腰骶灵活性训练对腰椎间盘突出症患者干预效果的临床研究

Effect of lumbosacral mobility exercise on patients with lumbar disk herniation

目的观察腰骶灵活性训练对于腰椎间盘突出症患者活动度、疼痛和功能障碍的影响。方法前瞻性选取空军特色医学中心收治的腰椎间盘突出症患者51例,按照随机分组方法分为实验组(n=27)和对照组(n=24),两组患者均接受以冯氏脊柱定点旋转复位法为主的保守治疗,试验组患者在此基础上增加腰骶灵活性训练,即改良的腰骶猫式动作、仰卧位骨盆前后倾、骨盆侧屈、骨盆侧旋共4个动作,15个/组,2组/d,5 d/周,为期3周。在干预前后比较两组患者的坐位活动度、站位活动度、腰椎延展性以及主观疼痛(VAS评分)和功能障碍程度(ODI指数)。结果相比于对照组,实验组患者站立位腰椎屈曲延展性显著改善,差异具有统计学意义(t=2.557,P=0.014);站立位屈曲活动度(t=-3.035,P=0.004)、屈曲+右侧屈+右侧旋(t=-3.345,P=0.002)以及屈曲+左侧屈+左侧旋(t=-4.072,P=0.000)活动度均增加;VAS评分(t=2.908,P=0.008)和ODI指数(t=2.095,P=0.047)均显著减小,差异均有统计学意义(P<0.05)。结论腰骶灵活性训练能够改善腰椎间盘突出症患者腰椎的延展性,增加腰椎的活动度,改善腰椎-骨盆节律,改善前屈及前屈对角线动作的功能动作能力,并能够帮助腰椎间盘突出症患者缓解疼痛和主观功能障碍程度。

Objective To observe the effect of the lumbosacral mobility exercise on mobility,pain(VAS)and disability(ODI)in patients with lumbar disc herniation.Methods 51 cases of patients with lumbar disc herniation admitted in the Air force medical center were enrolled in this prospective study,and they were randomly divided into the experimental group(27 cases)and the control group(24 cases).The two groups of patients both received the Feng’s osteopathic therapy,and on this basis the patients in the experimental group added the lumbosacral mobility exercises,including the modified lumbosacral cat-camel movement,supine pelvic tilt exercise,pelvic lateral flexion exercise and pelvic rotation exercises.These exercises lasted for 3 weeks,5 d/week,2 sets/d,15 repetitions/set.Sitting mobility,standing mobility,the modified Schober’s test,VAS sores and ODI indexes of the two groups are measured before and after the therapy.Results Comparing with the control group,the modified Schober’s scores(t=2.557,P=0.014),the mobility of flexion(t=-3.035,P=0.004),flexion + right lateral flexion+ right rotation(t=-3.345,P=0.002),flexion + left lateral flexion + left rotation(t=-4.072,P=0.000)of the whole spine in standing position in the experimental group were significantly increased;VAS scores(t=2.908,P=0.008)and ODI index(t=2.095,P=0.047)were significantly decreased.Conclusion Lumbosacral mobility exercise can improve lumbar extensibility in patients with lumbar disc herniation,increase lumbar mobility,improve lumbar-pelvic rhythm and the functional ability of forward bending and forward bending diagonal motion.It can also help them relieve the pain and disability.