不同呼吸训练对慢性非特异性腰痛患者躯干深层肌肉形态与功能的影响

doi:10.3969/j.issn.1006-9771.2026.04.009

Abstract

Abstract:

Objective To compare the effect of diaphragmatic and abdominal breathing training on the morphology and function of deep trunk muscles in patients with chronic nonspecific low back pain.

Methods From March to May, 2025, a total of 37 patients with chronic nonspecific low back pain recruited at Xi 'an Physical Education University, were randomly divided into control group (n = 12), abdominal breathing group (n = 12) and diaphragmatic breathing group (n = 13). All groups received transcutaneous electrical nerve stimulation and core stability training. On this basis, the abdominal breathing group was added with abdominal breathing training, and the diaphragmatic breathing group was added with diaphragmatic breathing training, for six weeks. The degree of pain was evaluated with Visual Analogue Scale (VAS) before and after intervention, while the activation levels of multifidus and transversus abdominis were evaluated with the root mean square value (RMS) of surface electromyography, and the thickness of the multifidus muscle, transverse abdominis muscle, diaphragm and diaphragm mobility were evaluated with musculoskeletal ultrasound.

Results After intervention, all the indicators improved in all the groups (P< 0.001), except for the diaphragm thickness and mobility in the control group. All the effects (F> 4.634, P< 0.016) of VAS score were significant, and were better in the diaphragmatic/abdominal breathing groups than in the control group (P< 0.01). The intra-group effects (F> 64.869, P< 0.001) and interaction effects (F> 12.379, P< 0.001) of muscle morphology and function indexes were significant, and the RMS of multifidus and transversus abdominis, left multifidus thickness, bilateral transversus abdominis thickness, diaphragm thickness, and diaphragm excursion was better in the diaphragmatic breathing group than in the control group and the abdominal breathing group (P< 0.001), while bilateral transversus abdominis RMS, diaphragm excursion, and right multifidus thickness were better in the abdominal breathing group than in the control group (P< 0.037).

Conclusion The combination of diaphragmatic/abdominal breathing exercises can further improve the morphology and function of the deep muscles of trunk in patients with chronic nonspecific low back pain, and diaphragmatic breathing may be superior to abdominal breathing.

Key words: chronic nonspecific low back pain, diaphragmatic breathing, abdominal breathing

CLC Number:

R681.5

MA Zhuyi, REN Chaoxue. Effect of different breathing training on morphology and function of deep trunk muscles in patients with chronic nonspecific low back pain[J]. Chinese Journal of Rehabilitation Theory and Practice, 2026, 32(4): 453-462.

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References 42

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组别	n	性别(男/女)/n	年龄/岁	身高/m	体质量/kg	病程/月	BMI/(kg·m^-2)
对照组	12	2/10	21.83±1.85	1.64±0.08	55.50±8.51	11.00±7.29	20.51±1.96
膈式呼吸组	13	2/11	23.15±2.04	1.64±0.08	57.58±10.75	11.54±6.42	20.95±3.31
腹式呼吸组	12	2/10	23.00±2.45	1.68±0.09	59.91±11.35	10.42±4.01	21.13±1.98
χ²/F值		0.239	1.413	0.693	0.553	0.106	0.191
P值		1.000	0.257	0.507	0.580	0.899	0.827

组别	n	治疗前	治疗后
对照组	12	3(3，3)	2(1.25，2)
膈式呼吸组	13	3(3，3)	1(0，1.5)
腹式呼吸组	12	3(3，3)	1(0.25，1)

效应	自由度	F值	P值
组内	1	163.774	< 0.001
组间	2	4.634	0.016
组内×组间	2	6.008	0.006

组别		平均值差	P值	95%CI
组别		平均值差	P值	下限	上限
对照组	膈式呼吸组	0.987	< 0.001	0.424	1.550
对照组	腹式呼吸组	0.833	0.002	0.259	1.408
膈式呼吸组	腹式呼吸组	-0.154	1.000	-0.717	0.409

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
左多裂肌RMS	对照组	12	51.50	19.34	61.17	26.16
左多裂肌RMS	膈式呼吸组	13	52.92	13.09	84.38	11.64
	腹式呼吸组	12	53.08	24.05	66.50	24.05
右多裂肌RMS	对照组	12	49.08	21.09	60.00	25.28
右多裂肌RMS	膈式呼吸组	13	50.23	17.84	85.38	11.32
	腹式呼吸组	12	51.83	26.25	65.58	24.93
左腹横肌RMS	对照组	12	61.42	20.00	72.25	19.27
	膈式呼吸组	13	62.00	15.88	106.34	16.40
	腹式呼吸组	12	63.00	18.83	89.42	25.49
右腹横肌RMS	对照组	12	62.08	17.86	73.50	15.86
	膈式呼吸组	13	64.85	15.40	104.63	14.83
	腹式呼吸组	12	61.83	21.75	89.33	23.31

Effect of different breathing training on morphology and function of deep trunk muscles in patients with chronic nonspecific low back pain

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变量	效应	平方和	自由度	均方	F值	P值
左多裂肌RMS	组内	6106.873	1	6106.873	141.304	< 0.001
左多裂肌RMS	组间	2035.364	2	1017.682	1.302	0.285
	组内×组间	1715.188	2	857.594	19.844	< 0.001
右多裂肌RMS	组内	7345.329	1	7345.329	98.345	< 0.001
右多裂肌RMS	组间	2317.329	2	1158.664	1.351	0.273
	组内×组间	2219.787	2	1109.893	14.860	< 0.001
左腹横肌RMS	组内	13663.706	1	13663.706	471.632	< 0.001
	组间	3752.762	2	1876.381	2.572	0.091
	组内×组间	3516.208	2	1758.104	60.685	< 0.001
右腹横肌RMS	组内	12713.778	1	12713.778	454.146	< 0.001
	组间	3601.073	2	1800.536	2.784	0.076
	组内×组间	2517.983	2	1258.992	44.972	< 0.001

变量	效应	平方和	自由度	均方	F值	P值
左多裂肌肌肉厚度	组内	1.357	1	1.357	110.887	< 0.001
	组间	0.893	2	0.446	1.390	0.263
	组内×组间	0.482	2	0.241	19.714	< 0.001
右多裂肌肌肉厚度	组内	2.132	1	2.132	120.828	< 0.001
	组间	0.877	2	0.439	1.392	0.262
	组内×组间	0.437	2	0.218	12.379	< 0.001
左腹横肌肌肉厚度	组内	0.089	1	0.089	157.557	< 0.001
	组间	0.026	2	0.013	2.504	0.097
	组内×组间	0.047	2	0.024	42.236	< 0.001
右腹横肌肌肉厚度	组内	0.106	1	0.106	318.404	< 0.001
	组间	0.022	2	0.011	2.716	0.081
	组内×组间	0.029	2	0.015	43.973	< 0.001

变量	效应	平方和	自由度	均方	F值	P值
膈肌肌肉厚度	组内	0.040	1	0.040	64.869	< 0.001
	组间	0.020	2	0.010	2.876	0.070
	组内×组间	0.028	2	0.014	22.624	< 0.001
膈肌移动度	组内	42.221	1	42.221	174.848	< 0.001
	组间	20.997	2	10.499	2.132	0.134
	组内×组间	32.321	2	16.160	66.924	< 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
左多裂肌肌肉厚度	对照组	12	2.33	0.31	2.43	0.30
	膈式呼吸组	13	2.39	0.46	2.87	0.33
	腹式呼吸组	12	2.31	0.50	2.54	0.50
右多裂肌肌肉厚度	对照组	12	2.28	0.31	2.43	0.30
	膈式呼吸组	13	2.31	0.39	2.83	0.39
	腹式呼吸组	12	2.16	0.54	2.51	0.47
左腹横肌肌肉厚度	对照组	12	0.28	0.06	0.30	0.05
	膈式呼吸组	13	0.26	0.05	0.40	0.05
	腹式呼吸组	12	0.30	0.05	0.35	0.07
右腹横肌肌肉厚度	对照组	12	0.28	0.06	0.32	0.06
	膈式呼吸组	13	0.27	0.04	0.40	0.04
	腹式呼吸组	12	0.30	0.04	0.36	0.05

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
膈肌肌肉厚度	对照组	12	0.23	0.05	0.23	0.04
	膈式呼吸组	13	0.22	0.05	0.32	0.06
	腹式呼吸组	12	0.23	0.03	0.27	0.04
膈肌移动度	对照组	12	5.43	1.86	5.49	1.87
	膈式呼吸组	13	5.12	1.22	8.36	1.30
	腹式呼吸组	12	5.72	1.77	6.95	1.55