《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (1): 107-116.doi: 10.3969/j.issn.1006-9771.2025.01.010

• 应用研究 • 上一篇    下一篇

核心训练联合呼吸训练对腰椎间盘突出症患者多裂肌和腹横肌的形态学及功能效果

宋佳苧, 娄晓乐, 刘换, 韩雪, 徐磊, 王敏()   

  1. 蚌埠医科大学第一附属医院康复医学科,安徽蚌埠市 233000
  • 收稿日期:2024-10-06 修回日期:2024-12-21 出版日期:2025-01-25 发布日期:2025-01-22
  • 通讯作者: 王敏(1964-),男,汉族,安徽淮南市人,主任医师,硕士研究生导师,主要研究方向:神经康复,E-mail: charleywangmin@126.com
  • 作者简介:宋佳苧(1999-),女,汉族,山西运城市人,硕士研究生,治疗师,主要研究方向:肌骨康复。
  • 基金资助:
    1.安徽省临床医学研究转化专项项目(202304295107020085);2.安徽省中医药领军人才建设项目(康复)(2018-23-1);3.蚌埠医科大学研究生科研创新计划150项资助立项项目(Byycx23067)

Morphologic and functional effect of core training combined with respiratory training on multifidus and transversus abdominis in patients with lumbar disc herniation

SONG Jianing, LOU Xiaole, LIU Huan, HAN Xue, XU Lei, WANG Min()   

  1. Department of Rehabilitation Medicine, the First Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui 233000, China
  • Received:2024-10-06 Revised:2024-12-21 Published:2025-01-25 Online:2025-01-22
  • Contact: WANG Min, E-mail: charleywangmin@126.com
  • Supported by:
    Anhui Province Clinical Medical Research Translation Special Program(202304295107020085);Anhui Province Traditional Chinese Medicine Leading Talents Construction Project (rehabilitation)(2018-23-1);Bengbu Medical University Graduate Student Research and Innovation Program 150 Grants Established Projects (No. Byycx23067)(Byycx23067)

摘要:

目的 探讨在核心稳定训练基础上联合呼吸训练对腰椎间盘突出症患者的效果。

方法 2023年1月至2024年10月蚌埠医科大学第一附属医院收治的96例腰椎间盘突出症患者,随机分为对照组(n = 32)、核心组(n = 32)和呼吸组(n = 32)。各组均进行常规康复治疗,核心组行核心稳定训练,呼吸组行呼吸训练联合核心稳定训练,共4周。比较训练前后视觉模拟量表(VAS)评分、日本骨科协会量表(JOA)评分和Oswestry功能障碍指数(ODI)评分;采用表面肌电图(sEMG)检测多裂肌、腹横肌的平均肌电值(AEMG)和均方根值(RMS);肌骨超声测量患侧多裂肌和腹横肌厚度。

结果 各组VAS、JOA和ODI评分的组内效应(F > 597.796, P < 0.001)、组间效应(F > 16.535, P < 0.001)和交互效应(F > 49.622, P < 0.001)均显著。两两比较,呼吸组优于核心组和对照组(P < 0.05),核心组显著优于对照组(P < 0.001)。各组腹横肌和多裂肌厚度的组内效应(F > 7971.631, P < 0.001)、组间效应(F > 177.760, P < 0.001)和交互效应(F > 478.771, P < 0.001)均显著;两两比较,呼吸组显著优于核心组和对照组(P < 0.001),核心组显著优于对照组(P < 0.001)。各组多裂肌和腹横肌RMS的组内效应(F > 144303.007, P < 0.001)、组间效应(F > 1495.458, P < 0.001)和交互效应 (F > 3121.361, P < 0.001)均显著;两两比较,呼吸组显著优于核心组和对照组(P < 0.001),核心组显著优于对照组(P < 0.01)。各组多裂肌和腹横肌AEMG的组内效应(F > 1890.532, P < 0.001)、组间效应(F > 607.132, P < 0.001)和交互效应(F > 824.923, P < 0.001) 均显著;两两比较,呼吸组显著优于核心组和对照组(P < 0.001),核心组显著优于对照组(P < 0.001)。

结论 核心训练联合呼吸训练可以通过增强核心肌群的力量和控制能力,能够减轻腰椎间盘突出症患者疼痛,改善功能障碍,从而提高生活质量。

关键词: 腰椎间盘突出, 核心稳定性训练, 呼吸训练, 超声成像

Abstract:

Objective To explore the effect of respiratory training based on core stabilization training on lumbar disc herniation.

Methods From January, 2023 to October, 2024, 96 patients with lumbar disc herniation admitted to the First Affiliated Hospital of Bengbu Medical University were divided into control group (n = 32), core group (n= 32) and respiratory group (n = 32). All the groups underwent conventional rehabilitation therapy, with core stabilization training in the core group and respiratory training combined with core stabilization training in the respiratory group, additionally, for four weeks. Before and after training, the scores of Visual Analogue Scale, Japanese Orthopaedic Association (JOA) and Oswestry Dysfunction Index (ODI) were compared, the average electromyographic value (AEMG) and root mean square (RMS) value of the multifidus and transversus abdominis were detected by surface electromyography (sEMG); and the thickness of the multifidus and transversus abdominis were measured by musculoskeletal ultrasonography bilaterally.

Results The intra-group effect (F > 597.796, P< 0.001), inter-group effect (F > 16.535, P< 0.001) and interaction effect (F > 49.622, P< 0.001) were significant in the scores of VAS, JOA and ODI; which were better in the respiratory group than in the control group and the core group (P< 0.05), and were better in the core group than in the control group (P< 0.001). The intra-group effect (F > 7971.631, P< 0.001), inter-group effect (F > 177.760, P< 0.001) and interaction effect (F > 478.771, P< 0.001) were significant in the thickness of the transversus abdominis and multifidus; which were better in the respiratory group than in the control group and the core group (P< 0.001), and were better in the core group than in the control group (P< 0.001). The intra-group effect (F > 144303.007, P< 0.001), inter-group effect (F > 1495.458, P< 0.001) and interaction effect (F > 3121.361, P < 0.001) were significant in the RMS of the multifidus and transversus abdominis; which were better in the respiratory group than in the control group and the core group (P< 0.001), and were better in the core group than in the control group (P< 0.001). The intra-group effect (F > 1890.532, P< 0.001), inter-group effect (F > 607.132, P< 0.001) and interaction effect (F > 824.923, P< 0.001) were significant in the AEMG of the multifidus and transversus abdominis; which were better in the respiratory group than in the control group and core group (P< 0.001), and were better in the core group than in the control group (P< 0.001).

Conclusion Core training combined with respiratory training can more effectively reduce pain and improve dysfunction by enhancing the strength and control of the core muscles, thus improving the quality of life of patients with lumbar disc herniation.

Key words: lumbar disc herniation, core stability training, respiratory training, ultrasound imaging

中图分类号: