基于生物力学的整复-松解-强化方案干预速滑运动员骶髂关节功能障碍疗效观察

Observation on the Effect of Biomechanical-based Rehabilitation-Release-Intensification Program in the Intervention of SLJD in Speed Skaters

目的 观察基于生物力学的整复-松解-强化方案干预速滑运动员骶髂关节功能障碍(Sacroiliac joint dysfunction,SLJD)的疗效。方法 以2019年4月—2020年4月在速度滑冰国家队担任队医期间治疗的66名运动员为研究对象,其中男29例,女37例。年龄15~30岁,中位数23岁。采取基于生物力学的整复-松解-强化方案进行干预治疗,观察运动员自觉症状、临床检查、日常生活动作等指标,根据Roland-Morris功能障碍评分(RDQ)、腰椎功能评分(JOA)以及疼痛视觉模拟评分(VAS)进行评分;参照《中医病证诊断疗效标准》进行临床疗效评定。结果 治疗后运动员下腰痛缓解,骶髂关节压痛减轻,行走、坐、站等功能增强,疼痛激发试验阴性。治疗前后患者VAS评分明显降低,治疗前为6.44±1.25,治疗后为1.35±0.73,差异有统计学意义(P<0.05);治疗前后患者RDQ评分明显降低,治疗前评分为16.55±2.21,治疗后评分为4.70±1.52,差异有统计学意义(P<0.05);治疗前后患者JOA评分明显升高,治疗前评分为15.11±1.46,治疗后评分为26.42±1.45,差异有统计学意义(P<0.05);临床疗效评定:好转63例,无效3例,总有效率达96%。结论 基于生物力学的整复-松解-强化方案干预速滑运动员SLJD,能显著改善运动员疼痛症状及功能障碍,提升腰椎功能,减少复发率,值得在运动队推广应用。

Objective To observe the curative effect of a biomechanical-based restoration-release-intensification program in the intervention of sacroiliac joint dysfunction(SLJD)in speed skating athletes.Methods A total of 66 athletes who were treated as team doctors in the national speed skating team from April 2019 to April 2020 were selected as the research objects,including 29 males and 37 females.The age ranged from 15 to 30 years,with a median of 23 years.The manipulative technique of first rehabilitating,then releasing and then de-enhancing was used for treatment.The athletes’subjective symptoms,clinical examinations,activities of daily living and other indicators were observed.The clinical efficacy was evaluated according to the“Traditional Chinese Medicine Diseases and Syndrome Diagnosis and Efficacy Criteria”.Results After treatment,the lower back pain of the athlete was relieved,the tenderness of the sacroiliac joint was relieved,the functions of walking,sitting and standing were enhanced,and the pain provocation test was negative.The VAS score of patients before and after treatment was significantly decreased,before treatment was 6.44±1.25,and after treatment was 1.35±0.73,the difference was statistically significant(P<0.05).The RDQ score of patients before and after treatment was significantly decreased,and the score before treatment was 16.55±2.21,the score after treatment was 4.70±1.52,the difference was statistically significant(P<0.05);the JOA score of patients before and after treatment increased significantly,the score before treatment was 15.11±1.46,and the score after treatment was 26.42±1.45,the difference was statistically significant(P<0.05);Clinical evaluation:63 cases were improved and 3 cases were ineffective.and the total effective rate was 96%.Conclusions The biomechanical-based restoration-release-intensification program intervenes in speed skating athletes with SLJD,which can significantly improve the pain symptoms and functional impairment of athletes,improve lumbar spine function,and reduce the recurrence rate.It is worthy of promotion and application in sports teams.