居家核心稳定训练对腰椎间盘突出症患者疗效的观察

Effect of home core stabilization training on patients with lumbar disc herniation

目的:探讨居家核心稳定性训练对腰椎间盘突出症(Lumbar disc herniation,LDH)的远期治疗效果及对预防复发的作用。方法:选取我科诊断明确的LDH住院患者46例,采用随机数字表法分为训练组和对照组各23例。两组患者在住院期间均接受常规康复治疗及腰部核心稳定性训练,出院时均接受LDH相关的健康教育,训练组在此基础上每天自行进行腰部核心稳定性训练。于出院前及出院后1个月、6个月使用视觉模拟评分法(VAS)、日本骨科协会评估治疗分数(JOA)、单桥耐力试验(UHBE)评估疼痛、腰椎功能及腰椎稳定性,观察治疗后1个月和6个月内复发情况。结果:出院后1个月时两组患者的VAS评分、JOA评分、UHBE时间不存在统计学差异(P>0.05)。出院后6个月时训练组的VAS评分、JOA评分、UHBE时间改善均好于对照组,差异具有统计学意义(P<0.05)。在出院后1个月时两组复发率不存在统计学差异,在6个月时训练组复发率低于对照组,差异有统计学意义(P<0.05)。结论:LDH患者居家行核心稳定性训练,可以进一步减轻患者的疼痛,改善腰椎功能,提高腰椎稳定性,减少复发。

Objective:To investigate the long-term therapeutic effect of home core stability training on Lumbar disc herniation(LDH)and its role in preventing recurrence.Methods:46 cases of LDH inpatients diagnosed in our department were selected and divided into training group and control group with 23 cases in each group by random number table method.Both groups received routine rehabilitation and lumbar core stability training during hospitalization,and LDH-related health education at discharge.On this basis,the training group performed lumbar core stability training by themself every day.Visual analogue scale(VAS),Japanese Orthopaedic Association Scores(JOA)and Unilateral hip Bridge endurance test(UHBE)were used to assess pain,lumbar function and stability before discharge and at 1 and 6 months after discharge.Recurrence was observed at 1 month and 6 months after treatment.Results:There were no significant differences in VAS score,JOA score and UHBE time between the two groups at 1 month after discharge(P>0.05).At 6 months after discharge,the VAS score,JOA score and UHBE time in the training group were better than those in the control group,and the differences were statistically significant(P<0.05).At 1 month after discharge,there was no significant difference in the recurrence rate between the two groups.At 6 months,the recurrence rate of the training group was lower than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:Core stability training at home for LDH patients can further reduce pain,improve lumbar function,improve lumbar stability and reduce recurrence.