中国组织工程研究

中国组织工程研究 ›› 2022, Vol. 26 ›› Issue (18): 2894-2899.doi: 10.12307/2022.700

• 骨科植入物相关临床实践 Clinical practice of orthopedic implant • 上一篇    下一篇

深层肌肉刺激慢性非特异性腰痛患者腰肌表面肌电变化与 步态时空及动力学的参数变化

陈  进1，2，李加斌2，顾铭星2，唐  蓉1，陆建霞1   

  1. 1江苏医药职业学院，江苏省盐城市   224000；2盐城市第一人民医院康复医学科，江苏省盐城市   224000
  • 收稿日期:2021-08-24 接受日期:2021-10-11 出版日期:2022-06-28 发布日期:2022-01-30
  • 通讯作者: 陆建霞，硕士，副教授，江苏医药职业学院，江苏省盐城市 224000
  • 作者简介:陈进，女，汉族，1989年生，江苏省盐城市人，在读硕士，主管治疗师，主要从事康复治疗技术研究。
  • 基金资助:
    江苏医药职业学院双高建设资助项目，项目负责人：陆建霞；江苏省教育科学“十三五”规划2020年度课题(D2020/03/15)，项目负责人：陆建霞

Effect of deep muscle stimulation on psoas surface electromyography and spatiotemporal and kinetic gait parameters in patients with chronic non-specific low back pain

Chen Jin1, 2, Li Jiabin2, Gu Mingxing2, Tang Rong1, Lu Jianxia1   

  1. 1Jiangsu Vocational College of Medicine, Yancheng 224000, Jiangsu Province, China; 2Department of Rehabilitation Medicine, Yancheng No. 1 People’s Hospital, Yancheng 224000, Jiangsu Province, China
  • Received:2021-08-24 Accepted:2021-10-11 Online:2022-06-28 Published:2022-01-30
  • Contact: Lu Jianxia, Master, Associate professor, Jiangsu Vocational College of Medicine, Yancheng 224000, Jiangsu Province, China
  • About author:Chen Jin, Master candidate, Therapist in charge, Jiangsu Vocational College of Medicine, Yancheng 224000, Jiangsu Province, China; Department of Rehabilitation Medicine, Yancheng No. 1 People’s Hospital, Yancheng 224000, Jiangsu Province, China
  • Supported by:
    Double High Construction Fund of Jiangsu Vocational College of Medicine (to LJX); the 13th Five-Year Plan of Jiangsu Provincial Education and Science in 2020, No. D2020/03/15 (to LJX)

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摘要：

文题释义：
慢性非特异性腰痛：是临床十分常见的慢性疼痛性疾病，据报道，70%-85%的成年人一生中有腰疼经历，对其工作和生活质量造成严重影响。
深层肌肉刺激疗法：以深层肌肉刺激特定频率的机械振动直接作用于肌筋膜触发点，刺激较强，作用深厚，同时振动波可使肌肉内毛细血管开放，促进局部血液循环，供给痛点肌肉组织足够的营养成分，能促进淋巴回流，有助于水肿吸收，消除神经根水肿，进一步促进局部疼痛物质吸收，短时间内可有效缓解疼痛。

背景：深层肌肉刺激疗法是一种局部振动疗法，可有效缓解因牵拉或劳累所致损伤、乳酸堆积，或筋膜粘连造成的疼痛和功能受限，但其对慢性非特异性腰痛作用的研究报道相对不足。
目的：探讨深层肌肉刺激疗法对慢性非特异性腰痛患者腰肌表面肌电变化、步态时空与动力学参数特征的影响。
方法：选取2019年2月至2020年6月在盐城市第一人民医院就诊的102例慢性非特异性腰痛患者作为研究对象，采用随机单盲对照试验设计，按随机数字表法分为2组，各51例。对照组予以传统腰椎节段稳定性训练，观察组在传统腰椎节段稳定性训练基础上，给予深层肌肉刺激疗法。统计两组临床疗效、治疗前及治疗1，6个月疼痛程度、腰椎功能、腰肌表面肌电变化、步态时空与动力学参数特征、生活质量及不良反应。
结果与结论：观察组总有效率(96%)高于对照组(82%)(P < 0.05)，观察组治疗1，6个月后目测类比评分均低于对照组(P < 0.05)，多裂肌、回旋肌前屈60°、外展90°、后伸45°时最大肌电值明显高于对照组(P < 0.05)，步长对称指数、足偏角对称指数、站立相对指数、初始双支撑垂直地面反作用力、单支撑相垂直地面反作用力、终末双支撑垂直地面反作用力均低于对照组(P < 0.05)，Oswestry功能障碍指数低于对照组(P < 0.05)，SF-36评分高于对照组(P < 0.05)；观察组和对照组不良反应发生率分别为3.9%(2/51)，5.9%(3/51)，差异无显著性意义(P﹥0.05)。结果表明，深层肌肉刺激疗法有助于减轻慢性非特异性腰痛患者的疼痛，恢复腰椎功能并改善步态。

https://orcid.org/0000-0002-4081-2535 (陈进) 

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 深层肌肉刺激疗法, 慢性非特异性腰痛, 腰肌表面肌电, 腰椎功能, 疼痛程度

Abstract: BACKGROUND: As a local vibration therapy, deep muscle stimulation therapy can effectively relieve the pain and functional limitation caused by traction or fatigue, lactic acid accumulation, or fascia adhesion. However, less is reported on its effect on chronic non-specific low back pain.  
OBJECTIVE: To investigate the effect of deep muscle stimulation therapy on the changes of psoas surface electromyography as well as spatiotemporal and kinetic gait parameters in patients with chronic non-specific low back pain.
METHODS:  This was a single-blind randomized controlled trial. A total of 102 patients with chronic non-specific low back pain admitted to Yancheng No. 1 People’s Hospital from February 2019 to June 2020 were enrolled and randomly divided into two groups (n=51 per group): a control group and an observation group. Patients in the control group received a traditional lumbar stabilization exercise, and patients in the observation group received deep muscle stimulation therapy based on the lumbar stabilization exercise. Clinical efficacy, pain degree, lumbar spine function, psoas surface electromyography changes, spatiotemporal and kinetic gait parameters, quality of life, and adverse reactions were statistically analyzed before treatment, 1 and 6 months after treatment.  
RESULTS AND CONCLUSION: The overall efficiency of the observation group (96%) was higher than that of the control group (82%; P < 0.05). After 1 and 6 months of treatment, the visual analog scale scores of the observation group were lower than those of the control group (P < 0.05). The maximal electromyographic value of the multifidus and musculi rotatores at 60° anteflexion, 90° abduction, and 45° extension was significantly higher in the observation group than the control group (P < 0.05). The step length symmetry index, foot deflection angle symmetry index, standing relative index, initial double support vertical ground reaction force, single support phase vertical ground reaction force, and terminal double support vertical ground reaction force were lower in the observation group than the control group (P < 0.05). Compared with the control group, the Oswestry dysfunction index was lower (P < 0.05), and the SF-36 score was higher in the observation group (P < 0.05). The incidence of adverse reactions in the observation group and control group were 3.9% (2/51) and 5.9% (3/51), respectively, and there was no significant difference (P > 0.05). To conclude, deep muscle stimulation therapy can relieve pain, restore lumbar function and improve gait in patients with chronic non-specific low back pain.

Key words: deep muscle stimulation therapy, chronic non-specific low back pain, psoas surface electromyography, lumbar function, pain degree

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