慢性腰痛等速躯干屈伸训练的最佳角速度探讨

Discussion on the best angular velocity of isokinetic trunk flexion and extension training for chronic low back pain

目的探讨慢性非特异性腰痛(chronic non-specific low back pain,CNLBP)行等速躯干屈伸训练的最佳角速度。方法选择2017年2月~2020年2月本院收治的90例CNLBP患者,采用随机数字表法均分A、B、C三组,分别采用30°/s、60°/s以及90°/s的不同角速度行等速躯干屈伸训练治疗,连续治疗1个月。比较治疗前后Oswestry功能障碍指数(Oswestry dysfunction index,ODI)、VAS评分;采用躯干等速肌力测试比较三组患者治疗前后的腰背肌群伸肌、屈肌峰力矩(peak torque,PT)以及平均功率(Average power,AP)。结果三组治疗后ODI指数、VAS评分均显著降低,且A组显著低于B、C组(P<0.05),B组、C组差异无统计学意义(P>0.05);三组治疗后腰背肌群伸肌、屈肌PT、AP均显著升高,且治疗后A组伸肌、屈肌PT显著高于B组、C组(P<0.05),三组伸肌、屈肌AP差异无统计学意义(P>0.05)。结论低速度(30°/s角速度)的等速躯干屈伸训练治疗CNLBP能获得最佳治疗效果,且角速度越低则腰背肌群肌力提升效果越好,但做功功率无明显差异。

Objective To explore the optimal angular velocity for isokinetic trunk flexion and extension training for chronic non-specific low back pain(CNLBP).Methods In this study,90 patients with CNLBP in our hospital from February 2017 to February 2020 were selected.They were randomly divided into three groups,which were set as groups A,B,and C by the digital table method.They were treated with isokinetic trunk flexion and extension training at different angular velocities:30°/s,60°/s and 90°/s,continuous treatment for 1 month.The Oswestry dysfunction index(ODI)and pain visual simulation(VAS)scores were compared before and after treatment.The trunk isokinetic muscle strength test was used to compare the extensor,flexor peak torque(PT)and power(AP)of the three groups before and after treatment.Results The ODI index and VAS score of the three groups were significantly reduced after treatment,and those of group A were significantly lower than group B and group C,the differences were statistically significant(P<0.05).There was no statistically significant difference between group B and group C(P>0.05).The PT and AP of the extensor and flexor muscles of the back muscles of the three groups were significantly increased after treatment,and the PT of the extensor and flexor of the A group was significantly higher than that of B group and C group after treatment,and the difference was statistically significant(P<0.05).There was no significant difference in AP of extensor and flexor among the three groups(P>0.05).Conclusion At low speed,that is,30°/s angular velocity isokinetic trunk flexion and extension training for CNLBP,the best therapeutic effect can be obtained.The lower the angular velocity,the better the muscle strength of the back muscles,but there is no significant difference in power.