《中国康复理论与实践》

中国康复理论与实践 >

2018 , Vol. 24 >Issue 12: 1456 - 1460

DOI: https://doi.org/10.3969/j.issn.1006-9771.2018.12.019

临床研究

悬吊训练对产后腰痛的效果

  • 刘艳丽 ,
  • 赵祥虎 ,
  • 夏扬 ,
  • 卢洁 ,
  • 徐亮 ,
  • 陆雪松
展开
  • 1.东南大学附属中大医院康复医学科,江苏南京市 210009;
    2.江都人民医院产后康复中心,江苏扬州市 225200
刘艳丽(1985-),女,汉族,湖南邵阳市人,硕士,医师,主要研究方向：孕产康复。

收稿日期: 2018-06-08

  修回日期: 2018-07-08

  网络出版日期: 2019-01-04

基金资助

南京市医学科技发展项目(No. YKK17286)

收起

Effects of Sling Exercise Therapy on Postpartum Low Back Pain

  • LIU Yan-li ,
  • ZHAO Xiang-hu ,
  • XIA Yang ,
  • LU Jie ,
  • XU Liang ,
  • LU Xue-song
Expand
  • 1. Department of Rehabilitation Medicine, Zhongda Hospital Affiliated to Southeast University, Nanjing, Jiangsu 210009, China;
    2. Postpartum Rehabilitation Center of Jiangdu People's Hospital, Yangzhou, Jiangsu 225200, China

Received date: 2018-06-08

  Revised date: 2018-07-08

  Online published: 2019-01-04

Supported by

Nanjing Medical Science and Technology Development Project (No. YKK17286)

Fold

摘要

目的 探讨悬吊训练对产后腰痛的临床疗效。方法 2017年2月至2018年2月,产后腰痛的患者66例随机分为对照组(n = 33)和观察组(n = 33)。对照组给予常规康复理疗和美式脊椎矫正,观察组在对照组基础上辅以悬吊训练。治疗前和治疗6周后采用疼痛数字评分、Oswestry功能障碍指数和腹横肌厚度进行评价。结果 治疗前,两组疼痛数字评分、Oswestry功能障碍指数评分和腹横肌厚度均无显著性差异(P > 0.05)。治疗6周后,两组疼痛数字评分、Oswestry功能障碍指数评分较治疗前均显著降低(t > 14.579, P < 0.001);两组腹横肌厚度较治疗前均显著增加(t > 15.855, P < 0.001);且观察组上述指标均显著优于对照组(t > 4.818, P < 0.001)。结论 在常规康复理疗和美式脊椎矫正治疗基础上再辅以悬吊训练,可进一步减轻产后腰痛患者的疼痛,改善功能,提高生活质量。

关键词： 产后腰痛; 悬吊训练; 美式脊椎矫正; 肌骨超声

本文引用格式

刘艳丽 , 赵祥虎 , 夏扬 , 卢洁 , 徐亮 , 陆雪松 . 悬吊训练对产后腰痛的效果[J]. 中国康复理论与实践, 2018 , 24(12) : 1456 -1460 . DOI: 10.3969/j.issn.1006-9771.2018.12.019

Abstract

Objective To explore the clinical effect of sling exercise on postpartum low back pain (PLBP). Methods From February, 2017 to February, 2018, 66 PLBP patients were randomly divided into control group (n = 33) and observation group (n = 33). The control group received routine rehabilitation physiotherapy and American chiropractic, and the observation group was supplemented with sling exercise therapy additionally. They were evaluated with Numerical Rating Scale (NRS), Oswestry Disability Index (ODI) and the thickness of transversus abdominis before and six weeks after treatment. Results Before treatment, there was no significant difference in the scores of NRS, ODI and the thickness of transversus abdominis between two groups (P > 0.05). Six weeks after treatment, the scores of NRS and ODI significantly decreased (t > 14.579, P < 0.001), and the transversus abdominis thickness significantly improved (t > 15.855, P < 0.001) in both groups. All the above indexes were significantly better in the observation group than in the control group (t > 4.818, P < 0.001). Conclusions ling exercise therapy, combined with American chiropractic treatment and routine rehabilitation physiotherapy, can further relieve pain in patients with PLBP, and improve the function and the quality of life.

Key words： postpartum low back pain; sling exercise therapy; American chiropractic; musculoskeletal ultrasound

参考文献

[1] 宋成宪,王润妹,李太良,等.妊娠相关下腰痛的流行病学特征及治疗进展[J]. 中华全科医学, 2017, 15(4): 659-662.
[2] Tseng PC, Puthussery S, Pappas Y, et al.A systematic review of randomised controlled trials on the effectiveness of exercise programs on lumbo pelvic pain among postnatal women[J]. BMC Pregnancy Childbirth, 2015, 15: 316.
[3] Ostgaard HC, Zetherström G, Roos-Hansson E.Back pain in relation to pregnancy: a 6-year follow-up[J]. Spine, 1997, 22(24): 2945-2950.
[4] Bergström C, Persson M, Mogren I.Pregnancy-related low back pain and pelvic girdle pain approximately 14 months after pregnancy-pain status, self-rated health and family situation[J]. BMC Pregnancy Childbirth, 2014, 14: 48.
[5] Perkins J, Hammer RL, Loubert PV.Identification and management of pregnancy-related low back pain[J]. J Nurse Midwifery, 1998, 43(5): 331-340.
[6] Sabino J, Grauer JN.Pregnancy and low back pain[J]. Curr Rev Musculoskelet Med, 2008, 1(2): 137-141.
[7] Vleeming A, Albert HB, Ostgaard HC, et al.European guidelines for the diagnosis and treatment of pelvic girdle pain[J]. Eur Spine J, 2008, 17(6): 794-819.
[8] 宋成宪,蔡款,刘益芬,等. 产后6周妇女腹部核心肌厚度变化的超声学研究[J]. 中国妇幼保健, 2018, 33(2): 266-269.
[9] 林科宇,许轶,王楚怀,等.悬吊式核心稳定训练对慢性非特异性下背痛的疗效[J]. 中国康复医学杂志, 2014, 29(10): 923-928.
[10] 孙敬龙,李丽. 悬吊运动训练治疗腰椎间盘突出症的疗效观察[J]. 中国康复医学杂志, 2014, 29(4): 374-376.
[11] Schwerla F, Rother K, Rother D, et al.Osteopathic manipulative therapy in women with postpartum low back pain and disability: a pragmatic randomized controlled trial[J]. J Am Osteopath Assoc, 2015, 115(7): 416-425.
[12] 郭艮春,马飞翔,张桂芳. 美式整脊治疗产后腰骶疼痛的临床观察[J].中国临床研究, 2017, 30(1): 113-115.
[13] 冈斯德. 科学&艺术的脊椎矫正[M]. 台北:中华脊椎健康研究中心, 2004: 3-4, 15-16, 65-70.
[14] 王雪强,郑依莉,胡浩宇,等. 常用腰痛功能障碍评估量表的研究进展[J]. 中国康复理论与实践, 2017, 23(6): 672-676.
[15] Kiesel KB, Uhl TL, Underwood FB, et al.Measurement of lumbar multifidus muscle contraction with rehabilitative ultrasound imaging[J]. Man Ther, 2007, 12(2): 161-166.
[16] Stuge B.Current knowledge on low back pain and pelvic girdle pain during pregnancy and after childbirth: a narrative review[J]. Curr Womens Health Rev, 2015, 11(1): 68-74.
[17] Verstraete EH, Vanderstraeten G, Parewijck W.Pelvic Girdle Pain during or after Pregnancy: a review of recent evidence and a clinical care path proposal[J]. Facts Views Vis Obgyn, 2013, 5(1): 33-43.
[18] Bjelland EK, Stuge B, Vangen S, et al. Mode of delivery and persistence of pelvic girdle syndrome 6 months postpartum [J]. Am J Obstet Gynecol, 2013, 208(4): 298. e1-e298, e7.
[19] Sihvonen T, Huttunen M, Makkonen M, et al.Functional changes in back muscle activity correlate with pain intensity and prediction of low back pain during pregnancy[J]. Arch Phys Med Rehabil, 1998, 79(10): 1210-1212.
[20] Fujiwara A, Tamai K, An HS, et al.The relationship between disc degeneration, facet joint osteoarthritis, and stability of the degenerative lumbar spine[J]. J Spinal Disord, 2000, 13(5): 444-450.
[21] 韩春远,王卫星,成波锦,等. 核心力量训练的基本问题-核心区与核心稳定性[J]. 天津体育学院学报, 2012, 27(2): 117-120.
[22] Chang WD, Lin HY, Lai PT.Core strength training for patients with chronic low back pain[J]. J Phys Ther Sci, 2015, 27(3): 619-622.
[23] Standaert CJ.Core stabilization for low back pain and performance[J]. Sport Ortho Trauma, 2011, 27(2): 92-98.
[24] Hastings V, McCallister AM, Curtis SA, et al. Efficacy of osteopathic manipulative treatment for management of postpartum pain[J]. J Am Osteopath Assoc, 2016, 116(8): 502-509.
[25] 吴勤峰,孙丽,沈光宇,等. 美式脊椎矫正联合神经松动术治疗神经根型颈椎病的疗效[J]. 江苏医药, 2015, 41(8): 962-964.
[26] 李琳,叶祥明,林坚,等. 核心稳定性训练治疗妊娠期腰痛的临床效果分析[J]. 中国康复医学杂志, 2012, 27(11): 1073-1074.
[27] 苟艳芸,江征,罗庆禄. 核心稳定性训练对产后下腰痛患者的效果探讨[J]. 中国当代医药, 2016, 23(32): 87-89.
[28] Taylor DA, Merten SL, Sandercoe GD, et al.Abdominoplasty improves low back pain and urinary incontinence[J]. Plast Reconstr Surg, 2018, 141(3): 637-645.
[29] Chaudry S, Rashid F, Shah SIH.Effectiveness of core stabilization exercises along with postural correction in postpartum back pain[J]. Rawal Med J, 2013, 38(3): 256-259.
[30] 郭险峰,元帅霄,李旭. 悬吊运动训练对成人特发性脊柱侧弯慢性腰背疼痛的康复效果[J]. 中国康复理论与实践, 2010, 16(8): 716-719.
[31] 王成秀,徐远红,杨凤翔,等. 悬吊运动训练对非特异性下背痛患者远期疗效的临床研究[J]. 中国康复, 2011, 26(2): 103-105.
[32] Lee JS, Yang SH, Koog YH, et al.Effectiveness of sling exercise for chronic low back pain: a systematic review[J]. J Phys Ther Sci, 2014, 26(8): 1301-1306.
[33] Yue YS, Wang XD, Xie B, et al.Sling exercise for chronic low back pain: a systematic review and meta-analysis[J]. PLoS One, 2014, 9(6): e99307.
[34] 胡智宏,孔叶平,叶倩.悬吊训练作用机制及临床应用研究进展[J].中国康复医学杂志, 2016, 31(8): 924-927.
[35] 于瑞,许轶,王楚怀,等. 慢性非特异性下背痛患者悬吊运动疗法治疗后表面肌电信号的变化[J]. 中国康复医学杂志, 2015, 30(8): 801-803.
[36] 谢文辉,梁仕山,缪秋娴. 局部阻滞对骶髂关节致密性骨炎所致产后腰骶痛的疗效观察[J]. 广东医学院学报, 2015, 33(2): 194-196.
Options
文章导航

/

〈 〉