杠杆定位手法对腰椎间盘突出症患者表面肌电信号及腰椎功能的影响

The effect of surface electromyography and lumbar function of leverage replacement manipulation for patients with lumbar disc herniation

目的探讨杠杆定位手法对腰椎间盘突出症患者表面肌电信号及腰椎功能的影响。方法选择2018年7月—2019年6月收治的腰椎间盘突出症患者118例为研究对象,采用随机数字表法分为治疗组61例、对照组57例。对照组采用腰椎牵引治疗联合平面用力推拿手法,治疗组采用腰椎牵引治疗联合杠杆定位手法。治疗1个疗程后,比较2组患者临床疗效、表面肌电信号、腰椎功能等指标。结果治疗组腰椎间盘突出症患者总有效率(90.16%)高于对照组(75.44%,χ^(2)=4.359,P<0.05);患侧竖脊肌积分肌电值(IEMG)、均方根值(RMS)、中位频率值(MF)高于对照组[(27.45±4.23)V·s vs.(18.32±3.25)V·s,(32.45±5.12)μV vs.(21.34±4.20)μV,(82.25±10.21)Hz vs.(68.12±9.23)Hz,t=13.110、12.836、7.867,均P<0.05];多裂肌IEMG、RMG、MF高于对照组[(42.36±6.20)V·s vs.(25.45±4.62)V·s,(45.24±7.72)μV vs.(34.32±6.12)μV,(90.45±12.14)Hz vs.(75.32±9.24)Hz,t=16.707、8.476、7.578,均P<0.05];腰腿痛程度、自理能力、提取重物、坐立状况、站立状况、睡眠质量评分低于对照组(均P<0.05)。结论杠杆定位手法有助于改善腰椎间盘突出症患者核心肌群募集能力与耐疲劳性能,促进腰椎功能恢复,提高临床疗效。

Objective To study effect of surface electromyography and lumbar function of leverage replacement manipulation for patients with lumbar disc herniation.Methods A total of 118 patients with lumbar disc herniation,from July 2018 to June 2019,were divided into treatment group(61 cases)and control group(57 cases).The control group was given lumbar traction therapy combined with plane forceful massage technique,and the treatment group was given lumbar traction therapy combined with leverage replacement manipulation.1 course after therapy,clinical efficacy,surface electromyography,and lumbar function were compared between two groups.Results The effective rate(90.16%)of treatment group was higher than that control group(75.44%),χ^(2)=4.359,P<0.05.Affected side erector spinae muscles IEMG,RMS,MF in the treatment group were higher than control group[(27.45±4.23)V·s vs.(18.32±3.25)V·s,(32.45±5.12)μV vs.(21.34±4.20)μV,(82.25±10.21)Hz vs.68.12±9.23)Hz],t=13.110,12.836,7.867,all P<0.05).Multifidus muscle IEMG,RMG,MF in the treatment group were higher than control group[(42.36±6.20)V·s vs.(25.45±4.62)V.s,(45.24±7.72)μV vs.(34.32±6.12)μV,(90.45±12.14)Hz vs.(75.32±9.24)Hz],t=16.707,8.476,7.578,all P<0.05).Lumbago and leg pain,self-care ability,weight extraction,sitting and standing status,standing status,and sleep quality score in the treatment group were lower than control group(all P<0.05).Conclusion Leverage replacement manipulation help to improve the core muscle recruitment ability and fatigue resistance,promote the recovery of lumbar function,then improve the clinical efficacy.