肌电生物反馈放松训练对下背痛伴疼痛灾难化患者的康复疗效观察
发布时间：2018-08-21 11:08
【摘要】：下背痛(low back pain,LBP)是以腰部疼痛为代表的一组症状群或症状综合征,患者表现为腰骶臀部疼痛,可伴有下肢放射痛症状。LBP在临床上十分常见,约80%的人在不同时期会出现LBP;LBP患者通常会不自主减少娱乐及健身活动,同时多数患者会出现一系列心理行为问题,如食欲减退、失眠、冷漠、工作能力下降等,对其工作、生活造成一定程度影响。慢性LBP的产生是生理学、心理学、社会学、经济学以及人口统计学等多种因素相互作用的结果,单一疗法往往治疗效果欠佳。而以往研究的LBP所发生的心理因素仅仅停留在情绪因素(焦虑和抑郁),并没有对认知因素做进一步的研究。近年欧美国家逐渐将疼痛灾难化作为疼痛心理学领域的研究重点,研究认为疼痛灾难化可明显的影响慢性疼痛患者的疼痛感受、心理状态、临床疗效及生活质量。因此对于伴有疼痛灾难化的LBP患者,进行心理康复的进一步研究具有重要的价值。本研究通过疼痛灾难化问卷(PCS)、疼痛VAS评分及Oswestry腰痛问卷(ODI)综合评估肌电生物反馈放松训练对LBP伴疼痛灾难化患者康复疗效的影响,为临床更合理应用心理康复手段辅助治疗LBP伴疼痛灾难化患者提供参考资料。目的:观察心理康复(肌电生物反馈放松训练)对下背痛伴疼痛灾难化患者康复治疗效果的影响。方法:1共选取2015年1月至2016年4月在承德医学院附属医院康复医学科就诊的LBP伴疼痛灾难化的患者50例。采用随机数字表法分为实验组(23例)、对照组(27例)。2实验组采用肌电生物反馈放松训练和心理疏导干预及常规康复治疗;对照组采用心理疏导干预和常规康复治疗。于治疗前、治疗14d后采疼痛灾难化问卷(PCS)、疼痛视觉模拟评分量表(VAS)及OSWESTRY(ODI)腰痛问卷对两组患者进行评定。结果:1肌电生物反馈放松训练对LBP伴疼痛灾难化患者PCS的影响PCS评分:治疗14d后发现两组患者PCS,实验组(22.74±3.74),对照组(27.67±3.15),均较治疗前改善(P0.05);实验组患者的改善幅度显著,与对照组差异具有统计学意义(P0.05)。2肌电生物反馈放松训练对LBP伴疼痛灾难化患者疼痛的影响疼痛VAS评分:治疗14d后发现两组患者疼痛VAS评分,实验组为(2.78±0.52)分,对照组为(3.48±0.64)分,均较治疗前改善(P0.05);实验组患者的改善幅度显著,与对照组差异具有统计学意义(P0.05)。3肌电生物反馈放松训练对LBP伴疼痛灾难化患者腰椎功能的影响治疗14d后发现两组患者ODI评分,实验组为(14.35±1.77)分,对照组为(18.81±4.22)分,均较治疗前改善(P0.05);实验组患者的改善幅度显著,与对照组差异具有统计学意义(P0.05)。结论:1肌电生物反馈放松训练能明显改善LBP患者的疼痛认知状态、疼痛程度及患者的腰椎功能。2本研究中,按两个阶段进行放松训练,第一阶段阈值导向的张力认知训练,第二阶段放松性下调训练。本研究结果证明此研究方法可靠、有效,并且可实施性强。3肌电生物反馈放松训练对下背痛伴疼痛灾难化的患者康复治疗效果有明显的意义,有必要进一步研究LBP与心理因素的临床相关性及其如何心理干预的研究,使LBP的治疗方法更系统化,以提高临床疗效。
[Abstract]:Low back pain (LBP) is a group of symptoms or symptomatic syndrome represented by lumbar pain. LBP is very common in clinic. About 80% of the people will have LBP in different periods. LBP patients usually reduce their recreational and fitness activities involuntarily, and most of the patients will have LBP. There will be a series of psychological and behavioral problems, such as loss of appetite, insomnia, apathy, decreased ability to work, and so on, which will affect their work and life to a certain extent. In recent years, European and American countries have gradually made painful catastrophe a research focus in the field of pain psychology. Research shows that painful catastrophe can significantly affect the pain feelings and psychology of patients with chronic pain. This study assessed the effects of EMG biofeedback relaxation training on LBP patients with catastrophic pain by means of PCS, VAS and Oswestry Low Back Pain Inventory (ODI). Objective: To observe the effect of psychological rehabilitation (EMG biofeedback relaxation training) on the rehabilitation of patients with LBP and catastrophic pain. Fifty patients with LBP accompanied by pain catastrophe were randomly divided into experimental group (23 cases) and control group (27 cases). 2 The experimental group was treated with EMG biofeedback relaxation training, psychological counseling intervention and routine rehabilitation therapy; the control group was treated with psychological counseling intervention and routine rehabilitation therapy. After 14 days of treatment, PCS, VAS and OSWESTRY were used to evaluate the effects of EMG biofeedback relaxation training on PCS in LBP patients with catastrophic pain. After 14 days of treatment, VAS score of pain was found in two groups, the experimental group was (2.78 + 0.52) score, and the control group was (3.48 + 0.52) score. After 14 days of treatment, the ODI scores of the two groups were (14.35 1.77) and (18.81 65 Conclusion: 1. EMG biofeedback relaxation training can significantly improve the pain cognition, pain degree and lumbar vertebral function of LBP patients. 2 In this study, relaxation training was carried out in two stages, the first stage. The results of this study show that this method is reliable, effective and practicable. 3 EMG biofeedback relaxation training has a significant effect on the rehabilitation of patients with low back pain and catastrophic pain. It is necessary to further study the clinical significance of LBP and psychological factors. The study of correlation and its psychological intervention has made LBP's treatment more systematic so as to improve its clinical efficacy.
【学位授予单位】：承德医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R493;R681.5
[Abstract]:Low back pain (LBP) is a group of symptoms or symptomatic syndrome represented by lumbar pain. LBP is very common in clinic. About 80% of the people will have LBP in different periods. LBP patients usually reduce their recreational and fitness activities involuntarily, and most of the patients will have LBP. There will be a series of psychological and behavioral problems, such as loss of appetite, insomnia, apathy, decreased ability to work, and so on, which will affect their work and life to a certain extent. In recent years, European and American countries have gradually made painful catastrophe a research focus in the field of pain psychology. Research shows that painful catastrophe can significantly affect the pain feelings and psychology of patients with chronic pain. This study assessed the effects of EMG biofeedback relaxation training on LBP patients with catastrophic pain by means of PCS, VAS and Oswestry Low Back Pain Inventory (ODI). Objective: To observe the effect of psychological rehabilitation (EMG biofeedback relaxation training) on the rehabilitation of patients with LBP and catastrophic pain. Fifty patients with LBP accompanied by pain catastrophe were randomly divided into experimental group (23 cases) and control group (27 cases). 2 The experimental group was treated with EMG biofeedback relaxation training, psychological counseling intervention and routine rehabilitation therapy; the control group was treated with psychological counseling intervention and routine rehabilitation therapy. After 14 days of treatment, PCS, VAS and OSWESTRY were used to evaluate the effects of EMG biofeedback relaxation training on PCS in LBP patients with catastrophic pain. After 14 days of treatment, VAS score of pain was found in two groups, the experimental group was (2.78 + 0.52) score, and the control group was (3.48 + 0.52) score. After 14 days of treatment, the ODI scores of the two groups were (14.35 1.77) and (18.81 65 Conclusion: 1. EMG biofeedback relaxation training can significantly improve the pain cognition, pain degree and lumbar vertebral function of LBP patients. 2 In this study, relaxation training was carried out in two stages, the first stage. The results of this study show that this method is reliable, effective and practicable. 3 EMG biofeedback relaxation training has a significant effect on the rehabilitation of patients with low back pain and catastrophic pain. It is necessary to further study the clinical significance of LBP and psychological factors. The study of correlation and its psychological intervention has made LBP's treatment more systematic so as to improve its clinical efficacy.
【学位授予单位】：承德医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R493;R681.5
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