基于实时超声的强化核心稳定训练对慢性腰痛的疗效观察

关键词：慢性非特异性腰痛  实时超声  核心稳定训练  腹横肌  等速运动

Keywords:chronic nonspecific low back pain  real-time ultrasound imaging  core stabilization training  TrA  isokinetic motion

摘要：

      摘要 目的：研究基于实时超声反馈的强化核心稳定训练对慢性非特异性腰痛（chronic nonspecific low back pain， CNLBP）患者的影响及疗效。 方法：选取2020年5月—2022年7月CNLBP患者30例，采用随机数字表法分为对照组（常规核心训练组）及观察组（强化核心训练组），干预疗程共计4周，每周3次。在试验开始前和治疗结束次日，采用视觉模拟评分量表（visual analogue scale，VAS）评估疼痛程度，指地距离（finger to floor distance，FFD）评估腰椎活动度，采用HUMAC NORM多关节等速测试康复系统评测两组训练前后躯干位置觉差值（absolute error，AE），并采用肌骨超声仪评估腹横肌厚度及收缩率。 结果：干预结束，两组患者VAS、FFD、AE评分较治疗前均有改善，差异具有显著性意义（P<0.05），且观察组改善较对照组更为明显（P<0.05），训练后两组腹横肌静息态及收缩态厚度相比无显著性意义，但观察组腹横肌收缩率较对照组明显提升，两组相比差异具有显著性意义。 结论：基于肌骨超声的强化核心稳定训练对CNLBP的治疗效果更好，可有助于减轻腰痛症状、提升本体感觉，增强肌肉收缩效能，改善功能障碍。

Abstract:

      Abstract Objective： To investigate the efficacy of enhanced core stabilization training based on real-time ultrasound imaging in patients with chronic nonspecific low back pain （CNLBP）. Method： From May， 2020 to July， 2022， 30 patients with CNLBP were randomly divided into two groups with 15 patients in each group. The treatment course was 4 weeks， with real-time ultrasound imaging feedback combined with core stabilization training or core stabilization training alone. The pain was assessed with visual analogue scale （VAS）， the lumbar spine mobility was assessed with the finger-to-floor distance （FFD）， and the HUMAC NORM multi-joint isokinetic testing and rehabilitation system was used to evaluate the spine flexion absolute error （AE）. The musculoskeletal ultrasonography was used to evaluate the thickness and contraction rate of transversus abdominis （TrA）. Result： After training， the scores of VAS， FFD， and AE in the flexion position of 2 groups were improved compared with the scores before treatment，and the differences were statistically significant （P<0.05）， and the improvement in the experimental group was more obvious than that in the control group （P<0.05）. There was no statistical significance in the thickness of TrA between the two groups after training. However， the contraction rate of TrA in the observation group was significantly higher than that in the control group， and the difference was statistically significant （P<0.05）. Conclusion： Enhanced core stabilization training based on real-time ultrasound imaging has a better short-term therapeutic effect on CNLBP， which is more helpful in reducing pain intensity， enhancing muscle contraction efficiency， and improving the dysfunction of CNLBP patients.