正骨手法联合核心稳定性训练对产后腰痛的影响

Effects of bone-setting manipulation combined with core stability training on postpartum back pain

目的探讨正骨手法联合核心稳定性训练对产后腰痛的影响。方法选择2018年5月—2020年8月盐城市第三人民医院诊治的产后腰痛患者46例,按随机数字表法分为观察组和对照组,每组23例。2组患者均接受正骨手法,观察组在手法治疗的基础上增加核心稳定性训练。治疗8周后进行疗效评价,观察指标包括数字疼痛分级法(NRS)评分、Oswestry功能障碍指数(ODI)评分、躯干屈伸肌群峰力矩;于治疗结束1年后随访时统计2组患者腰痛复发率。结果治疗8周后,2组疼痛NRS评分、ODI评分均较治疗前明显降低(P均<0.05),且观察组均明显低于对照组(P均<0.05);2组屈肌群和伸肌群峰力矩均较治疗前明显增加(P均<0.05),且观察组屈肌群峰力矩均明显高于对照组(P均<0.05);治疗结束1年后随访,观察组复发率为13.0%(3/23),明显低于对照组的39.1%(9/23),差异有统计学意义(P<0.05)。结论正骨手法联合核心稳定性训练能够有效改善产后腰痛患者的症状及功能障碍,降低复发率。

Objective It is to investigate the effect of bone-setting manipulation combined with core stability training on postpartum back pain.Methods A total of 46 patients with postpartum back pain who were diagnosed and treated in Yancheng Third People’s Hospital from May 2018 to August 2020 were selected and divided into an observation group and a control group according to the random number table method,with 23 cases in each group.Both groups were treated with bone-setting manipulation,and the observation group was treated with core stability training on the basis of manipulation therapy.The curative effect was evaluated after 8 weeks of treatment,and the observation indicators included the Numerical Pain Scale(NRS)score,the Oswestry Disability Index(ODI)score,and the peak torque(PT)of the trunk flexors and extensors;the recurrence rate of low back pain in the two groups was counted during the follow-up 1 year after the end of treatment.Results After 8 weeks of treatment,the pain NRS scores and ODI scores of the two groups were significantly improved compared with those before treatment(all P<0.05),and the pain NRS scores and ODI scores of the observation group after treatment were significantly lower than those of the control group(all P<0.05);the PT values of flexors and extensors in both groups were significantly improved compared with those before treatment(all P<0.05),and the PT values of flexors and extensors in the observation group were significantly higher than those in the control group(all P<0.05).In addition,one-year follow-up after treatment showed that the recurrence rate of the observation group was 13.0%(3/23),which was significantly lower than that 39.1%(9/23)of the control group,the difference was statistically significant(P<0.05).Conclusion Bone-setting manipulation combined with core stability training can effectively improve the symptoms and dysfunction of patients with postpartum low back pain,and reduce the recurrence rate.