深层核心肌群训练对产后骨盆带疼痛患者负荷转移活动运动控制的影响

关键词：深层核心肌群训练  产后骨盆带疼痛  核心功能  负荷转移活动  运动控制

Keywords:deep muscle training  postpartum pelvic girdle pain  core function  load transfer ability  motor control

摘要：

      摘要 目的：本研究旨在观察深层核心肌群训练对产后骨盆带疼痛（postpartum pelvic girdle pain， PPGP）患者疼痛及负荷转移活动运动控制的影响，探讨深层核心训练改善PPGP疼痛的可能作用机制。 方法：2024年7月—2025年4月，福建中医药大学附属康复医院产后骨盆带疼痛患者56例随机分为对照组（n=28）和试验组（n=28）。两组均接受常规治疗，试验组在此基础上进行深层核心肌群训练，每周3次，连续8周。治疗前后，应用实时超声评估腹横肌最大呼气时厚度、主动直腿抬高活动（active straight leg raise， ASLR）时厚度、优先激活率、弹性模量等参数反映腹横肌功能变化，应用骨盆带问卷（pelvic girdle questionnaire， PGQ）评估患者疼痛和功能障碍的变化，采用视觉模拟评分（visual analogue scale， VAS）评估疼痛程度变化，ASLR得分评估躯干和下肢之间负荷转移活动能力的变化。 结果：治疗8周后，试验组的腹横肌在最大呼气时收缩厚度、ASLR活动时厚度均较对照组显著增加（P＜0.05），且在呼吸过程中的收缩率和激活过程中的优先激活率均较对照组显著增加（P＜0.05）。试验组腹横肌在静息状态、最大呼气、ASLR测试中的弹性模量均较对照组显著增加（P＜0.05）。除此之外，疼痛评分和功能评估结果显示，干预后试验组的VAS得分、PGQ得分和ASLR评分均较对照组显著降低（P＜0.05）。 结论：深层核心肌群训练可以有效改善PPGP患者疼痛和功能，其作用机制可能与改善腹横肌功能以及负荷转移活动中运动控制能力相关。

Abstract:

      Abstract Objective：To investigate the effects of deep core muscle training on pain and motor control during load transfer activities in patients with postpartum pelvic girdle pain （PPGP）， and to explore the potential mechanisms by which deep core stability training alleviates PPGP pain. Method：From July 2024 to April 2025， 56 PPGP women at the Affiliated Rehabilitation Hospital of Fujian University of Traditional Chinese Medicine were randomly divided into a control group （n=28） and an experimental group （n=28）. Both groups received conventional treatment， while the experimental group underwent deep core stability muscle training in addition to the conventional treatment， three times a week for eight consecutive weeks. Before and after the treatment， real-time ultrasound was used to assess the thickness of the transversus abdominis muscle（TrA）during maximal expiratory contraction， the thickness during ASLR activity，priority activation rate， the elastic modulus， and the elastic velocity， which reflect the changes in the movement control ability of the TrA muscle. The pelvic girdle questionnaire （PGQ） was used to assess the changes in pain and functional impairment in patients， with pain intensity assessed using the visual analogue scale （VAS）， and the ASLR score used to assess the changes in load transfer activity ability between the trunk and lower limbs. Result：After eight weeks of treatment， the thickness of the TrA contraction during maximal expiratory and ASLR activity in the experimental group was significantly greater than that in the control group （P<0.05）， and the contraction rate during breathing and the pre-activation rate during activation were both significantly higher than those in the control group （P<0.05）. The percentage of internal oblique muscle activation in the experimental group during maximal expiration was significantly lower than that in the control group （P<0.05）. The elastic modulus of TrA in the experimental group at rest， during maximal expiration， and during ASLR testing were all significantly greater than those in the control group （P<0.05）. In addition， the results of pain scores and functional scales showed that the VAS score， PGQ score， and the ASLR score in the experimental group were all significantly lower than those in the control group after intervention （P<0.05）. Conclusion：The deep core muscle training program can effectively alleviate pain and improve function in patients with PPGP， and its mechanism may be related to enhancing TrA function and the motor control during load-transfer activities in PPGP.