运动疗法对康复治疗师职业性肌肉骨骼疾患的康复效果研究

发布时间：2019-02-16 06:43

【摘要】：目的采用运动疗法对患职业性肌肉骨骼疾患的康复治疗师进行干预,并评价运动疗法的康复效果,观察运动疗法对治疗师疼痛、肌肉力量及抗疲劳能力的影响,为治疗师职业性肌肉骨骼疾患的康复提供参考。方法选取唐山市60名颈肩和上背有职业性肌肉骨骼疾患的康复治疗师,采用随机数字表法随机分为对照组(n=30)与干预组(n=30)。对照组完成日常的工作后只单纯休息,无系统治疗;干预组完成日常工作后进行运动疗法的干预,干预项目包括:1准备活动,以低强度活动为主,包括两个小结:关节活动和肌肉牵伸;2力量和耐力练习,以中强度活动为主,每次干预20min,1次/天,5天/周,持续8周。两组均在试验前、四周后和八周后对颈部竖脊肌(CES)、斜方肌上部(UT)和斜方肌中部(MT)进行视觉模拟评分(VAS)和表面肌电(s EMG)信号的测定,运用美国DELSYS表面肌电图测试系统自带的分析软件Acq Knowledge4.1进行分析得出表面肌电最大自主收缩(MVC)、均方根(RMS)和平均频率(MF)的测定值。用重复测量方差分析对VAS、MVC、RMS和MF值进行统计学分析,时间因素和分组因素存在交互效应的进一步用多元方差分析做简单效应分析。结果1试验前对照组与干预组VAS、MVC、RMS和MF的比较,差异均无统计学意义(P0.05),试验前两组治疗师的疼痛程度、肌肉力量和抗疲劳能力均衡可比;四周后对照组与干预组只有颈部左侧的MVC和RMS,肩部右侧的RMS差异有统计学意义(P0.05),其余指标比较均无统计学意义(P0.05),运动疗法干预四周时干预组比对照组颈肩部肌肉力量明显增强,但疼痛程度无明显减轻,抗疲劳能力无明显提高;八周后对照组与干预组VAS、MVC、RMS和MF比较差异均有统计学意义(P0.05),干预组经八周运动疗法干预后,比对照组疼痛程度明显减轻、肌肉力量明显增强、抗疲劳能力也明显提高。2对照组VAS、MVC、RMS和MF在试验前、四周后和八周后三个时间点上的两两比较均无统计学意义(P0.05),对照组疼痛程度、肌肉力量和抗疲劳能力均无明显变化;而干预组VAS、MVC、RMS和MF在三个时间点上的两两比较均有统计学意义(P0.05),干预组四周后比干预前、八周后比干预前和八周后比四周后,疼痛程度明显减轻,肌肉力量明显增强,抗疲劳能力也明显提高。结论运动疗法干预能有效减轻治疗师疼痛、增强肌肉力量、提高抗疲劳能力,从而有效缓解职业性肌肉骨骼疾患的症状,且运动疗法干预八周比干预四周效果更好。
[Abstract]:Objective to observe the effects of exercise therapy on pain, muscle strength and anti-fatigue ability of occupational musculoskeletal diseases, and to evaluate the rehabilitation effect of exercise therapy. To provide a reference for the rehabilitation of occupational musculoskeletal disorders. Methods 60 rehabilitation therapists with occupational musculoskeletal diseases on neck, shoulder and upper back in Tangshan City were randomly divided into two groups: control group (n = 30) and intervention group (n = 30). In the control group, after completing the daily work, only rest, no systematic treatment; The intervention group carried on the intervention of exercise therapy after the completion of daily work. The intervention items included: 1 preparation activities, mainly low-intensity activities, including two small summaries: joint activity and muscle drafting; (2) strength and endurance exercises, mainly of moderate intensity activities, once a day, 5 days per week for 8 weeks. The visual analogue scores (VAS) and surface electromyography (s EMG) signals of the upper part of the (CES), trapezius muscle and (MT) of the middle trapezius muscle were measured before, four and eight weeks after the experiment in both groups. The root mean square (RMS) (RMS) and mean frequency (MF) of (MVC), with maximal spontaneous contraction of surface myography were obtained by using the software Acq Knowledge4.1, which is included in the DELSYS surface electromyogram testing system in the United States of America. The VAS,MVC,RMS and MF values were statistically analyzed by repeated measurement variance analysis, and the simple effect analysis was made by multivariate variance analysis when there was interaction between time factor and grouping factor. Results 1 there was no significant difference in VAS,MVC,RMS and MF between the control group and the intervention group before the trial (P0.05). The pain degree, muscle strength and anti-fatigue ability of the two groups were balanced before the trial. Four weeks later, the control group and the intervention group only left neck MVC and RMS, shoulder right RMS difference was statistically significant (P0.05), the other indicators were not statistically significant (P0.05). Compared with the control group, the muscle strength of neck and shoulder in the intervention group increased significantly after four weeks of exercise therapy, but the degree of pain was not obviously alleviated, and the ability of anti-fatigue was not obviously improved. After eight weeks, there were significant differences in VAS,MVC,RMS and MF between the control group and the intervention group (P0.05). After eight weeks exercise therapy, the pain degree and muscle strength in the intervention group were significantly reduced than those in the control group. The anti-fatigue ability of the control group was also significantly improved. 2There was no significant difference between VAS,MVC,RMS and MF in the control group at the three time points before, four and eight weeks after the experiment (P0.05), and the pain degree of the control group was not significant (P0.05). There was no significant change in muscle strength and anti-fatigue ability. There was significant difference between VAS,MVC,RMS and MF at three time points in intervention group (P0.05). The pain degree of intervention group was significantly reduced after four weeks than before, eight weeks after intervention and eight weeks after intervention. The muscle strength is obviously enhanced, and the anti-fatigue ability is also obviously improved. Conclusion exercise therapy intervention can effectively relieve pain, strengthen muscle strength, improve anti-fatigue ability, thus effectively alleviate the symptoms of occupational musculoskeletal diseases. The effect of exercise therapy intervention for eight weeks is better than that for four weeks.
【学位授予单位】：华北理工大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R49

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