八段锦联合物理疗法治疗慢性腰痛的疗效观察

Therapeutic effect of Baduanjin combined with physical therapy for chronic low back pain

目的:观察八段锦联合物理疗法治疗慢性腰痛的临床疗效及对竖脊肌表面肌电信号的影响。方法:将84例慢性腰痛患者随机分为观察组和对照组各42例。对照组采用常规物理治疗,观察组在对照组基础上行八段锦训练,共治疗4周。分别于治疗前、治疗后和随访6个月时记录2组患者疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI),表面肌电仪分别采集腰部前屈、后伸及最大屈曲状态下竖脊肌平均肌电值信号并计算屈曲-放松比(FRR)。结果:治疗4周后,2组患者VAS评分及ODI值均较治疗前显著降低(均P<0.01),屈曲与后伸过程中平均肌电值(FLEXAEMG、EXEAEMG)及相应FRR值均显著升高(均P<0.01),最大屈曲状态肌电值(MVFAEMG)显著降低(P<0.01),且观察组优于对照组(P<0.05);随访6个月时,对照组VAS评分及ODI值较治疗后均升高(均P<0.05),FLEXAEMG、EXEAEMG、FRR降低(P<0.05),MVFAEMG升高(P<0.05);观察组VAS评分及ODI值与治疗后比较无显著性差异,FLEXAEMG、EXEAEMG、FRR降低(均P<0.05),MVFAEMG升高(P<0.05),组间比较,观察组均优于对照组(均P<0.05)。结论:八段锦训练能够有效缓解慢性腰痛的临床症状且远期疗效更佳,这可能与八段锦训练提高竖脊肌收缩和放松能力并增强腰椎稳定性有关。

Objective:To observe the clinical efficacy of Baduanjin training in treating chronic low back pain(LBP)and its influence on the surface EMG signal of erector spinae.Methods:Totally,84 cases of chronic LBP were collected and randomly divide into observation group and control group,with 42 cases in each group.Both groups received conventional physical therapy,and the observation group received Baduanjin training additionally for a total of 4 weeks.The pain visual analogue scale(VAS)and Oswestry dysfunction index(ODI)scores were recorded before treatment,after treatment,and during the 6-month follow-up.Surface electromyography(sEMG)was used to collect the average electromyographic value of the lumbar erector spinae muscle in three different states(flexion,extension and maximum flexion)of lumbar spine,and then the flexion-relaxation ratio(FRR)was calculated.Results:(1)After treatment,VAS and ODI scores in the two groups were significantly lower than those before treatment(P<0.01),FLEXAEMG,EXEAEMG and FRR were significantly increased(P<0.01),and MVFAEMG significantly reduced,and there were no significant differences between the observation group and the control group(P<0.05);(2)At 6th month of follow-up,the VAS and ODI scores and MVFAEMG in the control group were significantly increased,and the FLEXAEMG,EXEAEMG and FRR decreased(all P<0.05).The observation group had no significant changes in VAS and ODI scores,while the FLEXAEMG,EXEAEMG and FRR decreased(P<0.05),and MVFAEMG increased(P<0.05).There was significant difference between two groups(P<0.05).Conclusion:Baduanjin training can effectively relieve the clinical symptoms of chronic LBP and has better long-term effects,which are related to the improvement of the contraction and relaxation of erector spinal muscles and the stability of the lumbar spine.