目的 通过表面肌电图探讨多点多轴悬吊训练对非特异性腰痛(NLBP)的治疗效果。方法 2016年10月至2017年11月,24例单侧NLBP患者(NLBP组)随机分为动态组(n=12)和静态组(n=12);另选健康志愿者12例为对照组。NLBP组均采用多点多轴悬吊训练系统训练,动态组选择仰卧位骨盆上移训练,静态组选择仰卧位腰椎中立保持训练,共训练10 d。治疗前后测量痛侧多裂肌平均肌电值(AEMG)和疼痛视觉模拟评分(VAS);对照组测单侧多裂肌AEMG。结果 治疗前,静息位及骨盆上移时NLBP组AEMG明显高于对照组(t>3.209, P<0.01),中立保持位NLBP组AEMG低于对照组(t=-2.364, P<0.05)。治疗后NLBP组各体位AEMG均改善(t>2.982, P<0.01),静息位和中立保持位AEMG与对照组无显著性差异(F<2.921, P>0.05),骨盆上移AEMG动态组显著高于对照组和静态组(P<0.001)。治疗后,静态组和动态组VAS均显著降低(t>10.416, P<0.001),静态组显著低于动态组(t=-4.389, P<0.001)。结论 NLBP患者疼痛肌肉出现特异性表面肌电改变;多点多轴悬吊训练通过改善腰部核心肌群产生治疗作用,且静态保持训练比动态上抬训练效果更佳。
Objective To study the effect of multi-point multi-axis suspension training on nonspecific low back pain (NLBP) through surface electromyography (sEMG). Methods From October, 2016 to November, 2017, 24 patients with unilateral NLBP (NLBP group) were randomly divided into dynamic group (n=12) and static group (n=12); other 12 healthy volunteers were selected as control group. NLBP group was trained on multi-point multi-axis suspension training system, the dynamic group accepted pelvic-up training in the supine position, while the static group accepted lumbar neutral keep training, for ten days. NLBP group was measured with average electromyographic values (AEMG) of affected musculi multifidi before and after treatment, and assessed with Visual Analogue Scale (VAS) of pain; while the control group was measured AEMG of unilateral musculi multifidi. Results The AEMG in static and pelvic-up positions was more in NLBP group than in the control group before treatment (t>3.209, P<0.01), and it was less when keeping neutral position (t=-2.364, P<0.05). The AEMG improved in NLBP groups after treatment (t>2.982, P<0.01). The AEMG in static position and in keeping neutral position was not significantly different among the three groups after treatment (F<2.921, P>0.05), and it was the most in the dynamic group as pelvic-up (P<0.001). The score of VAS decreased in both NLBP groups after treatment (t>10.416, P<0.001), and it was less in the static group than in the dynamic group (t=-4.389, P<0.001).Conclusion sEMG changes take place in patients with NLBP. Multi-point multi-axis suspension training is effective through improving the core muscle group, and it is more effective in static maintenance training.
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