抗阻呼吸训练联合核心稳定性训练治疗慢性非特异性腰痛的临床观察研究

Clinical Observational Study on the Treatment of Chronic Non-Specific Low Back Pain with Resistance Breathing Training Combined with Core Stability Training

目的配合核心稳定性训练,观察抗阻呼吸训练对治疗慢性非特异性腰痛(Chronic Nonspecific Low Back Pain,CNLBP)的临床疗效。方法选择2022年7月至2023年12月福建中医药大学附属人民医院收治的52例CNLBP患者,根据随机数字表法分为试验组(接受抗阻呼吸训练)与对照组(接受腹式呼吸训练),每组各26例。两组患者均以常规康复治疗为基础,配合核心稳定性训练,5次/周,共治疗4周。治疗前后采用视觉模拟评分法(Visual Analogue Scale,VAS)、Oswestry功能障碍指数(Oswestry Disability Index,ODI)及表面肌电竖脊肌屈曲-放松比值(Flexion Relaxation Ratios,FRR)的变化对两组患者进行评价。结果治疗后,两组患者VAS及ODI评分均降低(P<0.001),但治疗后两组间VAS、ODI评分差异无统计学意义(P>0.05);治疗后两组FRR均提高,且试验组改善优于对照组,差异具有统计学意义(P<0.001)。结论基于核心稳定性训练,结合呼吸训练可以改善CNLBP患者的疼痛和功能表现,恢复屈曲-松弛现象。与腹式呼吸相比,抗阻呼吸训练可更有效地提高竖脊肌屈曲-放松比值,激活深层核心稳定肌群,放松紧张的腰背部肌肉,改善腰背部肌群自我收缩调节能力,恢复屈曲-松弛现象。

Objective To compare the clinical efficacy of resistance breathing training versus diaphragmatic breathing,in conjunction with core stability training,for the treatment of chronic non-specific low back pain(CNLBP).Methods From July 2022 to December 2023,52 patients with chronic non-specific low back pain(CNLBP)were selected from the People's Hospital affiliated with Fujian University of Traditional Chinese Medicine.They were randomly assigned to either the experimental group(n=26)or the control group(n=26)using a random number table method.Both groups received conventional rehabilitation therapy combined with core stability training.The control group underwent diaphragmatic breathing training,while the experimental group received resistance breathing training,performed 5 times per week for 4 weeks.Evaluations were conducted before and after treatment using Visual Analog Scale(VAS)scores,Oswestry Disability Index(ODI)scores,and the flexion-relaxation ratio(FRR)of the erector spinae muscles measured by surface electromyography.Results Post-treatment,both groups showed significant reductions in VAS scores(P<0.001)and ODI scores(P<0.001).However,there were no statistically significant differences in VAS and ODI scores between the two groups after treatment(P>0.05).Both groups exhibited significant improvements in FRR,with the experimental group showing superior improvement compared to the control group,which was statistically significant(P<0.001).Conclusion Core stability training combined with breathing exercises can improve pain and functional outcomes in CNLBP patients,restoring the flexion-relaxation phenomenon.Compared to diaphragmatic breathing,resistance breathing training more effectively enhances the flexion-relaxation ratio of the erector spinae muscles,activates deep core stabilizing muscles,relaxes tense lumbar and back muscles,improves the self-regulation of lumbar and back muscle contraction,and restores the flexion-relaxation phenomenon.