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

doi:10.3969/j.issn.1006-9771.2025.01.010

Abstract

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

CLC Number:

R681.53

SONG Jianing, LOU Xiaole, LIU Huan, HAN Xue, XU Lei, WANG Min. Morphologic and functional effect of core training combined with respiratory training on multifidus and transversus abdominis in patients with lumbar disc herniation[J]. Chinese Journal of Rehabilitation Theory and Practice, 2025, 31(1): 107-116.

Figures/Tables 14

Table 1

Comparison of baseline data among three groups"

组别	n	性别(男/女)/n	年龄/岁	病程/d	身高/cm	体质量/kg	体质量指数/(kg $⋅$ m^-2)
对照组	32	19/13	40.69±8.16	107.19±7.37	168.64±6.85	67.08±7.52	23.52±1.33
核心组	32	16/16	41.53±6.21	106.22±7.34	168.87±4.60	65.82±6.46	23.02±1.18
呼吸组	32	16/16	39.00±9.99	108.59±7.60	168.89±5.55	65.14±8.11	22.73±1.52
χ²/F值		0.753	0.778	0.825	0.018	0.572	2.791
P值		0.686	0.462	0.441	0.982	0.566	0.066

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References 37

[1]	DING Y, CHEN J Y, YANG J C, et al. Disc degeneration contributes to the denser bone in the sub-endplate but not in the vertebral body in patients with lumbar spinal stenosis or disc herniation[J]. Spine J, 2023, 23(1): 64-71.
[2]	LU H B, WANG L S, LI M Q, et al. The association between changes in multifidus muscle morphology and back pain scores following discectomy surgery for lumbar disc herniation: a systematic review and meta-analysis[J]. Eur Spine J, 2022, 31(7): 1784-1794.
[3]	RABIA T K, SEDEF Y, CETIN S, et al. The impact of protrusion size on pain, range of motion, functional capacity, and multifidus muscle cross-sectional area in lumbar disc herniation[J]. JOR Spine, 2023, 102(46): e35367.
[4]	LI R, LI Y H, KONG Y L, et al. Virtual reality-based training in chronic low back pain: systematic review and meta-analysis of randomized controlled trials[J]. J Med Internet Res, 2024;26: e45406
[5]	SANNASI R, DAKSHINAMURTHY A, DOMMERHOLT J, et al. Diaphragm and core stabilization exercises in low back pain: a narrative review[J]. J Bodyw Mov Ther, 2023, 36: 221-227. doi: 10.1016/j.jbmt.2023.07.008 pmid: 37949564
[6]	SHI J, LIU Z, ZHOU X C, et al. Effects of breathing exercises on low back pain in clinical: a systematic review and meta-analysis[J]. Complement Ther Med, 2023, 79: 102993.
[7]	JIANG X Y, SUN W Y, CHEN Q, et al. Effects of breathing exercises on chronic low back pain: a systematic review and meta-analysis of randomized controlled trials[J]. J Back Musculoskelet Rehabil, 2024, 37(1): 13-23.
[8]	MERCEDES D, KARINE D, BÉNÉDICTE N, et al. Ultrasound elastography of back muscle biomechanical properties: a systematic review and meta-analysis of current methods[J]. Insights Imaging, 2024, 15(1): 206.
[9]	BOZORGMEHR A, TAKANMJANI I E, AKBARI M, et al. Reliability of ultrasound measurements of the lumbar multifidus and transversus abdominis muscles during lying and unstable sitting positions in individuals with and without chronic low back pain[J]. J Biomed Phys Eng, 2023, 13(2): 157-168. doi: 10.31661/jbpe.v0i0.2003-1078 pmid: 37082545
[10]	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): 477-487.
	Chinese Orthopaedic Association of Spinal Surgery Group, Chinese Orthopaedic Association of Orthopaedic Rehabilitation Group. Clinical practice guideline for diagnosis and treatment of lumbar disc herniation[J]. Chin J Orthopaed, 2020, 40(8): 477-487.
[11]	XU S M, WANG R, MA S Z, et al. Interventional effect of core stability training on pain and muscle function of youth with chronic non-specific lower back pain: a randomized controlled trial[J]. Heliyon, 2024, 10(12): e32818.
[12]	DAFKOU K, KELLIS E, ELLINOUNDIS A, et al. The effect of additional external resistance on inter-set changes in abdominal muscle thickness during bridging exercise[J]. J Sports Sci Med, 2020, 19(1): 102-111.
[13]	BRUNO D S G, LEONARDO C D S, HEBE F C, et al. Inspiratory muscle training with an electronic resistive loading device improves prolonged weaning outcomes in a randomized controlled trial[J]. Crit Care Med, 2021, 49(4): 589-597. doi: 10.1097/CCM.0000000000004787 pmid: 33332819
[14]	LEILA A, ALI Y, BEHNAM G B, et al. Inspiratory muscle training in rehabilitation of low back pain: a randomized controlled trial[J]. J Sport Rehabil, 2020, 29(8): 1151-1158.
[15]	陈灵慧, 郑琦, 李岩, 等. 在核心稳定训练基础上联合呼吸训练对慢性非特异性腰痛患者前馈控制的效果[J]. 中国康复理论与实践, 2024, 30(6): 737-744. doi: 10.3969/j.issn.1006-9771.2024.06.015
	CHEN L H, ZHENG Q, LI Y, et al. Effect of respiratory training based on core stability training on feedforward control in patients with chronic nonspecific low back pain[J]. Chin J Rehabil Theory Pract, 2024, 30(6): 737-744.
[16]	曾琳钰, 陈子明, 曾俊卿, 等. 超声测量坐骨神经横截面积在单侧腰椎间盘突出症内镜术后早期疗效评估中的应用[J]. 实用医学杂志, 2025, 41(1): 35-40.
	ZENG L Y, CHEN Z M, ZENG J Q, et al. Ultrasound measurement of sciatic nerve cross-sectional area in early outcome assessment after endoscopic surgery for unilateral lumbar disc herniation[J]. 2025, 41(1): 35-40.
[17]	严秀芬, 胡玥. 核心稳定性训练配合疼痛干预对腰椎间盘突出症患者腰椎功能、疼痛程度的影响[J]. 中国现代药物应用, 2024, 18(21): 171-174.
[18]	LATHLEAN T J H, RAMACHANDRAN A K, SIM S, et al. The clinical utility and reliability of surface electromyography in individuals with chronic low back pain: a systematic review[J]. J Clin Neurosci, 2024, 129: 110877.
[19]	GE L, HUANG H J, YU Q H, et al. Effects of core stability training on older women with low back pain: a randomized controlled trial[J]. Eur Rev Aging Phys Act, 2022, 19(1): 10.
[20]	JOURDAN A, SOUCASSE A, SCEMAMA U, et al. Abdominal wall morphometric variability based on computed tomography: influence of age, gender, and body mass index[J]. Clin Anat, 2020, 33(8): 1110-1119.
[21]	KIM N, YOON S H, KIM M, et al. Effect of direct vibration on the activity of deep trunk muscles of patients with non-specific chronic low back pain[J]. J Back Musculoskelet Rehabil, 2022, 35(5): 1109-1118.
[22]	HIAING S S, PUNTUMETAKUL R, KHINE E E, et al. Effects of core stabilization exercise and strengthening exercise on proprioception, balance, muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain: a randomized controlled trial[J]. BMC Musculoskelet Disord, 2021, 22(1): 998.
[23]	LI X, LIU H, GE L, et al. Cortical representations of transversus abdominis and multifidus muscles were discrete in patients with chronic low back pain: evidence elicited by TMS[J]. Neural Plast, 2021, 2021: 6666024.
[24]	HODGES P W, RICHARDSON C A. Lipid and metabolic alteration involvement in physiotherapy for chronic nonspecific low back pain[J]. Lipids Health Dis, 2022, 21(1): 125.
[25]	KAMAZ M, KIREŞI D, OĞUZH, et al. Effect of exercise and manual therapy or kinesiotaping on sEMG and pain perception in chronic low back pain: a randomized trial[J]. BMC Musculoskelet Disord, 2024, 25(1): 583.
[26]	MOLINA-HERNÁNDEZ M, RODRÍGUEZ-SANZ D, CHICHARRO J, et al. Effectiveness of simultaneous bilateral visual diaphragm biofeedback under low back pain: influence of age and sex[J]. Front Physiol, 2024, 15: 1407594.
[27]	PEROTTI L, STAMM O, MESLETZKY L, et al. Needs and attitudes of older chronic back pain patients towards a wearable for ultrasound biofeedback during stabilization exercises:a qualitative analysis[J]. Int J Environ Res Public Health, 2023, 20(6): 4927.
[28]	AMIRI B, ZEMKOVÁ E. Diaphragmatic breathing exercises in recovery from fatigue-induced changes in spinal mobility and postural stability: a study protocol[J]. Front Physiol, 2023, 14: 1220464.
[29]	MASROOR S, TANWAR T, ALDABBAS M, et al. Effect of adding diaphragmatic breathing exercises to core stabilization exercises on pain, muscle activity, disability, and sleep quality in patients with chronic low back pain: a randomized control trial[J]. J Chiropr Med, 2023, 22(4): 275-283. doi: 10.1016/j.jcm.2023.07.001 pmid: 38205226
[30]	OH Y J, PARK S H, LEE M M. Comparison of effects of abdominal draw-in lumbar stabilization exercises with and without respiratory resistance on women with low back pain: a randomized controlled trial[J]. Med Sci Monit, 2020, 26: e921295.
[31]	MARUGÁN-RUBIO D, CHICHARRO J L, BECERRO-DE-BENGOA-VALLEJO R, et al. Effectiveness of ultrasonography visual biofeedback of the diaphragm in conjunction with inspiratory muscle training on muscle thickness, respiratory pressures, pain, disability, quality of life and pulmonary function in athletes with non-specific low back pain: a randomized clinical trial[J]. J Clin Med, 2022, 11(15): 4318.
[32]	罗香, 冷晓辉, 王扬, 等. 腹横肌生物力学及应用研究进展[J]. 中国临床解剖学杂志, 2024, 42(2): 236-238.
	LUO X, LENG X H, WANG Y, et al. Research progress on the biomechanics and application of transversus abdominis[J]. Chin J Clin Anat, 2024, 42(2): 236-238.
[33]	NAGHDI N, MOHSENI-BANDPEI M A, TAGHIPOUR M, et al. Lumbar multifidus muscle morphology changes in patient with different degrees of lumbar disc herniation: an ultrasonographic study[J]. Medicina, 2021, 57(7): 699.
[34]	CASTRO J, CORREIA L, DONATO B S, et al. Cognitive functional therapy compared with core exercise and manual therapy in patients with chronic low back pain: randomised controlled trial[J]. Pain, 2022, 163(12): 2430-2437. doi: 10.1097/j.pain.0000000000002644 pmid: 35384931
[35]	KWON J W, PARK S Y, BAEK K H, et al. Breathing exercise called the maximal abdominal contraction maneuver[J]. Medicina, 2021, 57(2): 129.
[36]	陈沛, 任超学, 李新通, 等. 呼吸训练在非特异性腰痛防治中的研究进展[J]. 中国康复理论与实践, 2020, 26(8): 913-916. doi: 10.3969/j.issn.1006-9771.2020.08.008
	CHEN P, REN C X, LI X T, et al. Advance in respiratory training for prevention and treatment of nonspecific low back pain (review)[J]. Chin J Rehabil Theory Pract, 2020, 26(8): 913-916.
[37]	王钊, 贾凡, 赵莹, 等. 坐位压力生物反馈疗法联合Flexi-bar对慢性非特异性腰痛的效果[J]. 中国康复理论与实践, 2023, 29(1): 110-118. doi: 10.3969/j.issn.1006-9771.2023.01.017
	WANG Z, JIA F, ZHAO Y, et al. Effect of combination of pressure biofeedback therapy and Flexi-bar in sitting on chronic non-specific low back pain[J]. Chin J Rehabil Theory Pract, 2023, 29(1): 110-118.

编号	训练内容
1	四点跪位，脊柱中立位，持续收缩10 s，保持自然呼吸
2	基于初始姿势(即步骤1所示)，缓慢将右上肢抬起，直至完全伸展，持续15 s，随后平稳放下，重复对侧动作
3	基于初始姿势(即步骤1所示)，缓慢将左下肢抬起，直至完全伸展，持续15 s，随后平稳放下，重复对侧动作
4	基于初始姿势(即步骤1所示)，缓慢将左下肢抬起，直至完全伸展，同时抬起右上肢，持续15 s，随后平稳放下，重复对侧动作
5	基于初始姿势(即步骤1所示)，将左下肢抬起至完全伸展再抬起右上肢，下肢交替伸直-屈曲。然后返回，重复对侧动作

变量	组别	n	治疗前		治疗后
变量	组别	n	均值	标准差	均值	标准差
VAS	对照组	32	4.22	1.26	3.28	1.51
	核心组	32	4.38	1.24	2.59	1.52
	呼吸组	32	4.41	1.13	2.16	1.22
JOA	对照组	32	12.41	1.48	15.63	1.36
	核心组	32	12.44	1.41	18.22	1.39
	呼吸组	32	12.28	1.28	20.44	1.41
ODI	对照组	32	38.50	1.90	28.44	1.58
	核心组	32	37.97	1.94	21.44	1.41
	呼吸组	32	38.19	1.89	18.50	1.59

变量		平方和	自由度	均方	F值	P值
VAS	组间	7.073	2	3.536	16.535	< 0.001
	组内	131.672	1	131.672	597.796	< 0.001
	组内×组间	14.156	2	7.078	49.622	< 0.001
JOA	组间	176.625	2	88.313	816.205	< 0.001
	组内	1569.797	1	1569.797	23896.243	< 0.001
	组内×组间	195.125	2	97.562	1091.526	< 0.001
ODI	组间	902.260	2	451.130	3082.809	< 0.001
	组内	11423.755	1	11423.755	29320.479	< 0.001
	组内×组间	770.385	2	385.193	2883.858	< 0.001

变量	组别		平均值差	P值	95%CI
变量	组别		平均值差	P值	下限	上限
VAS	对照组	呼吸组	0.266	0.014	0.046	0.486
	对照组	核心组	0.469	< 0.001	0.257	0.681
	呼吸组	核心组	0.203	0.030	0.016	0.390
JOA	对照组	呼吸组	-1.312	< 0.001	-1.481	-1.144
	对照组	核心组	-2.344	< 0.001	-2.509	-2.179
	呼吸组	核心组	-1.031	< 0.001	-1.129	-0.934
ODI	对照组	呼吸组	3.766	< 0.001	3.586	3.945
	对照组	核心组	5.125	< 0.001	4.964	5.286
	呼吸组	核心组	1.359	< 0.001	1.187	1.532

变量	组别	n	治疗前		治疗后
变量	组别	n	均值	标准差	均值	标准差
多裂肌厚度	对照组	32	9.86	0.18	10.48	0.16
	核心组	32	9.80	0.18	11.07	0.15
	呼吸组	32	9.77	0.19	11.36	0.15
腹横肌厚度	对照组	32	12.41	1.48	15.63	1.36
	核心组	32	12.44	1.41	18.22	1.39
	呼吸组	32	12.28	1.28	20.44	1.41

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

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变量		平方和	自由度	均方	F值	P值
多裂肌厚度	组间	5.181	2	2.591	177.760	< 0.001
	组内	64.103	1	64.103	7971.631	< 0.001
	组内×组间	7.730	2	3.865	478.771	< 0.001
腹横肌厚度	组间	176.625	2	88.313	816.205	< 0.001
	组内	1569.797	1	1569.797	23896.243	< 0.001
	组内×组间	195.125	2	97.562	1091.526	< 0.001

变量		平方和	自由度	均方	F值	P值
多裂肌RMS	组间	1635.612	2	817.806	1495.458	< 0.001
	组内	9083.252	1	9083.252	24295.658	< 0.001
	组内×组间	1621.101	2	810.550	3121.361	< 0.001
腹横肌RMS	组间	3279.954	2	1639.977	9325.126	< 0.001
	组内	17432.848	1	17432.848	144303.007	< 0.001
	组内×组间	3359.959	2	1679.980	9644.435	< 0.001

变量		平方和	自由度	均方	F值	P值
多裂肌AMEG	组间	398.949	2	199.475	607.132	< 0.001
	组内	1890.532	1	1890.532	3637.316	< 0.001
	组内×组间	422.373	2	211.187	824.923	< 0.001
腹横肌AMEG	组间	1599.998	2	799.999	4669.470	< 0.001
	组内	7223.595	1	7223.595	13718.319	< 0.001
	组内×组间	1625.358	2	812.679	6123.054	< 0.001

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变量	组别	n	治疗前		治疗后
变量	组别	n	均值	标准差	均值	标准差
多裂肌RMS	对照组	32	49.54	1.69	56.60	1.59
	核心组	32	49.83	1.55	62.80	1.59
	呼吸组	32	49.59	1.85	70.83	2.06
腹横肌RMS	对照组	32	65.74	1.51	75.76	1.73
	核心组	32	65.57	1.86	82.54	1.65
	呼吸组	32	65.59	1.63	95.78	2.11

变量	组别	n	治疗前		治疗后
变量	组别	n	均值	标准差	均值	标准差
多裂肌AMEG	对照组	32	42.79	2.11	45.69	1.83
	核心组	32	42.79	1.93	48.60	1.60
	呼吸组	32	42.70	1.83	52.81	1.73
腹横肌AMEG	对照组	32	58.03	1.62	63.39	2.06
	核心组	32	57.93	1.63	69.78	1.77
	呼吸组	32	57.97	1.70	77.56	1.65