运动疗法在软组织所致下腰痛术后康复治疗中的应用

Application of cinesiateics on the rehabilitation of low back pain induced by soft tissues

目的:影响下腰痛治疗效果的原因很多,探讨由腰骶部慢性骨筋膜间隔综合征所致慢性腰痛术后的运动疗法,对患者术后腰部功能恢复的效果。方法:腰骶部慢性骨筋膜间隔综合征所致慢性腰痛患者58例,男27例,女31例;年龄18～66岁;慢性腰痛时间2～42年,平均29年。治疗采用腰骶部骨筋膜间隔切开减压及术后竖脊肌功能训练的方法。结果:58例患者术后经1～28个月,平均1.5个月康复功能训练后,术前久坐、久站、长时间行走、长时间固定姿势卧床及长时间弯腰后腰痛症状及阳性体征消失55例,缓解3例。术前腰骶部骨筋膜间隔内压在静息、运动中和运动后6min内分别为(1.4±0.1),(24.9±1.5)和(1.8±0.2)kPa,术后分别为0.9±0.1),(21.6±1.6)和0.9±0.1)kPa,手术前后比较((差异有显著性意义(t值分别为2.04,2.32,3.21,P<0.05或0.01)。超声多普勒表明腰骶部骨骼肌内最大血流速度和平均血流速度较术前分别增加(0.17±0.02)kHz和(0.09±0.01)kHz(P<0.05)。结论:腰骶部慢性骨筋膜间隔综合征所致慢性腰痛采用骨筋膜间隔切开减压及术后竖脊肌功能训练的方法是可行的。

AIM:There are a lot of causes that affect the therapeutic effect for low back pain(LBP).The purpose of the paper is to explore the cinesiateics after operation for chronic lumbar pain induced by chronic compartment syndrome and the effect of rehabilitation on lumbar function after operation. METHODS:Fifty eight chronic lumbar pains induced by chronic compartment syndrome,27 males and 31 females, 18 to 66 years old, were enrolled and the duration of chronic lumbar pain was 2 to 42 years, and the mean time was 29 years. Lumbosacral osteofascial decompression by using mini invasive surgery and the functional exercise of erector spinae were employed. RESULTS:Among 58 patients after 1 to 28 months of operation, the symptoms of low back pain and positive physical sign of prolonged sitting, prolonged standing, prolonged walking, prolonged lying in bed with a fixed posture, and prolonged bending from the waist of 55 patients were disappeared, and those of 3 patients were alleviated meanly 1.5 months after functional exercise.Intramuscular pressures in rest state, during movement and no more than 6 minutes after movement were(1.4 ±0.1),(24.9±1.5) and(1.8±0.2) kPa respectively before operation,and(0.9±0.1),(21.6±1.6)and(0.9±0.1) kPa respectively after operation. There were significant differences before and after operation (t=2.04,2.32,3.21;P< 0.05 or P< 0.01). Results of ultrasonic Doppler on lumbosacral skeletal muscle showed maximal blood flow velocity and mean blood flow velocity were increased by(0.17±0.02) kHz and(0.09±0.01) kHz respectively after operation(P< 0.05). CONCLUSION:It is available that postoperative decompression by osteofascial mini invasive surgery and functional exercise of erector spinae are employed to treat chronic lumbar pain induced by lumbosacral chronic osteofascial compartment syndrome.