局部肌肉振动对男性慢性非特异性腰痛患者腰背肌疲劳的即刻效应

Immediate effects of local muscle vibration on the muscle fatigue in the male chronic non-specific back pain patients

目的:通过表面肌电(surface electromyography, sEMG)探讨局部肌肉振动对慢性非特异性腰痛(chronic non-specific low back pain,CNSLBP)患者腰背肌疲劳的即刻效应。方法:16例CNSLBP患者进行Biering-S?rensen测试(BST)。前后进行三阶段测试,每阶段测试含2次BST(分别记作BST1、BST2)。第一阶段测试(空白对照阶段):先进行BST,俯卧位休息5min,再进行第二次BST;间隔1周后,进行第二阶段测试(局部肌肉振动阶段):先进行BST,俯卧位使用深层肌肉刺激器(deep muscle stimulator,DMS)对双侧腰竖脊肌、多裂肌振动治疗5min,再进行第二次BST;第二阶段测试后再间隔1周,进行第三阶段测试(局部肌肉假振动阶段):先进行BST,间隔充气状态医用橡胶手套下,俯卧位使用DMS对双侧腰竖脊肌、多裂肌振动治疗5min,再进行第二次BST。观察三种不同干预下BST维持时间及双侧腰竖脊肌、多裂肌的sEMG指标:平均功率频率(mean power frequency, MPF)。结果:①三个阶段BST维持时间比较:BST2较BST1均下降,差异具有显著性意义(P<0.05);BST2间比较,局部肌肉振动阶段显著高于空白对照阶段、局部肌肉假振动阶段,差异具有显著性意义(P<0.05);②三个阶段双侧腰竖脊肌/多裂肌MPF比较:除外局部肌肉振动阶段对侧多裂肌差异无显著性意义(P=0.057),BST2较BST1均下降,差异具有显著性意义(P<0.05);BST2间比较,局部肌肉振动阶段显著高于空白对照阶段、局部肌肉假振动阶段,差异具有显著性意义(P<0.05);③双侧腰竖脊肌间/多裂肌间比较:BST1中,痛侧均显著高于对侧,差异具有显著性意义(P<0.01),BST2中,除外局部肌肉振动阶段双侧腰竖脊肌间差异无显著性意义(P=0.053)、局部肌肉振动阶段双侧多裂肌间比较P=0.042,其他阶段痛侧均显著高于对侧,差异具有显著性意义(P<0.05)。结论:局部肌肉振动对缓解CNSLBP患者腰背肌疲劳具有良好的即刻效应,并可有效平衡双侧腰背肌的易疲劳性。

Objective:To study the immediate effects of local muscle vibration on the muscle fatigue in the chronic non-specific low back pain(CNSLBP)patients by surface electromyography(sEMG).Method:Sixteen CNSLBP patients participated in this study.They were tested altogether for three stages at different time point with a week interval.For each stage,the back muscle endurance test(Biering-SФrensen test,BST)was performed to the patients twice with 5min interval.BST1 was carried out firstly,BST2 was carried out after a 5 min interval.In the first stage,it is rest only without any treatment during the interval.In the second stage,during the 5min interval,bilateral lumbar erector muscle and multifidus muscle were treated with a deep muscle stimulator(DMS)as patients at prone position.BST2 was carried out finally.In the third stage),BST1 was carried out firstly.Secondly,during the 5 min interval,the patients rest at prone position,the stimulation were given through an inflated medical gloves above the muscles also with patients at prone position.The duration of endurance and the mean power frequency(MPF)of sEMG on bilateral lumber erector spinae and the multifidus muscle were observed at every stage.Result:①The durations of endurance of BST2 decreased compared to that of BST1,and the differences were significant statistically(P<0.05)for all 3 stages.But the durations of endurance at vibration treatment stage decreased less than that at the control and the sham treatment stages(P<0.05).②The MPF of BST2 were all decreased compared to that of BST1,and the differences were all significant statistically(P<0.05)except that of the contralateral multifidus of the vibration treatment stage(P=0.057).But the values of the vibration treatment stage decreased much less than that of the control and the sham treatment stage(P<0.05).③For the erector spinae and the multifidus:For the values of BST1,the pain muscle is significantly greater than that of the offside muscle(P<0.01).For the values of BST 2,the pain muscle is significantly greater than that of the offside muscle(P<0.05)except that of the vibration treatment stage(P=0.053).Conclusion:The treatment of local muscle vibration may have good immediate effects for relieve the muscle fatigue in the CNSLBP patient,and could equalize the fatigability of the bilateral lumbar muscles.