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

Abstract

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

CLC Number:

R681.5

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.

Figures/Tables 4

Table 1

Comparison of baseline data between two groups"

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

Table 1

Table 2

Table 3

Table 4

References 22

[1]	毛田, 李浩, 汪伟, 等. 腰椎斜扳法联合体外冲击波治疗腰椎小关节紊乱症的临床研究[J]. 中国中医骨伤科杂志, 2023, 31(2): 40-43.
	MAO T, LI H, WANG W, et al. Clinical analysis of lumbar oblique pulling method combined with extracorporeal shock wave on the treatment of lumbar facet joint disorder[J]. Chin J Tradit Med Traumatol Orthop, 2023, 31(2): 40-43.
[2]	张志芳, 张芳. 八段锦操结合心理辅导对腰椎骨折患者术后心理状态及功能恢复的影响[J]. 中国健康心理学杂志, 2022, 30(5): 670-673.
	ZHANG Z F, ZHANG F. Effect of eight-brocades exercise combined with psychological counseling on postoperative psychological state and functional recovery of patients with lumbar fracture[J]. Chin J Health Psychol, 2022, 30(5): 670-673.
[3]	NAEEM K, NATHANI K R, BARAKZAI M D, et al. Modifications in lumbar facet joint are associated with spondylolisthesis in the degenerative spine diseases: a comparative analysis[J]. Acta Neurochirurgica, 2021, 163: 863-871. doi: 10.1007/s00701-020-04657-3
[4]	ZHENG J, DUAN C, MA C. Spinal fixed-point rotating reduction for treatment of facet joint disorders[J]. Altern Ther Health Med, 2023, 29(7): 316-321. pmid: 37499146
[5]	李正祥, 李秀彬, 吴松. 脊柱微调手法联合远近配穴针刺治疗神经根型颈椎病的临床研究[J]. 中医正骨, 2020, 32(8): 1-5.
	LI Z X, LI X B, WU S. A clinical study of spinal fine-tuning manipulation combined with acupuncture at distal and proximal acupoints for treatment of cervical spondylotic radiculopathy[J]. J Tradit Chin Orthop Traumatol, 2020, 32(8): 1-5.
[6]	张晓红, 杜美华. 思维导图联合核心肌群训练对腰椎间盘突出症患者腰椎功能及疼痛程度的影响[J]. 护理实践与研究, 2020, 17(23): 76-78.
	ZHANG X H, DU M H. Effect of mind map combined with core muscle training on lumbar function and pain degree in patients with lumbar disc herniation[J]. Nurs Prac Res, 2020, 17(23): 76-78.
[7]	AVILA L, NEVES M L, ABREU A R, et al. Cognitive functional therapy (CFT) compared with core training exercise (CTE) in patients with failed back surgery syndrome (FBSS): a study protocol for a randomized controlled trial[J]. J Bodyw Mov Ther, 2021, 26: 428-434. doi: 10.1016/j.jbmt.2020.08.016 pmid: 33992278
[8]	国家中医药管理局. 中医病证诊断疗效标准[M]. 南京: 南京大学出版社, 1994: 201.
	State Administration of Traditional Chinese Medicine. Diagnosis and curative effect criteria of TCM diseases[M]. Nanjing: Nanjing University Press, 1994: 201.
[9]	关骅. 中国骨科康复学[M]. 北京: 人民军医出版社, 2011: 310-311.
	GUAN H. Chinese orthopaedic rehabilitation[M]. Beijing: People's Military Medical Press, 2011: 310-311.
[10]	彭琳, 张菊英. 简化McGill疼痛问卷中文版在腰椎间盘突出所致坐骨神经痛患者中的适用性[J]. 中国康复医学杂志, 2013, 28(11): 1035-1040.
	PENG L, ZHANG J Y. Applicability of the Chinese version of short form-McGill Pain Questionaire among patients with sciatica disease caused by lumbar intervertebral disc protrusion[J]. Chin J Rehabil Med, 2013, 28(11): 1035-1040.
[11]	都元涛, 方积乾. 世界卫生组织生存质量测定量表中文版介绍及其使用说明[J]. 现代康复, 2000, 4(8): 1127-1129, 1145.
	DU Y T, FANG J Q. The introduce and usage of WHOQOL instrument in Chinese[J]. Mod Rehabil, 2000, 4(8): 1127-1129, 1145.
[12]	张凯东, 邓强, 张彦军, 等. 邓强主任医师俯卧牵拉按压复位联合仰卧牵抖法治疗腰椎小关节综合征经验总结[J]. 西部中医药, 2022, 35(2): 119-121.
	ZHANG K D, DENG Q, ZHANG Y J, et al. Chief Physician Deng Qiang's treatment of lumbar facet joint disorder by prone traction and compression reduction combined with supine traction and shaking[J]. West J Chin Med, 2022, 35(2): 119-121.
[13]	PALMA F, PERRAMONT N, ROJAS V, et al. Electromyographic amplitude and coactivation of the core muscles during different unstable push-up exercises[J]. Med Sport, 2021, 74: 209-222.
[14]	朱妹妹, 盛海兵. 脊柱微调手法结合神经根封闭治疗腰椎间盘突出症临床观察[J]. 海南医学, 2019, 30(20): 2650-2653.
[15]	马铭辰, 唐宏亮, 卢栋明, 等. 短杠杆微调手法推拿治疗脊柱相关疾病研究概况[J]. 山东中医杂志, 2022, 41(2): 233-238.
	MA M C, TANG H L, LU D M, et al. Research overview on the treatment of spine related diseases with short lever fine-tuning manipulation[J]. Shandong J Tradit Chin Med, 2022, 41(2): 233-238.
[16]	贺志亮, 王德成, 张慧. 脊柱定点旋转复位法结合小针刀松解治疗腰椎小关节紊乱症的临床疗效分析[J]. 中国中西医结合外科杂志, 2019, 25(6): 991-997.
	HE Z L, WANG D C, ZHANG H. Clinical effect analysis on spinal fixed point rotation reduction combined with needle-knife release in treatment of lumbar facet joint disorders[J]. Chin J Surg Integr Tradit Western Med, 2019, 25(6): 991-997.
[17]	KAPETANAKIS S, GKANTSINIKOUDIS N. Anatomy of lumbar facet joint: a comprehensive review[J]. Folia Morphol (Warsz), 2021, 80(4): 799-805. doi: 10.5603/FM.a2020.0122 pmid: 33084010
[18]	李嘉仪. 康复护理联合核心肌群训练对腰椎间盘突出症病人术后躯体功能和疼痛的影响[J]. 全科护理, 2021, 19(14): 1934-1937.
[19]	廖军锋, 黄希照, 龙桂花, 等. 核心肌群训练联合俯卧位牵引对腰椎间盘突出症的疗效分析[J]. 中华生物医学工程杂志, 2021, 27(4): 409-413.
	LIAO J F, HUANG X Z, LONG G H, et al. Therapeutic efficacy of core muscle training plus traction in prone position for lumbar disc herniation[J]. Chin J Biomed Eng, 2021, 27(4): 409-413.
[20]	郑皓云, 祝永刚, 柳根哲, 等. 中医微调手法推拿对腰椎间盘突出症患者腰部核心稳定肌群功能的影响[J]. 湖南中医药大学学报, 2022, 42(7): 1180-1184.
	ZHENG H Y, ZHU Y G, LIU G Z, et al. Effect of fine-tuning manipulation massage of traditional Chinese medicine on the function of lumbar core stable muscle groups in patients with lumbar disc herniation[J]. J Hunan Univ Chin Med, 2022, 42(7): 1180-1184.
[21]	WON H S, YANG M, KIM Y D. Facet joint injections for management of low back pain: a clinically focused review[J]. Anesth Pain Med (Seoul), 2020, 15(1): 8-18.
[22]	杨雷刚, 杨云刚, 杨秀明. 腰椎旁间隙注射银杏叶+黄芪注射液配合改良腰椎斜扳法对腰椎小关节紊乱综合征患者腰椎功能及生活质量的影响[J]. 四川中医, 2021, 39(9): 146-149.

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

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

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