悬吊推拿运动技术对老年腰椎间盘突出症患者恐动症效果的随机对照试验：基于脑-骨轴理论

doi:10.3969/j.issn.1006-9771.2024.07.016

Abstract

Abstract:

Objective To explore the effect of sling exercise with Tuina therapy on kinesiophobia in old patients with lumbar disc herniation, and analyze the mechanism based on brain-bone axis.
Methods A total of 56 old patients with chronic lumbar disc herniation and kinesiophobia were selected from the Rehabilitation Hospital of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine from September, 2022 to December, 2023; and randomly divided into control group (n = 28) and experimental group (n = 28). The control group accepted conventional exercise therapy, while the experimental group accepted sling exercise with Tuina therapy, for four weeks. They were assessed with simplified Chinese version of Tampa Scale of Kinesiophobia (TSK), Japanese Orthopaedic Association score (JOA) and Visual Analogue Scale for pain (VAS) before and after treatment, while the bone mineral density (BMD) was tested, the levels of osteoprotegerin (OPG), norepinephrine (NE) and corticosteroids (Cor) in serum were measured, and the median frequency (MF) of weak-link erector spinae was detected with surface electromyography.
Results Two cases dropped off in the control group, and one in the experimental group. The scores of all the assessment improved in both groups after treatment (|t| > 14.168, P < 0.001), as well as the serum levels of OPG, NE and Cor (|t| > 2.103, P < 0.05), BMD (|t| > 2.726, P < 0.05), and MF of erector spinae (|t| > 14.736, P < 0.001); all of them were better in the experimental group than in the control group (|t| > 2.154, P < 0.05).
Conclusion Sling exercise with Tuina therapy can improve the pain and kinesiophobia of lumbar disc herniation in the old adults, which may promote the recovery of physical and mental function through regulating the levels of hormones and neurotransmitters related to the brain-bone axis.

Key words: aged, lumbar disc herniation, kinesiophobia, sling exercise with Tuina therapy, brain-bone axis, randomized controlled trial

CLC Number:

R681.53

DAN Yuqin, SU Jianing, DING Yi, WANG Xueyan, XU Danghan, WANG Jinghua, WU Yujing, ZHANG Mengyuan, YIN Meng, LU Haifeng, YU Gongchang, LI Li. Effect of sling exercise with Tuina therapy on kinesiophobia in old patients with lumbar disc herniation: a randomized controlled trial based on concept of brain-bone axis[J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(7): 861-868.

Figures/Tables 2

Table 1

Table 2

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变量	组别	n	测试	$\bar{x}±s$	t值	P值
TSK评分	对照组	26	前测	51.43±5.02	14.168	< 0.001
			后测	29.13±5.39
	试验组	27	前测	53.78±4.86	22.485	< 0.001
			后测	24.63±4.27
	治疗前两组均值差			2.35±4.94	-1.725	0.091
	治疗后两组均值差			-4.50±4.92	3.368	0.001
JOA评分	对照组	26	前测	12.06±1.57	-20.853	< 0.001
			后测	20.14±1.28
	试验组	27	前测	12.93±1.84	-18.882	< 0.001
			后测	23.72±1.96
	治疗前两组均值差			0.87±1.72	-1.833	0.073
	治疗后两组均值差			3.58±1.72	-7.855	< 0.001
VAS评分	对照组	26	前测	6.12±0.89	15.975	< 0.001
			后测	2.34±0.62
	试验组	27	前测	6.28±0.94	23.006	< 0.001
			后测	2.07±0.18
	治疗前两组均值差			0.16±0.92	-0.674	0.504
	治疗后两组均值差			-0.27±0.55	2.154	0.036

项目	组别	n	测试	$\bar{x}±s$	t值	P值
骨密度/(g·cm^-2)	对照组	26	前测	0.54±0.06	-2.726	0.012
			后测	0.58±0.08
	试验组	27	前测	0.56±0.07	-3.858	0.001
			后测	0.66±0.09
	治疗前两组均值差			0.02±0.06	-1.505	0.139
	治疗后两组均值差			0.08±0.09	-3.180	0.003
OPG/(pg·mL^-1)	对照组	26	前测	2486.23±317.36	-2.507	0.019
			后测	2678.91±307.56
	试验组	27	前测	2480.58±322.19	-4.947	< 0.001
			后测	2857.54±310.68
	治疗前两组均值差			-5.65±319.80	0.064	0.949
	治疗后两组均值差			178.63±309.13	-2.103	0.040
NE/(ng·mL^-1)	对照组	26	前测	8.54±1.03	3.438	0.002
			后测	7.61±0.72
	试验组	27	前测	8.99±0.96	7.546	< 0.001
			后测	7.12±0.58
	治疗前两组均值差			0.45±0.10	-1.653	0.105
	治疗后两组均值差			-0.49±0.66	2.664	0.010
Cor/(ng·mL^-1)	对照组	26	前测	192.67±63.25	2.489	0.020
			后测	156.59±43.72
	试验组	27	前测	196.28±59.43	3.991	< 0.001
			后测	130.25±42.33
	治疗前两组均值差			3.61±61.43	-0.214	0.831
	治疗后两组均值差			-26.34±43.04	2.230	0.030
MF/Hz	对照组	26	前测	81.29±2.01	-14.736	< 0.001
			后测	92.07±3.16	-19.919	< 0.001
	试验组	27	前测	80.84±2.05
			后测	96.58±3.27
	治疗前两组均值差			-0.45±2.03	0.822	0.415
	治疗后两组均值差			4.51±3.22	-5.096	< 0.001

Effect of sling exercise with Tuina therapy on kinesiophobia in old patients with lumbar disc herniation: a randomized controlled trial based on concept of brain-bone axis

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[3]	SU Zhaoyin, KANG Weihan, LIU Yatao, LÜ Yuan, Michael NERLICH. Relationship between physical activity levels and stroke risk among middle-aged and older adults in China based on CHARLS data [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(4): 449-453.
[4]	LIU Xing, ZHOU Yumei, XU Huili, PENG Jianying, XIE Zheshu, XING Limin, ZHAO Jun. Structural equation model of influencing factors of anticipatory grief among main caregivers of young and middle-aged patients with severe stroke [J]. Chinese Journal of Rehabilitation Theory and Practice, 2024, 30(4): 454-461.
[5]	SHEN Xingxing, CHEN Weijian, LI Congcong, LI Junyi, WANG Shuai, YE Zixuan, XIANG Ruian, XU Xuemeng. Characteristics of paravertebral muscles in patients with unilateral lumbar disc herniation [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(9): 1098-1103.
[6]	WU Jiayu, MENG Detao, LIANG Xiaoxiao. Effect of physical activity levels on risk of Parkinson's disease: a cross-sectional analysis based on China Health and Retirement Longitudinal Study [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2023, 29(10): 1135-1139.
[7]	PENG Juan,WANG Jieping,HUANG Wei,FAN Bishuang,YU Jihua,ZENG Jin,HUANG Liheng,AN Lijuan,XU Fangyuan. Effects of threshold inspiratory muscle training on respiratory function, motor function and quality of life for patients with chronic obstructive pulmonary disease: a meta-analysis [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(9): 1022-1031.
[8]	XU Jinyan,ZHANG Qianqian,ZHANG Ying. Factors influencing satisfaction of rehabilitation services quality for older people purchased by government [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(6): 730-738.
[9]	XUAN Wenru,SHEN Yuqing,ZHOU Miao,FENG Shiwen. Bilingual training for cognition of older adults: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(5): 578-584.
[10]	LIU Xiaoyan,DING Xia,DONG Chen,LI Rong,SUN Chi. Status and related factors of fall among the elderly in community and hospital [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(4): 389-398.
[11]	ZHANG Pingping,ZHANG Ting,FENG Haiyang,LI Zhenrong,CHEN Ping,LI Tao,LU Dezhi,WANG Xiaowen. Investigation on dysphagia and aspiration among the elderly in nursing home in Weifang, Shandong, China [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(4): 467-472.
[12]	GE Zhangwei,HUANG Xin,LIU Zhengdong,ZHANG Min,ZHANG Jiakui. Factors related to post-operative delirium in middle-aged and elderly patients in intensive care unit and risk prediction model [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(3): 340-345.
[13]	SHI Haonan,XIE Ying,GUI Peijun,ZHANG Bo,CHEN Chen. Effect of cranial electrotherapy stimulation on mild cognitive impairment for older adults [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(3): 346-349.
[14]	ZHAO Kecong,ZHANG Baocui,FAN Jingyu,YANG Wei,WANG Xuehua,YUE Xiaoxin,CAO Yanyuan,CHEN Ruikun,LIU Siyu,MIN Hongwei. Effect of continuous nursing intervention on nursing quality and postoperative function in elderly patients after femoral intertrochanteric fracture [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(2): 170-174.
[15]	LAN Wencen,ZHANG Danxuan,WANG Bin. Benefits of dual-task intervention on balance function for healthy aged people: a systematic review [J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2022, 28(12): 1426-1434.