呼吸训练联合姿势控制训练对青年非特异性下背痛疗效的影响

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目的:探讨呼吸训练联合姿势控制训练对青年非特异性下背痛(NLBP)患者临床疗效的影响。方法:将84例符合入组标准的患者按照随机数字表法分为姿势控制组和联合训练组,每组42例。姿势控制组采用两点支撑式、船式、侧板式、单腿站立式、幻椅式和燕式六组姿势进行姿势控制训练;联合训练组则在姿势控制训练过程中增加混合性呼吸训练。2组患者均行为期6个月的训练干预,每周3次,每次40 min。分别于训练前(治疗前)、训练6个月结束时(治疗后)和随访到12个月时(随访时),采用疼痛目测类比法(VAS)评分、腰部功能障碍指数(ODI)对2组患者的疼痛程度、腰椎功能障碍程度进行临床疗效评估,通过超声检查测量腹横肌厚度并计算腹横肌收缩率,并采用肌肉厚度收缩率评估腰椎局部稳定性及运动控制能力。结果:治疗前,2组患者的VAS评分、ODI评分和腹横肌收缩率[姿势控制组(5.14±1.40)分、(23.14±7.35)分和(1.17±0.49)%;联合训练组(4.96±1.57)分、(24.47±6.63)分和(1.19±0.43)%]组间比较,差异无统计学意义(n P>0.05)。治疗后,2组患者的疼痛VAS评分、ODI评分和腹横肌收缩率[姿势控制组(2.64±1.09)分、(13.57±5.28)分和(1.64±0.39)%;联合训练组(2.10±0.59)分、(10.38±4.08)分和(1.81±0.38)%]较组内治疗前均有明显改善(n P<0.01)。随访时,2组患者的上述指标[姿势控制组(2.09±0.33)分、(11.07±4.17)分和(1.79±0.27)%;联合训练组(1.71±0.31)分、(9.28±2.21)和(2.01±0.22)%]亦较组内训练前均有明显改善(n P<0.01)。治疗后和随访时,联合训练组患者上述指标与姿势控制组比较,指标改善更为明显(n P<0.01)。n 结论:呼吸训练联合姿势控制训练可以更为有效地减轻NLBP患者的疼痛程度和改善患者的腰椎活动功能及运动控制能力。“,”Objective:To investigate the effect of combining breath control training with posture control training in treating non-specific low back pain (NLBP) among young persons.Methods:Eighty-four young persons with low back pain were divided into a postural control training group and a combination training group, each of 42. The posture control training involved the two-point support posture, the boat posture, the side plank posture, one-leg standing, the magic chair posture and the swallow balance posture. In the combined application group respiration training was added during the posture control training. Both groups received 6 months of training, three times a week for 40 minutes each time. A visual analogue scale (VAS), lumbar dysfunction index assessment (ODI) and transverse abdominal ultrasound were used to evaluate the pain, lumbar function and contractility of the transversal abdominal muscles before and after the training.Results:Before the training there were no significant differences between the two groups. Afterward, significant improvement was observed in the average VAS and ODI scores, as well as the average transverse abdominal systolic rate of both groups. At a 6-month follow-up the average scores of both groups were still significantly better than before the treatment. The combination group had improved significantly more than the posture control group, on average.Conclusion:Breath training combined with posture control training can effectively relieve low back pain and improve the motor functioning and control ability of young adults.
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