国际功能、残疾和健康分类康复组合(ICF-RS)用于老年非特异性下腰痛患者水中太极效果评价的研究

The study on the rehabilitation benefits of Ai-Chi in elderly patients with nonspecific low back pain by ICF rehabilitation set

目的:采用ICF康复组合(ICF-RS)评价非特异性下腰痛(nonspecific low back pain,NLBP)患者的功能状况,初步分析水中太极治疗NLBP的康复疗效。方法:74例NLBP患者随机分配入治疗组(水中太极)和对照组(核心肌力训练),每组各37例。按照预定的治疗方案进行为期8周的集中康复训练,通过ICF-RS评估NLBP患者的功能改善情况。结果:NLBP患者存在明显身体功能障碍的类目依次为:b152情感功能、b280痛觉、b455运动和耐受能力、b710关节活动能力、b730肌肉力量;存在明显活动与参与功能障碍依次为:d230进行日常事务、d410改变身体基本姿势、d415保持一种身体姿势、d640做家务、d660帮助别人、d710基本的人际交往、d770亲密关系、d850有报酬的就业、d920娱乐与休闲。2组NLBP患者治疗前后通过ICF-RS进行疗效评估,2组患者治疗后30条类目中14条明显改善(b152、b280、b455、b710、b730、d230、d410、d415、d640、d660、d710、d770、d850、d920),治疗组改善类目评分均较对照组改善明显,具有显著性差异(P<0.05)。结论:水中太极对NLBP痛患者有明显的临床疗效。ICF-RS可以用于评估NLBP患者的功能状况,指导康复治疗和进行疗效评价。

Objective:To evaluate the functional status of patients with non-specific low back pain by using ICF rehabilitation set(ICF-RS),and to preliminarily analyze the rehabilitation effect of Ai-Chi on non-specific low back pain(NLBP)patients.Method:Seventy-four NLBP patients were randomly assigned to treatment group(Ai-Chi)and control group(core strength training),with 37 cases in each group.An 8-week intensive rehabilitation training was performed according to the pre-determined treatment plan.The functional improvement of NLBP patients was evaluated by ICF-RS.Result:The most common physical dysfunctions in NLBP patients are b152 Emotional function,b280 Pain sensation,b455 Exercise and tolerance functions,b710 Mobility of joint function,b730 Muscle power function;the activity and participation dysfunction are d230 Daily affairs function,d410 Change basic body posture function,d415 Maintain body posture function,d640 Housework function,d660 Help others function,d710 Basic interpersonal function,d770 Intimate function,d850 paid employment function,d920 Entertainment and leisure function.The NLBP patients in the two groups were evaluated with ICF-RS before and after treatment.14 of the 30 categories in the two groups were improved after treatment(b152,b280,b455,b710,b730,d230,d410,d415,d640,d660,d710,d770,d920).The treatment group improved significantly compared with the control group,and the difference was statistically significant(P<0.05).Conclusion:Ai-Chi exercises has obvious clinical effect on patients with NLBP patients.ICF-RS can be used to evaluate the functional status of NLBP patients and management rehabilitation therapy and efficacy evaluation.