑞安, 许学猛. 单侧腰椎间盘突出症患者椎旁肌功能特征[J]. 《中国康复理论与实践》, 2023, 29(9): 1098-1103.
[11]	杨雅楠, 穆丽萍, 邢凤梅, 薛新宏, 王晓光, 陶徉聿, 孙竹梅, 张小丽. 基于计划行为理论的干预对肌少症老年人肌肉衰减状况及平衡能力的效果[J]. 《中国康复理论与实践》, 2023, 29(8): 869-874.
[12]	蒋长好, 黄辰, 高晓妍, 戴元富, 赵国明. 神经反馈训练对老年人认知功能效果的系统综述[J]. 《中国康复理论与实践》, 2023, 29(8): 903-909.
[13]	谭晓欢, 姜桂萍, 黄芯怡, 王丹丹, 张磊, 卜庆国, 吴雪萍. 社区高龄老年人下肢肌力与步速的关系：柔韧和动态平衡的链式中介作用[J]. 《中国康复理论与实践》, 2023, 29(6): 646-653.
[14]	袁媛, 杨剑. 社区老年人身体活动融合慢性病管理的健康效益：Scoping综述[J]. 《中国康复理论与实践》, 2023, 29(5): 541-550.
[15]	罗启航, 吴羽皙, 张嘉璇, 黎婉颖, 欧海宁, 林强, 梁俊杰. 老年人平衡功能的脑网络变化：基于功能性近红外线光谱研究[J]. 《中国康复理论与实践》, 2023, 29(2): 238-242.