探讨应用flexi-bar治疗慢性非特异性腰痛的临床研究

doi:10.3969/j.issn.1006-7795.2021.06.027

摘要/Abstract

摘要： 目的探讨应用flexi-bar治疗慢性非特异性腰痛的临床疗效,为指导临床及家庭训练制定更简单、有效的运动处方。方法选择2019年1月-2019年12月于首都医科大学附属北京友谊医院就诊的慢性非特异性腰痛患者60例,采用数字表法将其随机分为两组,对照组采用常规腰椎稳定性训练,试验组在此基础上联合flexi-bar训练。两组都将接受为期4周的运动干预,每周3次,每次40 min,包括5 min的热身和5 min的放松。试验组训练过程中15 min进行flexi-bar运动,在站立、双桥、卷腹和四点支撑体位下进行,flexi-bar振动保持30 s,休息30 s,每个动作做3组。两组训练前后分别应用疼痛数值评定量表(Numerical Rating Scale,NRS)、Oswestry腰背功能障碍指数(Oswestry disability index,ODI)、压力生物反馈仪 (pressure biofeedback unit,PBU)进行疼痛、腰椎功能和腹横肌激活能力的评估。结果治疗前两组患者NRS评分、ODI评分及腹横肌激活压力值比较,差异无统计学意义(P＞0.05)。经过4周的治疗,两组NRS评分、ODI评分及腹横肌激活能力压力值均较治疗前明显改善(均P＜0.01),且试验组患者NRS评分、ODI评分及压力值与对照组比较,差异有统计学意义(均P＜0.05)。结论应用flexi-bar治疗慢性非特异性腰痛可显著改善患者腰椎功能,缓解腰部疼痛症状,是一种安全有效的治疗方法。

关键词: Flexi-bar, 慢性非特异性腰痛, 压力生物反馈仪

Abstract: Objective To explore the clinical efficacy of flexi-bar in the treatment of chronic non-specific low back pain, and to formulate simpler and more effective exercise prescriptions for guiding clinical and family training. Methods From January 2019 to December 2019, 60 patients with chronic non-specific low back pain who came to our hospital were selected and randomly divided into two groups according to the random number table. The control group used conventional lumbar stability training, and the experimental group was combined on this basis flexi-bar training. Both groups will receive 4 weeks of exercise intervention, three times a week, 40 minutes each time, including 5 minutes of warm-up and 5 minutes of relaxation. The experimental group performed flexi-bar exercises for 15 minutes during the training process, in standing, double bridge, abdominal crunching and four-point support positions. The flexi-bar vibration was maintained for 30 s and rested for 30 s. Each exercise was performed 3 times. Before and after training, the two groups were applied with the Numerical Rating Scale (NRS), Oswestry disability index(ODI), and pressure biofeedback unit (PBU) to evaluate pain, lumbar spine function and transversus abdominis activation ability. Results Before treatment, there was no significant difference in NRS score, ODI score, and transversus abdominis activation pressure between the two groups of patients (P>0.05). After 4 weeks of treatment, the NRS, ODI score and transversus abdominis activation pressure of the two groups were not statistically significant. The values were significantly improved compared with before treatment (P<0.01), and the NRS, ODI scores and pressure values of the experimental group were significantly different from those of the control group (P<0.05). Conclusion The application of flexi-bar in the treatment of chronic non-specific low back pain can significantly improve the function of the patient's lumbar spine and relieve the symptoms of low back pain. It is a safe and effective treatment.

Key words: Flexi-bar, chronic non-specific low back pain, pressure biofeedback unit

中图分类号:

任伟, 李谷峰, 李素华, 李作翔, 谢瑛. 探讨应用flexi-bar治疗慢性非特异性腰痛的临床研究[J]. 首都医科大学学报, 2021, 42(6): 1065-1069.

Ren Wei, Li Gufeng, Li Suhua, Li Zuoxiang, Xie Ying. To explore the clinical study of flexi-bar in the treatment of chronic nonspecific low back pain[J]. Journal of Capital Medical University, 2021, 42(6): 1065-1069.

参考文献

[1] Frizziero A, Pellizzon G, Vittadini F, et al. Efficacy of core stability in non-specific chronic low back pain[J]. J Funct Morphol Kinesiol,2021,6(2):37.
[2] Maher C, Underwood M, Buchbinder R. Non-specific low back pain[J]. Lancet,2017,389(10070):736-747.
[3] Ghamkhar L, Kahlaee A H. Trunk muscles activation pattern during walking in subjects with and without chronic low back pain: a systematic review[J]. PM R,2015,7(5):519-526.
[4] 陈景洲,王惠娟,石真润,等. 慢性非特异性腰痛患者躯干肌的等速力学特征和肌电信号研究[J]. 中国康复医学杂志,2021,36(1):51-56.
[5] 袁松,高峰,刘飞,等. 局部振动疗法对慢性非特异性腰痛的疗效研究[J]. 中国康复,2018,33(3):234-236.
[6] 中国康复医学会脊柱脊髓专业委员会专家组. 中国急/慢性非特异性腰背痛诊疗专家共识[J]. 中国脊柱脊髓杂志,2016,26(12):1134-1138.
[7] Chung S H, You Y Y, Lee H J, et al. Effects of stabilization exercise using flexi-bar on functional disability and transverse abdominis thickness in patients with chronic low back pain[J]. J Phys Ther Sci,2018,30(3):400-404.
[8] Shafshak T S, Elnemr R. The visual analogue scale versus numerical rating scale in measuring pain severity and predicting disability in low back pain[J]. J Clin Rheumatol,2020,27(7):282-285.
[9] Garg A, Pathak H, Churyukanov M V, et al. Low back pain: critical assessment of various scales[J]. Eur Spine J,2020,29(3):503-518.
[10] Li X, Lo W, Lu S W, et al. Trunk muscle activity during pressure feedback monitoring among individuals with and without chronic low back pain[J]. BMC Musculoskelet Disord,2020,21(1):569.
[11] Ramos L A V, França F J R, Callegari B, et al. Are lumbar multifidus fatigue and transversus abdominis activation similar in patients with lumbar disc herniation and healthy controls? A case control study[J]. Eur Spine J, 2016,25(5):1435-1442.
[12] Javadian Y, Akbari M, Talebi G, et al. Influence of core stability exercise on lumbar vertebral instability in patients presented with chronic low back pain: A randomized clinical trial[J]. Caspian J Intern Med,2015,6(2):98-102.
[13] Saijo M, Ito E, Ichinohe T, et al. Lack of pain reduction by a vibrating local anesthetic attachment: a pilot study[J]. Anesth Prog,2005,52(2):62-64.
[14] Webright W G, Randolph B J, Perrin D H. Comparison of nonballistic active knee extension in neural slump position and static stretch techniques on hamstring flexibility[J]. J Orthop Sports Phys Ther,1997,26(1):7-13.
[15] Rubin C, Pope M, Fritton J C, et al. Transmissibility of 15-hertz to 35-hertz vibrations to the human hip and lumbar spine: determining the physiologic feasibility of delivering low-level anabolic mechanical stimuli to skeletal regions at greatest risk of fracture because of osteoporosis[J]. Spine (Phila Pa 1976),2003,28(23):2621-2627.
[16] Boucher J A, Abboud J, Nougarou F, et al. The effects of vibration and muscle fatigue on trunk sensorimotor control in low back pain patients[J]. PLoS One,2015,10(8):e135838.
[17] Phanpheng Y, Hiruntrakul A, Graduate S, et al. Effects of flexi bar training model to health-related physical fitness in overweight adults[J]. J Phys Ther Sci, 2020,32(8):489-495.
[18] Chung J S, Park S, Kim J, et al. Effects of flexi-bar and non-flexi-bar exercises on trunk muscles activity in different postures in healthy adults[J]. J Phys Ther Sci,2015,27(7):2275-2278.
[19] Gerhardt F, Dumitrescu D, Gartner C, et al. Oscillatory whole-body vibration improves exercise capacity and physical performance in pulmonary arterial hypertension: a randomised clinical study[J]. Heart,2017,103(8):592-598.
[20] Cerciello S, Rossi S, Visona E, et al. Clinical applications of vibration therapy in orthopaedic practice[J]. Muscles Ligaments Tendons J,2016,6(1):147-156.