中华物理医学与康复杂志
中華物理醫學與康複雜誌
중화물리의학여강복잡지
CHINESE JOURNAL OF PHYSICAL MEDICINE AND REHABILITATION
2014年
11期
859-863
,共5页
腰椎间盘突出症%腰部肌肉%核心稳定性训练%表面肌电图
腰椎間盤突齣癥%腰部肌肉%覈心穩定性訓練%錶麵肌電圖
요추간반돌출증%요부기육%핵심은정성훈련%표면기전도
Lumbar disc herniation%Lumbar muscles%Core stability exercise%Surface electromyography
目的 分析探讨腰椎间盘突出症患者核心稳定性训练治疗前后腰部肌肉表面肌电信号变化特征及其疗效.方法 邵逸夫医院康复医学科收集38例诊断明确且符合纳入排除标准的腰椎间盘突出症患者,采用随机数字表法将患者分为训练组和对照组,每组19例,对照组仅接受2周常规牵引理疗治疗,训练组在接受2周常规牵引理疗治疗后,再进行2周腰背肌核心稳定性训练.所有患者均在治疗前和治疗4周时(治疗后)进行VAS评分、JOA下背痛评分及表面肌电图(sEMG)检测,并进行统计学分析比较.结果 治疗后,对照组VAS评分[(1.11±0.74)分]和JOA评分[(21.05±3.08)分]及训练组VAS评分[(0.95±0.62)分]和JOA评分[(23.47±2.04)分]较组内治疗前改善(P＜0.01),组间对比,治疗后,训练组JOA评分高于对照组(P＜0.01).治疗后,训练组患侧竖脊肌中位频率值[(84.84土12.78)分]、患侧竖脊肌平均振幅值[(108.94±24.70)分]和患侧多裂肌的中位频率值[(95.63±16.35)分]均较组内治疗前提高(P＜0.05),健患侧对比差异无统计学意义(P＞0.05);组间对比,训练组患侧竖脊肌[(84.84±12.78)分]与多裂肌[(95.63±16.35)分]中位频率值均高于对照组(P＜0.05),但治疗前后2组平均振幅值比较,除患侧竖脊肌[(108.94±24.70)分]差异有统计学意义外(P＜0.05),余均无统计学意义(P＞0.05).结论 核心稳定性训练可进一步减轻腰椎间盘突出症患者腰部症状、改善腰背部核心肌群耐疲劳性和两侧多裂肌肌功能不平衡性,但训练对于腰部整体肌肉力量的改善程度有待于进一步延长治疗时间后的研究观察.
目的 分析探討腰椎間盤突齣癥患者覈心穩定性訓練治療前後腰部肌肉錶麵肌電信號變化特徵及其療效.方法 邵逸伕醫院康複醫學科收集38例診斷明確且符閤納入排除標準的腰椎間盤突齣癥患者,採用隨機數字錶法將患者分為訓練組和對照組,每組19例,對照組僅接受2週常規牽引理療治療,訓練組在接受2週常規牽引理療治療後,再進行2週腰揹肌覈心穩定性訓練.所有患者均在治療前和治療4週時(治療後)進行VAS評分、JOA下揹痛評分及錶麵肌電圖(sEMG)檢測,併進行統計學分析比較.結果 治療後,對照組VAS評分[(1.11±0.74)分]和JOA評分[(21.05±3.08)分]及訓練組VAS評分[(0.95±0.62)分]和JOA評分[(23.47±2.04)分]較組內治療前改善(P＜0.01),組間對比,治療後,訓練組JOA評分高于對照組(P＜0.01).治療後,訓練組患側豎脊肌中位頻率值[(84.84土12.78)分]、患側豎脊肌平均振幅值[(108.94±24.70)分]和患側多裂肌的中位頻率值[(95.63±16.35)分]均較組內治療前提高(P＜0.05),健患側對比差異無統計學意義(P＞0.05);組間對比,訓練組患側豎脊肌[(84.84±12.78)分]與多裂肌[(95.63±16.35)分]中位頻率值均高于對照組(P＜0.05),但治療前後2組平均振幅值比較,除患側豎脊肌[(108.94±24.70)分]差異有統計學意義外(P＜0.05),餘均無統計學意義(P＞0.05).結論 覈心穩定性訓練可進一步減輕腰椎間盤突齣癥患者腰部癥狀、改善腰揹部覈心肌群耐疲勞性和兩側多裂肌肌功能不平衡性,但訓練對于腰部整體肌肉力量的改善程度有待于進一步延長治療時間後的研究觀察.
목적 분석탐토요추간반돌출증환자핵심은정성훈련치료전후요부기육표면기전신호변화특정급기료효.방법 소일부의원강복의학과수집38례진단명학차부합납입배제표준적요추간반돌출증환자,채용수궤수자표법장환자분위훈련조화대조조,매조19례,대조조부접수2주상규견인리료치료,훈련조재접수2주상규견인리료치료후,재진행2주요배기핵심은정성훈련.소유환자균재치료전화치료4주시(치료후)진행VAS평분、JOA하배통평분급표면기전도(sEMG)검측,병진행통계학분석비교.결과 치료후,대조조VAS평분[(1.11±0.74)분]화JOA평분[(21.05±3.08)분]급훈련조VAS평분[(0.95±0.62)분]화JOA평분[(23.47±2.04)분]교조내치료전개선(P＜0.01),조간대비,치료후,훈련조JOA평분고우대조조(P＜0.01).치료후,훈련조환측수척기중위빈솔치[(84.84토12.78)분]、환측수척기평균진폭치[(108.94±24.70)분]화환측다렬기적중위빈솔치[(95.63±16.35)분]균교조내치료전제고(P＜0.05),건환측대비차이무통계학의의(P＞0.05);조간대비,훈련조환측수척기[(84.84±12.78)분]여다렬기[(95.63±16.35)분]중위빈솔치균고우대조조(P＜0.05),단치료전후2조평균진폭치비교,제환측수척기[(108.94±24.70)분]차이유통계학의의외(P＜0.05),여균무통계학의의(P＞0.05).결론 핵심은정성훈련가진일보감경요추간반돌출증환자요부증상、개선요배부핵심기군내피로성화량측다렬기기공능불평형성,단훈련대우요부정체기육역량적개선정도유대우진일보연장치료시간후적연구관찰.
Objective To analyze the surface-electromyography (sEMG) signals of patients with lumbar disc herniation before and after core stability exercise therapy.Methods Thirty-eight cases diagnosed with lumbar disc herniation were randomly divided into a control group (n =19) and an experimental group (n =19) using a random number table.The former was given two weeks' conventional traction physiotherapy,while the latter was given another two weeks of core stability exercise of lumbar and dorsal muscles after the conventional treatment.All of the patients were assessed using a visual analogue scale (VAS) and each was given a Japanese orthopedic association (JOA) score,sEMGs were recorded before and after 4 weeks of treatment.Results After treatment,average VAS scores[(1.11 ±0.74) and (0.95 ±0.62) respectively] and JOA scores[(21.05 ±3.08) and (23.47 ±2.04) respectively] in the control and experimental group both had improved significantly compared to that before treatment (P ＜ 0.01).The average JOA score in the experimental group was significantly higher than that in the control group (P ＜ 0.01) after the treatment.After treatment of 4 weeks,erector spinae median frequency (MF) values(84.84 ± 12.78) and erector spinae average amplitude (AEMG) value (108.94 ± 24.70) in the experimental group were significantly improved(P ＜ 0.05),so did the multifidus muscles MF value(95.63 ± 16.35) of affected side.There was no significant difference between the affected and unaffected side (P ＞ 0.05).Moreover,the MF values of the experimental group were significantly higher than that the control group (P ＜ 0.05) after treatment.There was significant difference between the average AEMG values of erector spinae of affected side before and after treatment (P ＜ 0.05).Conclusions Core stability exercise can further alleviate the symptoms of lumbar disc herniation after conventional traction physiotherapy.It improves the fatigue tolerance of the back's core muscles and relieves functional imbalance of the multifidus muscles.However,the time of therapy should be lengthened to study its effect on strengthening lumbar muscles.
