运动疗法对部队下腰痛病例的干预效果评价

发布时间：2018-05-18 23:14

本文选题：下腰痛 + 运动疗法　；参考：《中国人民解放军军事医学科学院》2017年硕士论文

【摘要】：目的下腰痛是运动医学及康复医学中常见的脊柱疾病,也是我军部队官兵常见疾病,对军人健康造成威胁,严重影响部队战斗力、官兵训练水平和生活质量。运动疗法是治疗下腰痛最常用和最有效的方法之一,是现代临床康复医疗的重要手段,但治疗效果存在异议。本研究应用徒手核心肌力训练和悬吊运动疗法两种运动疗法对下腰痛患者实施干预,分析和评价干预效果,以期为部队下腰痛患者防治提供参考依据。方法按照下腰痛纳入和排除标准,选择空军某场站2015年1月-2015年6月就诊的符合条件的144例下腰痛官兵为研究对象,为保持职业均衡性,选取三种不同职业类型的下腰痛病例,包括空勤人员48例,地勤人员48例和其他保障人员48例。采用抽签的方式将下腰痛病例随机分为三组,第1组为徒手核心肌力组(徒手核心肌力训练+普通物理治疗),第2组为悬吊运动疗组(悬吊运动疗法+普通物理治疗),第3组为对照组(普通物理治疗组),每组48例。按照试验设计,通过对空军某场站下腰痛患者应用徒手核心力量训练及悬吊运动疗法进行干预,在干预前、干预2周、4周、6周后对三组病例发放调查问卷,通过问卷评分了解腰痛程度、腰椎功能状况及活动度,同步测量三组病例的腰部肌力变化,收集并记录每一个阶段的资料。对所得结果进行分析比较,评价两种运动疗法对下腰痛患者干预效果。结果在干预过程中共有病例14例由于不良反应,退出干预试验,占总数的9.72%,全程参与试验的病例为130例,其中徒手核心肌力组43例,悬吊运动疗法组43例,对照组44例。全程参与干预试验的三组病例的平均年龄(F年龄=0.158,P=0.854)、体重(F体重=2.150,P=0.120)和疼痛时间(F腰痛时间=1.136,P=0.324)之间无显著性差异(P0.05)。徒手核心肌力组和悬吊运动疗法组评价指数中VAS评分(3.25 vs 3.30)、Roland评分(5.83vs5.93)、FFD评分(8.58vs8.10)无显著性差异(P0.05),但均与对照组VAS评分(2.41)、Roland评分(3.03)和FFD评分(7.40)有显著性差异(P0.05)。三组下腰痛干预有效率分别是90.90%、85.13%、46.82%。徒手核心肌力组与悬吊运动疗法组组间的各项指标均无显著性差异(P0.05),与对照组比较存在显著性差异(P0.05)。干预治疗结束后经过为期3个月电话随访,徒手核心肌力组有7例复发,悬吊运动疗法组有9例复发,对照组有14例复发。结论徒手核心肌力训练和悬吊运动疗法对下腰痛病例均有明显疗效。建议部队卫生机构,可根据相应的设施条件对下腰痛病例选用核心肌力训练或悬吊运动疗法进行干预,可有效缓解下腰痛症状和降低下腰痛发生率。
[Abstract]:Objective low back pain (LBP) is a common spinal disease in sports medicine and rehabilitation medicine. It is also a common disease of our army officers and soldiers. It is a threat to the health of soldiers and seriously affects the combat effectiveness, training level and quality of life of officers and soldiers. Exercise therapy is one of the most common and effective methods in the treatment of low back pain. In this study, two kinds of exercise therapy, bare-handed core muscle strength training and suspension exercise therapy, were applied to the patients with low back pain, and the intervention effect was analyzed and evaluated, in order to provide reference for the prevention and treatment of low back pain patients in the army. Methods according to the criteria of inclusion and exclusion of low back pain, 144 eligible low back pain officers and soldiers from a certain air force station from January 2015 to June 2015 were selected as the study objects. In order to maintain occupational balance, three low back pain cases of different occupational types were selected. Including aircrew 48, ground crew 48 and other support staff 48. The patients with low back pain were randomly divided into three groups by drawing lots. The first group was the unarmed core muscle strength group, the second group was the suspension exercise therapy group (general physical therapy group), the third group was the control group (general physical therapy group, 48 cases in each group). According to the experimental design, the patients with low back pain at a certain air force station were treated with unarmed core strength training and suspension exercise therapy. Before the intervention, 2 weeks and 4 weeks and 6 weeks after the intervention, questionnaires were given to the three groups of patients. The degree of low back pain, the function of lumbar vertebrae and the activity of lumbar vertebrae were evaluated by questionnaire. The changes of lumbar muscle strength were measured simultaneously, and the data of each stage were collected and recorded. The results were analyzed and compared to evaluate the effect of two kinds of exercise therapy on patients with low back pain. Results during the course of intervention, 14 cases withdrew from the intervention test due to adverse reactions, accounting for 9.72% of the total. 130 cases were involved in the whole process, including 43 cases in the unarmed core muscle strength group, 43 cases in the suspension exercise therapy group and 44 cases in the control group. There was no significant difference in the mean age of the three groups (P < 0. 158, P < 0. 054, P = 2. 150, P = 0. 120) and pain time (1. 136 / P, P = 0. 324). There was no significant difference between the three groups (P = 0. 05, P = 0. 05, P = 0. 05, P = 0. 05, P = 0. 05, P = 0. 05, P = 0. 05, P = 0. 05). There was no significant difference in the VAS score between the bare hand core muscle strength group and the suspension exercise therapy group (P 0.05), but there was no significant difference in the VAS score between the control group and the control group (P 0.05), but there was a significant difference between the two groups (P 0.05) and the FFD score was 7.40 (P < 0.05), but there was no significant difference in the evaluation index between the control group and the suspensory exercise therapy group (P < 0.05), but there was no significant difference in the evaluation index between the control group and the control group (P = 3.25 vs 3.30 vs 5.83 vs 5.93 vs 8.58 vs 8.10). The effective rate of low back pain intervention in the three groups was 90.90 and 85.132.It was 46.82. There was no significant difference in the indexes between the unarmed core muscle strength group and the suspension exercise therapy group (P 0.05), but there was a significant difference between the control group and the control group (P 0.05). After 3 months' telephone follow-up after the intervention treatment, 7 cases recurred in the unarmed core muscle strength group, 9 cases in the suspension exercise therapy group and 14 cases in the control group. Conclusion No-hand core muscle strength training and suspension exercise therapy are effective for low back pain cases. It is suggested that military health institutions may choose core muscle strength training or suspension exercise therapy according to the corresponding facility conditions, which can effectively alleviate the symptoms of low back pain and reduce the incidence of low back pain.
【学位授予单位】：中国人民解放军军事医学科学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R82

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