巴氏球核心稳定训练结合冲击波治疗慢性非特异性腰痛的效果观察

Effect observation of Swiss ball core stabilization exercises combined with extracorporeal shock wave therapy in the treatment of patients with chronic nonspecific low back pain

目的观察巴氏球核心肌群稳定性训练结合冲击波治疗对慢性非特异性腰痛腰椎功能和生活质量的临床效果。方法将60例慢性非特异性腰痛患者按照随机数字表法分为对照组和观察组各30例。两组患者均采用冲击波治疗,观察组在此基础上进行核心肌群稳定性训练,共治疗4周,分别于治疗前、治疗4周后进行量表评估。比较两组视觉模拟评分(VAS)、Schober试验距离及指地距离、Oswestry功能障碍指数(ODI)、Roland-Morris功能障碍量表(RMDQ)及简明健康状况调查问卷(SF-36),并观察两组3个月后的复发情况。结果治疗4周后,两组VAS、指地距离、ODI和RMDQ评分均低于治疗前,且观察组低于对照组(P<0.05);两组Schober试验距离均大于治疗前,且观察组优于对照组(P<0.05);两组SF-36评分各项指标均高于治疗前,且观察组生理功能、生理职能、躯体疼痛、活力、社会功能、精神健康评分高于对照组(P<0.05)。3个月后随访,观察组复发率6.7%,显著低于对照组33.3%(P<0.05)。结论巴氏球核心肌群稳定性训练结合冲击波可以缓解慢性非特异性腰痛患者的疼痛症状,改善脊柱的活动度,缓解腰椎功能障碍,提高生活质量,降低复发率,长期疗效佳,治疗效果优于单纯的冲击波疗法。

Objective To observe the clinical effects of Swiss ball core stabilization exercises combined with extracorporeal shock wave therapy for lumbar spine function and the quality of life in patients with chronic nonspecific low back pain.Methods Sixty patients with chronic nonspecific low back pain were selected.They were divided into a control group and an observation group by using random number table method,30 in each group.Both groups were treated with shock wave therapy.On the basis of the treatment,the observation group received individualized Swiss ball core stabilization exercises.The two groups accepted the treatment for 4 weeks.Visual analogue scale(VAS),Schober test distance,finger-to-floor distance(FFD),Oswestry Disability Index(ODI),RolandMorris Disability Questionnaire(RMDQ)and SF-36 were compared before and after 4 weeks of treatment between the two groups.The recurrence rate was observed after 3 months of treatment.Results After 4 weeks of treatment,the scores of VAS,FFD,ODI and RMDQ were decreased compared to before treatment in both groups,and the observation group were lower than the control group(P<0.05).The Schober test distances were increased compared to before treatment in both groups,and the observation group was larger than the control group(P<0.05).After treatment,the indexes of SF-36 were increased compared to before treatment in both groups,and the scores of PF,RP,BP,VT,SF and MH in the observation group were higher than those in the control group,(p<0.05).In 3 months of follow-up,the recurrence rate of the observation group was 6.7%,which was lower than 33.3%of the control group(P<0.05).Conclusions Swiss ball core stabilization exercises combined with extracorporeal shock wave therapy can effectively alleviate the pain symptoms of patients with chronic nonspecific low back pain,improve the activity and functional limitation of the lumbar spine.It also increases the quality of life and reduces the recurrence rate.The long-term curative effect is better than that of simple extracorporeal shock wave therapy.