动态神经肌肉稳定技术对老年慢性腰痛患者疗效及平衡控制的影响

关键词：动态神经肌肉稳定技术  老年  慢性腰痛  平衡控制

Keywords:dynamic neuromuscular stabilization  elderly  chronic low back pain  balance control

摘要：

      摘要 目的：探讨动态神经肌肉稳定技术（dynamic neuromuscular stabilization， DNS）对老年慢性腰痛（chronic low back pain， cLBP）患者疗效及平衡控制能力的影响。 方法：选取40例老年cLBP患者随机分为试验组和对照组，每组各20例。试验组接受DNS训练，对照组接受常规核心训练，每周3次，连续4周。使用视觉模拟评分法 （visual analogue scale， VAS）、Oswestry功能障碍指数 （Oswestry disability index， ODI）和Roland-Morris腰痛失能问卷 （Roland-Morris disability questionnaire， RMDQ） 评估两组受试者干预前后的疼痛和功能。使用平衡测试系统评估两组受试者干预前后睁眼双足站立、闭眼双足站立和睁眼单足站立时的平衡控制表现（重心的前后移动速度、左右移动速度和运动长度）。使用重复测量方差分析比较两组受试者干预前后临床量表评分及平衡表现之间的差异。 结果：两组受试者在接受4周干预后，VAS（F=63.386， P<0.001）、ODI（F=21.204， P<0.001）和RMDQ（F=38.501， P<0.001）评分组内相比干预前均明显减少（P<0.01），而两组组间比较无显著性差异（P>0.05）。干预后试验组相比于对照组在睁眼双足站立时左右移动速度（F=4.228， P=0.047）更小，在闭眼双足站立时左右移动速度 （F=6.560， P=0.015）更小，在睁眼单足站立时前后移动速度 （F=14.252， P=0.002）和运动长度 （F=1.014， P=0.036）更小。 结论：DNS训练能缓解老年cLBP患者的疼痛，改善其功能及平衡控制能力。

Abstract:

      Abstract Objective： To investigate the clinical effects and impact on balance control ability in elderly patients with chronic low back pain using dynamic neuromuscular stabilization（DNS） technique. Method： Forty elderly patients with chronic low back pain were randomly divided into two groups： an experimental group and a control group， with 20 participants in each group. The experimental group received DNS training， while the control group received conventional core muscle training. Both groups trained three times a week for four consecutive weeks. Before and after the intervention， visual analogue scale （VAS）， Oswestry disability index （ODI）， and Roland-Morris disability questionnaire （RMDQ） were used to evaluate the pain and functionality in both groups. The balance control performance of the two groups was evaluated using a balance testing system， assessing parameters such as anterior-posterior movement speed， left-right movement speed， and travel distance during open-eyed double-leg stance， closed-eyed double-leg stance， and open-eyed single-leg stance before and after intervention. Repeated measures analysis of variance was used to assess differences in clinical scales and balance performance before and after intervention in two groups. Result： After 4 weeks of intervention， both groups showed significant reductions in VAS（F=63.386， P<0.001）， ODI （F=21.204， P<0.001）， and RMDQ （F=38.501， P<0.001） scores compared to pre-intervention （P<0.01）. There were no statistically significant differences between two groups （P>0.05）. During open-eyed double-leg stance， the experimental group had smaller left-right movement speed than the control group （F=4.228， P=0.047）. During closed-eyed double-leg stance， the experimental group had smaller left-right movement speed （F=6.560， P=0.015） compared to the control group. During open-eyed single-leg stance， the experimental group had smaller anterior-posterior movement speed （F=14.252， P=0.002） and travel distance （F=1.014， P=0.036） compared to the control group. Conclusion： DNS training can relieve pain， improve functionality and balance control ability in elderly patients with chronic low back pain.