动态关节松动术联合核心稳定训练治疗非特异性下腰痛的疗效

doi:10.3969/j.issn.1006-5725.2024.18.016

Abstract

Abstract:

Objective To observe the clinical efficacy of dynamic joint mobilization combined with core stability training in the treatment of nonspecific low back pain. Methods 60 patients with nonspecific low back pain were randomly assigned into either the treatment group or control group. Each group had 30 patients. The treatment group received a therapeutic regimen combining dynamic joint mobilization and core stability training， while the control group only received core stability training. Both groups were evaluated for therapeutic effectiveness using the Visual Analogue Scale （VAS） for pain， the Oswestry Disability Index （ODI）， and the range of motion （ROM） of the lumbar spine before treatment， and at the 1st， 3rd， and 6th weeks after treatment. At the conclusion of the treatment， a thorough assessment of the overall therapeutic efficacy was performed. Results At the 1st， 3rd， and 6th weeks post-treatment， both groups showed statistically significant differences in VAS scores， ODI scores， and ROM scores over time （P < 0.05）. The improvements in these indices were significantly greater in the treatment group compared to the control group （P < 0.05）. The treatment group had considerably higher therapeutic effectiveness compared to the control group （P < 0.05）. Conclusions Dynamic joint mobilization combined with core stability training is effective in treating nonspecific low back pain. It can help with pain relief， lumbar and back function restoration， and lumbar and back mobility improvement. This approach is worthy of clinical application and promotion.

Key words: dynamic joint mobilization, core stability training, nonspecific low back pain

CLC Number:

R493

Lingling ZHU,Yanchun CHEN,Liang FANG,Chengyan CAI,Ting. LIU. Clinical effectiveness of dynamic joint mobilization combined with core stability training for nonspecific low back pain treatment[J]. The Journal of Practical Medicine, 2024, 40(18): 2602-2606.

Figures/Tables 4

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References 28

1	KNEZEVIC N N， CANDIDO K D， VLAEYEN J W S， et al. Low back pain［J］. Lancet，2021，398（10294）：78-92.
2	CHIAROTTO A， KOES B W. Nonspecific low back pain［J］. N Engl J Med，2022，386（18）：1732-1740.
3	HAYDEN J A， ELLIS J， OGILVIE R， et al. Exercise therapy for chronic low back pain［J］. Cochrane Database Syst Rev，2021，9（9）：CD009790.
4	NGUYEN C， BOUTRON I， ZEGARRA-PARODI R， et al. Effect of osteopathic manipulative treatment vs sham treatment on activity limitations in patients with nonspecific subacute and chronic low back pain： a randomized clinical trial［J］. JAMA Intern Med，2021，181（5）：620-630.
5	李继华，江华基，陈煜辉，等. 非特异性下腰痛对青少年生理功能影响及其医疗求助行为的调查研究［J］. 实用医学杂志，2019，35（13）：2166-2170.
6	POCOVI N C， DE CAMPOS T F， CHRISTINE LIN C W， et al. Walking， cycling， and swimming for nonspecific low back pain： A systematic review with meta-analysis［J］. J Orthop Sports Phys Ther，2022，52（2）：85-99.
7	TAGLIAFERRI S D， OWEN P J， MILLER C T， et al. Classifying Nonspecific Low Back Pain for Better Clinical Outcomes： Current Challenges and Paths Forward［J］. J Orthop Sports Phys Ther，2023，53（5）：239-243.
8	SHAH S， PRAKASH V. Limited evidence exists on determinants of physiotherapists' adherence to high value interventions in nonspecific low back pain management： A scoping review［J］. Musculoskeletal Care，2022，20（3）：442-453.
9	FERNÁNDEZ-CARNERO J， BELTRÁN-ALACREU H， ARRIBAS-ROMANO A， et al. Prediction of Patient Satisfaction after Treatment of Chronic Neck Pain with Mulligan’s Mobilization［J］. Life （Basel），2022，13（1）：48.
10	谢冰，肖乐，刘超，等. Mulligan动态关节松动术联合超短波及针灸治疗膝骨关节炎的临床疗效观察［J］. 中国康复，2023，38（11）：679-682.
11	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.
12	林秋水，吴晓东，王建喜，等. 经椎间盘阻滞治疗腰椎间盘突出症的疗效［J］. 实用医学杂志，2023，39（14）：1804-1808. doi:10.3969/j.issn.1006-5725.2023.14.013 doi: 10.3969/j.issn.1006-5725.2023.14.013
13	聂勇，朱俊琛，李迎春，等. 基于激痛点理论的针刀联合中药膏摩对胸背肌筋膜炎患者的影响及机制研究［J］. 实用医学杂志，2023，39（17）：2265-2270.
14	GONG C， DAI S， JIN B， et al. Comparison of Feng spinal mobilization with Maitland mobilization in management of chronic nonspecific low back pain： A cohort study［J］. Medicine （Baltimore），2023，102（7）：e32984.
15	BASTOS R M， MOYA C R， DE VASCONCELOS R A， et al. Treatment-based classification for low back pain： systematic review with meta-analysis［J］. J Man Manip Ther，2022，30（4）：207-227. doi:10.1080/10669817.2021.2024677 doi: 10.1080/10669817.2021.2024677
16	PSYCHARAKIS S G， COLEMAN S G S， LINTON L， et al. The WATER study： Which AquaTic ExeRcises increase muscle activity and limit pain for people with low back pain？［J］. Physiotherapy，2022，116：108-118.
17	TAGLIAFERRI S D， NG S K， FITZGIBBON B M， et al. Relative contributions of the nervous system， spinal tissue and psychosocial health to non‐specific low back pain： Multivariate meta‐analysis［J］. Eur J Pain，2022，26（3）：578-599. doi:10.1002/ejp.1883 doi: 10.1002/ejp.1883
18	CASHIN A G， WAND B M， O'CONNELL N E， et al. Pharmacological treatments for low back pain in adults： an overview of Cochrane Reviews［J］. Cochrane Database Syst Rev，2023，4（4）：CD013815. doi:10.1002/14651858.cd013815.pub2 doi: 10.1002/14651858.cd013815.pub2
19	ZHOU X， YANG J， MA Q Y， et al. The effectiveness of Tuina in managing chronic non-specific low back pain： A protocol of a multicenter international randomized controlled trial［J］. Medicine （Baltimore），2022，101（7）：e28883.
20	HUANG F， XIAO Z， ZHAN X， et al. Tuina combined with Adjuvant therapy for lumbar disc herniation： A network meta-analysis［J］. Complement Ther Clin Pract， 2022， 49：101627.
21	WIELAND L S， SKOETZ N， PILKINGTON K， et al. Yoga for chronic non‐specific low back pain［J］. Cochrane Database Syst Rev，2022，11（11）：CD010671.
22	LYTRAS D， IAKOVIDIS P， SYKARAS E， et al. Effects of a tailored mat-Pilates exercise program for older adults on pain， functioning， and balance in women with chronic non-specific low back pain： a randomized controlled trial［J］. Aging Clin Exp Res，2023，35（12）：3059-3071.
23	NYAYAPATI P， BOOKER J， WU P I， et al. Compensatory biomechanics and spinal loading during dynamic maneuvers in patients with chronic low back pain［J］. Eur Spine J，2022，31（7）：1889-1896.
24	BURAN ÇIRAK Y， YURDAIŞIK I， ELBAŞI N D， et al. Effect of sustained natural apophyseal glides on stiffness of lumbar stabilizer muscles in patients with nonspecific low back pain： randomized controlled trial［J］. J Manipulative Physiol Ther，2021，44（6）：445-454.
25	BHAT P V， PATEL V D， EAPEN C， et al. Myofascial release versus Mulligan sustained natural apophyseal glides′ immediate and short-term effects on pain， function， and mobility in non-specific low back pain［J］. Peer J，2021，9：e10706.
26	ZHENG F M， LI Z C， HUANG H J， et al. Home-based rehabilitation training with human key point detection for chronic low back pain patients： a randomized controlled trial protocol［J］. Trials，2023，24（1）：760.
27	ZOU C J， LI J H， WU F C， et al. The effects of core stability training in nurses with nonspecific low back pain［J］. Medicine （Baltimore），2021，100（25）：e26357. doi:10.1097/md.0000000000026357 doi: 10.1097/md.0000000000026357
28	HLAING S S， PUNTUMETAKUL R， KHINE E E， et al. Effects of core stabilization exercise and strengthening exercise on proprioception， balance， muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain： a randomized controlled trial［J］. BMC Musculoskelet Disord，2021，22（1）：998.

组别	治疗前	1周	3周	6周	F值	P值
观察组	5.23 ± 0.43	3.60 ± 0.50^*	2.20 ± 0.61^*#	1.07 ± 0.52^*#△	348.14	< 0.001
对照组	5.37 ± 0.49	4.13 ± 0.43^*	3.17 ± 0.46^*#	2.10 ± 0.31^*#△	216.40	< 0.001
F值	1.25	19.54	47.92	87.91
P值	0.27	< 0.001	< 0.001	< 0.001

组别	治疗前	1周	3周	6周	F值	P值
观察组	37.47 ± 1.50	26.67 ± 1.60^*	16.10 ± 1.81^*#	10.57 ± 1.45^*#△	3 171.89	< 0.001
对照组	37.20 ± 1.42	30.27 ± 1.46^*	24.53 ± 1.61^*#	18.13 ± 0.97^*#△	1 601.34	< 0.001
F值	0.50	82.58	363.62	560.73
P值	0.48	< 0.001	< 0.001	< 0.001

组别	治疗前	1周	3周	6周	F值	P值
观察组	51.73 ± 3.94	36.87 ± 3.68^*	27.20 ± 3.36^*#	19.80 ± 3.75^*#△	444.26	< 0.001
对照组	51.13 ± 4.22	43.67 ± 4.39^*	35.57 ± 4.05^*#	29.83 ± 3.64^*#△	239.41	< 0.001
F值	0.32	42.25	75.92	110.45
P值	0.57	< 0.001	< 0.001	< 0.001

疗效评价	观察组（n = 30）	对照组（n = 30）
优	20	7
良	8	16
可	2	5
差	0	2
Z值	3.36
P值	< 0.001

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Clinical effectiveness of dynamic joint mobilization combined with core stability training for nonspecific low back pain treatment

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