平衡姿势控制训练联合核心稳定性训练治疗慢性非特异性下背痛的临床疗效

The clinical effect of balanced postural control training combined with core stability training in the treatment for chronic nonspecific low back pain

目的:观察平衡姿势控制训练联合核心稳定性训练(CST)对慢性非特异性下背痛(CNLBP)患者的疼痛及静动态平衡控制能力的影响。方法:共有40例CNLBP患者纳入本研究,其中男性18例,女性22例,采用随机数字表法将其分为试验组(19例)及对照组(21例)。两组患者均接受常规理疗,试验组在此基础上进行核心稳定性训练和姿势控制训练,对照组进行核心稳定性训练。对照组核心稳定性训练30min/次,每天2次,每周5天,试验组核心稳定训练和姿势控制训练每天各1次,30min/次,每周5天,连续6周。分别在治疗前、治疗3周、治疗6周时对患者进行功能评定。使用视觉模拟量表(VAS)评价患者疼痛程度,使用Oswestry功能障碍指数(ODI)评价患者功能障碍程度,使用三维平衡测试仪进行静动态平衡评估来评价患者的姿势控制能力。静态平衡指标为三种体位下的重心摆动速度;动态平衡指标为稳定时间。结果:治疗3周两组VAS、ODI评分较治疗前显著降低(P<0.05),试验组闭眼站立和脚前后站立平衡得分较治疗前有显著差异(P<0.05)。治疗6周两组VAS、ODI评分较治疗前有显著性差异(P<0.01),对照组睁眼站立和闭眼站立平衡能力较治疗前显著改善(P<0.05),试验组静动态平衡指标较治疗前有显著性差异(P<0.01,P<0.05)。治疗6周试验组VAS、ODI、睁眼站立、闭眼站立、稳定时间得分较对照组显著改善(P<0.05),脚前后站立与对照组相比有显著差异(P<0.01)。结论:平衡姿势控制训练联合核心稳定性训练可以显著减轻CNLBP患者的疼痛及改善静动态的姿势控制能力。

Objective: To observe the effect of balance posture control training combined with core stability training onpain, static and dynamic balance control ability of chronic non-specific lower back pain.Method: Forty chronic non- specific low back pain patients were assigned randomly to either experimentalgroup (n=19) or control group (n=21). Both groups received routine physical therapy. Experimental group addedwith balanced postural control training and core stability training (CST), control group added with CST only.In the control group, the core stability training was given 30min/time, 2 times/day, 5 days per week. In theexperimental group, core stability training and postural control training were given 1 time each every day,30min/time, 5 days/week, 6 weeks in total. The patients were evaluated before treatment, 3 weeks after treat-ment, and 6 weeks after treatment. Visual analogue scales (VAS) were used to assess pain levels in patients.The Oswestry dysfunction index(ODI) was used to assess the extent of disability. Static and dynamic balanceassessment in three- dimensional balance test instrument was used to evaluate the postural control ability. Theswing speed of gravity center and time to stability were used as Static and dynamic balance index.Result: After 3 weeks treatment, the VAS and ODI scores of the two groups were significantly lower thanthose before treatment (P<0.05). The average COP velocitty scores as eyes closed and one foot in front ofthe experimental group were significantly improved(P<0.05). After 6 weeks treatment, the VAS and ODIscores of the two groups were more improved than those after 3 weeks treatment (P<0.01, P<0.05). The average COP velocity scores of the control group and experimental group as feet together and eyes opened oreyes closed were significantly slower than those after 3 weeks treatment(P<0.01, P<0.05). The average COP velocitty scores as one foot in front and time to stability of the 6 weeks treatment group were significantly improvedmore than those after 3 weeks treatment(P<0.01, P<0.05).Conclusion: Postural control training combined with core stability training can significantly reduce the pain ofpatients with CNLBP and improve the static and dynamic postural control ability.