选择性功能动作评估在颈、腰痛患者中的应用及对治疗效果的评价

Application of selective functional movement assessment in patients with neck and low back pain and evaluation of therapeutic effect

目的通过选择性功能动作评估(SFMA)方法精准评估颈、腰痛患者造成疼痛的主要功能障碍情况,为进一步个性化精准康复治疗提供指导和建议,并评价治疗效果。方法选择2022年6月至12月就诊于西安交通大学第一附属医院康复医学科门诊的30例颈、腰痛患者为研究对象,均进行SFMA精准评估,并实施相同频次和治疗周期的针对性治疗,评价患者的治疗效果;比较患者治疗前、后的视觉模拟评分法(VAS)评分及主动呼吸模式。结果治疗后,显效11例(36.67%),有效18例(60.00%),无效1例(3.33%),治疗总有效率为96.67%(29/30)。治疗前的VAS评分为(4.47±1.04)分,治疗2周后的VAS评分为(2.03±1.29)分。治疗前、后的VAS评分比较,差异具有统计学意义(t=9.371,P<0.001);随访1个月后的VAS评分为(1.50±1.30)分,与治疗2周后的VAS评分比较,差异无统计学意义(t=1.585,P=0.118)。治疗前,15例为胸腹联动呼吸模式,15例为胸式呼吸模式;治疗后,30例为胸腹联动呼吸模式,0例为胸式呼吸模式。治疗前、后的呼吸模式比较,差异具有统计学意义(χ^(2)=17.422,P<0.001)。结论应用SFMA对颈、腰痛患者的治疗有指导意义,可有效减轻颈、腰痛,且治疗效果维持时间长,值得临床应用与推广。

Objective To accurately assess the main dysfunction of pain in patients with neck and low back pain by selective functional movement assessment(SFMA)method,so as to provide guidances and suggestions for further personalized precise rehabilitation treatment,and to evaluate the therapeutic effect.Methods From June to December 2022,30 patients with neck and low back pain who were treated in the outpatient department of rehabilitation medicine of the First Affiliated Hospital of Xi'an Jiaotong University were selected as the research objects,and all of them were given SFMA accurate evaluation and targeted treatment with the same frequency and treatment cycle;the Visual Analogue Scale(VAS)score and active breathing mode before and after treatment were compared.Results After treatment,11 cases(36.67%)were markedly effective,18 cases(60.00%)were effective,1 case(3.33%)was ineffective,and the total effective rate of treatment was 96.67%(29/30).The VAS score before treatment was(4.47±1.04)points,and the VAS score after 2 weeks of treatment was(2.03±1.29)points.There was a statistically significant difference in VAS score before and after treatment(t=9.371,P<0.001).The VAS score after 1 month of follow-up was(1.50±1.30)points,which was not significantly different from the VAS score after 2 weeks of treatment(t=1.585,P=0.118).Before treatment,15 cases were in the thoracoabdominal linkage breathing mode and 15 cases were in the thoracic breathing mode;after treatment,30 cases were in the thoracoabdominal linkage breathing mode,and 0 case was in the thoracic breathing mode.There was a statistically significant difference in respiratory patterns before and after treatment(χ^(2)=17.422,P<0.001).Conclusion The application of SFMA has a guiding significance for the treatment of patients with neck and low back pain.It can effectively reduce neck and low back pain,and maintain the therapeutic effect for a long time.It is worthy of clinical application and promotion.