悬吊运动疗法对产后下背痛的疗效和表面肌电信号观察

Effect of sling exercise therapy supplemented with conventional rehabilitation on postpartum back pain

目的:观察常规康复基础上辅以悬吊运动疗法对产后下背痛患者的疼痛、日常生活活动能力以及竖脊肌表面肌电信号的影响。方法:32例产后下背痛患者按分娩方式分为观察组和对照组各16例。对照组采用常规康复治疗,观察组在此基础上增加悬吊运动疗法。2组治疗时间均为3d/周,共计4周。于治疗前、后评定患者疼痛相关的视觉模拟量表法(VAS)、简体中文版Oswestry失能问卷(SCODI),于治疗后使用时域指标平均肌电值(AEMG)、平均功率频率(MPF)和中位频率(MF)评价患者竖脊肌的痛侧和对侧表面肌电信号(sEMG)活动,比较2组疗效差异。结果:治疗后,2组患者VAS和SCODI评分均较治疗前明显降低(均P<0.05),且观察组患者VAS和SCODI评分更低于对照组(均P<0.05)。治疗后,观察组痛侧的竖脊肌的MF、MPF均较对照组痛侧下降、AEMG较对照组痛侧升高(均P<0.05)。结论:常规康复基础上辅以悬吊运动疗法能够明显改善产后下背痛患者的疼痛和日常生活活动能力,同时sEMG变化亦提示悬吊运动疗法对患者竖脊肌功能水平和疲劳程度明显改善。

Objective: To observe the effect of sling exercise therapy combined with conventional rehabilitation on pain, activities of daily living and surface electromyography of women with postpartum low back pain. Methods: Thirty-two women with postpartum low back pain were randomly divided into the observation group and the control group by stratified random number row rank method, with 16 cases in each group. The control group was treated with routine rehabilitation therapy, and the observation group was given the sling exercise therapy additionally on the basis of the routine rehabilitation therapy. The two groups were treated for 3 days/week for a total of 4 weeks. Before and after treatment using VAS and SCODI, and after treatment using sEMG(AEMG, MPF, MF) of the painful side and contralateral side of the erector, the therapeutic effects of the two groups were compared. Results: After treatment, the VAS and SCODI scores of the two groups were significantly lower than those before treatment(all P<0.05), and those in the observation group were lower than those in the control group(all P<0.05). After treatment, MF and MPF scores of erector muscle in the pain side of the observation group were lower than those in the control group, and AEMG was higher than that in the control group(all P<0.05). Conclusion: Routine rehabilitation combined with sling exercise therapy could significantly alleviate pain and improve activities of daily living in women with postpartum low back pain. At the same time, the change of sEMG also indicated that sling exercise therapy significantly improved the function and fatigue level of erector spinal muscles.