核心稳定性训练对腰椎间盘突出症患者表面肌电时频参数的影响

Effects of core stability exercise therapy on surface-electromyography signals in patients with lumbar disc herniation

目的通过核心肌群表面肌电时频参数的变化分析核心稳定性训练在腰椎间盘突出症患者康复治疗中的应用效果。方法纳入60例腰椎间盘突出症,采用随机数字表法分组,对照组30例接受常规物理治疗,观察组30例在常规物理治疗基础上增加核心稳定性训练。比较2组治疗4周、8周后的疼痛NRS评分、JOA评分、ODI指数、表面肌电图测试结果。采集腹直肌、腹外斜肌、竖脊肌、多裂肌及臀中肌的积分肌电值(IEMG)、均方根值(RMS)和中位频率值(MF)进行统计学分析。结果治疗4周后观察组疼痛NRS评分、JOA评分、ODI指数与对照组比较差异无统计学意义(P>0.05);治疗8周后观察组各指标明显优于对照组,差异有统计学意义(P<0.05)。治疗4周后,观察组与对照组腹直肌、腹外斜肌、竖脊肌、多裂肌及臀中肌的IEMG、RMG、MF差异无统计学意义(P>0.05);治疗8周后,观察组各部位肌肉IEMG、RMG、MF高于对照组,差异有统计学意义(P<0.05)。结论核心稳定性训练可持续提高腰椎间盘突出症患者核心肌群的募集能力和耐疲劳性能,并同时改善其腰痛症状及功能障碍,效果优于常规物理治疗。

Objective To analyze the effects of core stability exercise therapy in lumbar disc herniation with the change of surface-electromyography（s EMG） signals on core muscles. Methods Sixty patients with lumbar disc herniation were divided into two groups according to random number table. The control group was treated by regular physical therapy and the experimental group was treated by core stability exercise therapy plus regular physical therapy. The score of numeric rating scales（NRS）, Japanese orthopaedic association（JOA）, Oswestry disability index（ODI） and the data of s EMG signals between two groups were compared after 4 and 8 weeks. IEMG, RMS and MF from rectus abdominis（RA）, obliquus externus abdominis（OEA）, erector spinae（ES）, lumbar multifidus（LM） and gluteus medius（GM） were collected and statistically analyzed.Results No significant difference between two groups was observed in NRS, JOA and ODI after 4 weeks（P〉 0.05）, and the experimental group was significantly better than the control group in all above measurements after 8 weeks(P〈 0.05）. No significant difference between two groups was observed in IEMG, RMG and MF of RA, OEA, ES, LM and GM after 4 weeks（P〉 0.05）, and all above measurements of the experimental group were higher than those of control group after 8 weeks(P〈 0.05）. Conclusion Core stability training can continue to improve the ability of core muscles and relieve pain and dysfunction. It is better than the regular physical therapy.