在核心稳定训练基础上联合呼吸训练对慢性非特异性腰痛患者前馈控制的效果

doi:10.3969/j.issn.1006-9771.2024.06.015

Abstract

Abstract:

Objective To investigate the effect of respiratory training based on core stability training on feedforward control in patients with chronic nonspecific low back pain (CNLBP).

Methods A total of 60 patients with CNLBP in Jiaxing Second Hospital from January, 2022 to March, 2023 were randomly divided into control group (n = 30) and experimental group (n = 30). Both groups received health education, physical factor therapy and core stability training, while the experimental group received respiratory training in addition, for four weeks. Visual Analogue Scale (VAS) score, Japanese Orthopaedic Association low back pain (JOA) score and Oswestry Dysfunction Index (ODI) were compared between two groups before and after treatment, while surface electromyography was used to detect the root mean square (RMS) and integrated electromyography (iEMG) of transversus abdominis, multifidus and triceps (movement muscles), and the activation sequence and relative activation time of transversus abdominis, multifidus and triceps were calculated.

Results After treatment, the scores of VAS, JOA and ODI improved significantly in both groups (|t| > 8.515, P < 0.001), and the scores were better in the experimental group than in the control group (|t| > 2.089, P < 0.05). RMS and iEMG of transversus abdominis and multifidus improved significantly after treatment in both groups (|t| > 18.831, P < 0.001), and were significantly better in the experimental group (|t| > 3.481, P < 0.05). The transversus abdominis and multifidus in both groups were activated before the movement muscles, and the relative activation time of transversus abdominis and multifidus increased in negative (|t| > 48.115, P < 0.001), the experimental group being better (|t| > 3.229, P < 0.05).

Conclusion Combination of core stability training and respiratory training is beneficial in reducing the pain of patients with CNLBP, reducing the lumbar dysfunction, improving the order of muscle activation, and strengthening feedforward control.

Key words: chronic nonspecific low back pain, respiratory training, feedforward control, surface electromyography

CLC Number:

R685

CHEN Linghui, ZHENG Qi, LI Yan, FU Jianming, ZENG Ming, JIN Xin, LU Jingjing. Effect of respiratory training based on core stability training on feedforward control in patients with chronic nonspecific low back pain[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(6): 737-744.

Figures/Tables 6

Table 1

Comparison of VAS score between two groups pre- and post-treatment"

组别	n	测试	$x - ± s$	t值	P值
对照组	30	前测	4.10±1.49	8.515	< 0.001
		后测	3.10±1.21
试验组	30	前测	4.40±1.57	9.570	< 0.001
		后测	2.40±1.38
治疗前两组均值差			0.30±1.91	0.759	0.451
治疗后两组均值差			-0.70±1.66	2.089	0.041

Table 1

Table 2

Comparison of JOA score between two groups pre- and post-treatment"

组别	n	测试	$x - ± s$	t值	P值
对照组	30	前测	10.23±2.58	14.293	< 0.001
		后测	13.93±2.46
试验组	30	前测	10.03±3.20	12.008	< 0.001
		后测	17.47±1.08
治疗前两组均值差			-0.20±4.17	0.267	0.791
治疗后两组均值差			3.53±2.61	7.217	< 0.001

Table 2

Table 3

组别	n	测试	$x - ± s$	t值	P值
对照组	30	前测	41.01±5.07	17.929	< 0.001
		后测	24.10±1.01
试验组	30	前测	40.88±4.99	19.941	< 0.001
		后测	20.97±1.68
治疗前两组均值差			-0.13±6.31	0.100	0.921
治疗后两组均值差			-3.12±1.73	8.746	< 0.001

Table 3

Table 4

肌肉	组别	n	测试	$x - ± s$	t值	P值
腹横肌	对照组	30	前测	69.49±4.16	19.292	< 0.001
			后测	92.64±4.66
	试验组	30	前测	70.97±4.80	20.848	< 0.001
			后测	98.90±5.61
	治疗前两组均值差			1.48±5.73	1.276	0.207
	治疗后两组均值差			6.27±7.79	4.701	< 0.001
多裂肌	对照组	30	前测	39.95±7.18	18.831	< 0.001
			后测	70.52±4.22
	试验组	30	前测	38.82±6.70	24.895	< 0.001
			后测	80.70±5.77
	治疗前两组均值差			-1.13±11.27	0.630	0.531
	治疗后两组均值差			10.18±6.47	7.800	< 0.001

Table 4

Table 5

肌肉	组别	n	测试	$x - ± s$	t值	P值
腹横肌	对照组	30	前测	183.82±10.78	36.002	< 0.001
			后测	395.28±30.58
	试验组	30	前测	179.90±10.95	29.080	< 0.001
			后测	428.51±42.41
	治疗前两组均值差			-3.93±11.59	1.397	0.168
	治疗后两组均值差			33.23±54.76	3.481	0.001
多裂肌	对照组	30	前测	162.76±11.90	53.746	< 0.001
			后测	354.88±17.73
	试验组	30	前测	162.98±10.44	47.692	< 0.001
			后测	375.41±20.76
	治疗前两组均值差			0.22±14.75	0.076	0.940
	治疗后两组均值差			20.53±29.46	4.119	< 0.001

Table 5

Table 6

肌肉	组别	n	测试	$x - ± s$	t值	P值
腹横肌	对照组	30	前测	46.66±4.14	48.115	< 0.001
			后测	-10.14±5.29
	试验组	30	前测	47.28±3.48	61.026	< 0.001
			后测	-14.89±6.08
	治疗前两组均值差			0.63±5.56	0.628	0.533
	治疗后两组均值差			-4.76±7.32	3.229	0.002
多裂肌	对照组	30	前测	101.79±5.03	108.100	< 0.001
			后测	-19.55±4.61
	试验组	30	前测	100.05±4.61	95.403	< 0.001
			后测	-27.07±3.90
	治疗前两组均值差			-1.74±6.20	1.397	0.168
	治疗后两组均值差			-7.52±6.70	6.821	< 0.001

Table 6

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Effect of respiratory training based on core stability training on feedforward control in patients with chronic nonspecific low back pain

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