脊柱微调手法基础上核心肌群训练对腰椎小关节紊乱患者腰椎功能和生活质量的影响

doi:10.3969/j.issn.1006-9771.2024.02.015

摘要/Abstract

摘要：

目的探究在脊柱微调手法的基础上联合核心肌群训练对腰椎小关节紊乱患者的临床疗效。
方法选取2021年2月至2022年2月复旦大学附属华东医院收治的腰椎小关节紊乱患者80例，随机分为对照组和观察组，各40例，两组均给予常规治疗和脊柱微调手法治疗，观察组联合核心肌群训练，共6周。治疗前后，采用日本骨科协会腰椎功能评分、简化McGill疼痛问卷和世界卫生组织生活质量测定量表简表进行评定。随访3个月，观察两组复发率。
结果治疗后，两组各项评分均显著改善(t > 5.751, P < 0.001)，观察组各项评分均优于对照组(t > 2.051, P < 0.05);随访3个月，观察组复发率为7.89% (3/38)，明显低于对照组的28.13% (9/32) (χ² = 5.005, P = 0.025)。
结论联合应用核心肌群训练能进一步改善腰椎小关节紊乱患者的腰椎功能，减轻腰椎疼痛，降低复发率，提升生活质量。

关键词: 腰椎小关节紊乱, 核心肌群训练, 脊柱微调手法, 康复

Abstract:

Objective To explore the effect of core muscles training based on spinal fine-tuning manipulation on lumbar facet joint disorders.
Methods From February, 2021 to February, 2022, 80 patients with lumbar facet joint disorders in Huadong Hospital Affiliated to Fudan University were randomly divided into control group (n = 40) and observation group (n = 40) randomly. Both groups received routine treatment and spinal fine-tuning manipulation, while the observation group received core muscles training in addition, for six weeks. They were assessed with Japanese Orthopaedic Association (JOA) scores, Short-Form of McGill Pain Questionnaire and World Health Organization Quality of Life-BREF before and after treatment. The recurrence rate was observed after three months follow-up.
Results The scores of all the scales improved after treatment (t > 5.751, P < 0.001), and improved more in the observation group than in the control group (t > 2.051, P < 0.05). After three months follow-up, the recurrence rate was 7.89% (3/38) in the observation group, less than 28.13% (9/32) in the control group (χ² = 5.005, P = 0.025).
Conclusion Combination of core muscles training may improve lumbar function, reduce lumbar pain, reduce recurrence and improve quality of life for patients with lumbar facet joint disorders.

Key words: lumbar facet joint disorders, core muscles training, spine fine-tuning technique, rehabilitation

中图分类号:

R681.5

徐洲, 郑洁皎, 丁建伟, 张杰. 脊柱微调手法基础上核心肌群训练对腰椎小关节紊乱患者腰椎功能和生活质量的影响[J]. 《中国康复理论与实践》, 2024, 30(2): 238-242.

XU Zhou, ZHENG Jiejiao, DING Jianwei, ZHANG Jie. Effect of core muscles training based on spinal fine-tuning manipulation on lumbar spine function and quality of life in patients with lumbar facet joint disorders[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(2): 238-242.

图/表 4

表1

两组基线资料比较"

项目		观察组 (n = 40)	对照组 (n = 40)	χ²/t值	P值
性别/n	男	19	23	0.802	0.371
	女	21	17
年龄/岁		45.63±6.15	46.39±6.10	0.555	0.581
病程/d		18.64±3.36	19.26±3.55	0.802	0.425
体质量指数/(kg $⋅$ m^-2)		23.05±2.20	23.43±2.35	0.747	0.458
发病节段	L_3-4	16	12	0.879	0.348
/n	L_4-5	24	28
外伤/n	是	6	3	1.127	0.288
	否	34	37
工作性质	体力工作	9	13	1.003	0.317
/n	非体力工作	31	27

表1

表2

表3

表4

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组别	n	临床体征		主观症状		日常活动		t值^a	P值^a	t值^b	P值^b	t值^c	P值^c
组别	n	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	t值^a	P值^a	t值^b	P值^b	t值^c	P值^c
对照组	40	2.70±0.58	4.38±0.80	3.22±1.12	5.88±1.23	5.85±1.16	11.11±1.57	15.399	< 0.001	14.318	< 0.001	24.372	< 0.001
观察组	40	2.63±0.52	5.05±0.76	3.36±1.02	7.52±1.30	5.69±1.20	13.36±1.72	23.915	< 0.001	22.681	< 0.001	33.226	< 0.001
t值		0.568	3.840	0.585	5.796	0.606	6.111
P值		0.571	< 0.001	0.561	< 0.001	0.546	< 0.001

组别	n	PRI		VAS		PPI		t值^a	P值^a	t值^b	P值^b	t值^c	P值^c
组别	n	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后	t值^a	P值^a	t值^b	P值^b	t值^c	P值^c
对照组	40	11.42±2.01	6.10±2.15	6.45±1.14	3.86±1.00	3.81±1.14	1.92±0.65	16.176	< 0.001	15.309	< 0.001	13.356	< 0.001
观察组	40	11.83±2.46	4.97±1.72	6.67±1.36	2.32±0.64	3.93±1.20	1.29±0.41	20.759	< 0.001	27.512	< 0.001	20.741	< 0.001
t值		0.816	2.596	0.784	8.204	0.459	5.185
P值		0.417	0.011	0.435	< 0.001	0.648	< 0.001

组别	n	身体健康			心理			社会关系			环境因素
组别	n	治疗前	治疗后		治疗前	治疗后		治疗前	治疗后		治疗前	治疗后
对照组	40	15.03±2.05	18.85±3.36		16.35±2.96	20.52±3.86		6.52±1.86	9.08±2.18		20.79±3.29	31.56±3.87
观察组	40	15.26±2.16	21.35±3.56		16.24±3.06	22.28±4.27		6.87±2.03	10.32±2.62		21.25±3.68	33.52±4.36
t值		0.518	3.426		0.173	2.051		0.853	2.441		0.625	2.255
P值		0.606	0.001		0.863	0.043		0.396	0.017		0.534	0.027
组别	n	总分		t值^a	P值^a	t值^b	P值^b	t值^c	P值^c	t值^d	P值^d	t值^e	P值^e
组别	n	治疗前	治疗后	t值^a	P值^a	t值^b	P值^b	t值^c	P值^c	t值^d	P值^d	t值^e	P值^e
对照组	40	58.69±5.18	80.01±5.22	6.511	< 0.001	5.751	< 0.001	5.993	< 0.001	14.223	< 0.001	19.448	< 0.001
观察组	40	59.62±5.42	87.47±5.48	9.811	< 0.001	7.713	< 0.001	6.983	< 0.001	14.427	< 0.001	24.239	< 0.001
t值		0.832	6.612
P值		0.408	< 0.001