宋鹏飞,封盼盼,孙武东,等.筋膜手法和核心稳定性训练对老年非特异性下背痛的影响[J].中华物理医学与康复杂志,2026,48(6):531-539
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| 筋膜手法和核心稳定性训练对老年非特异性下背痛的影响 |
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| DOI：10.3760/cma.j.cn421666-20240625-00507 |
| 中文关键词: 非特异性下背痛 核心稳定性训练 筋膜手法 联合治疗 |
| 英文关键词: Low back pain Core stability exercise Fascia manipulation Combined therapy |
| 基金项目:南京市体育局2022年度体育科研局管课题(NO.NJTY2022-103) |
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| 中文摘要: |
| 目的 观察核心稳定性训练和筋膜手法对老年非特异性下背痛的影响。 方法 选取符合纳入和排除标准的慢性非特异性下背痛（NSLBP）老年人97例，按随机数字表法将其分为3组。核心稳定性训练组（33例）行核心稳定性训练，每次25 min，隔日1次，每周3次，持续12周；筋膜手法组（32例）行筋膜手法治疗，每次25 min，每周1次，持续12周；联合治疗组（32例）行核心稳定性训练和筋膜手法联合治疗，每周1次筋膜手法和同日核心稳定性训练，其余时段单独开展核心稳定性训练，每周3次，单次总时长25～50 min，持续12周。治疗前和治疗12周后，采用视觉模拟量表（VAS）、疼痛压力阈值（PPT）和Oswestry功能障碍指数（ODI）对受试者的身体功能和生活质量进行评估。 结果 治疗前，3组各指标差异无统计学意义（P>0.05）。治疗后，3组VAS评分、PPT（L3、L5、TA）、腰背肌耐力及ODI均较治疗前显著改善（P<0.05）。组间比较显示： 3组受试者PPT值组间差异无统计学意义（P>0.05）；联合治疗组VAS评分和ODI显著低于核心稳定性训练组和筋膜手法组（P<0.05）；核心稳定性训练组与联合治疗组腰背肌耐力显著高于筋膜手法治疗组（P<0.05）。重复测量方差分析显示，VAS、腰背肌耐力、ODI的时间×组别交互效应显著（P<0.05），而PPT各部位交互效应不显著（P>0.05）。变化率分析显示，C组VAS（53.9%）、腰背肌耐力（72.2%）、ODI（51.8%）及PPT各部位（20.0%~21.2%）的改善幅度最大。 结论 筋膜手法和核心稳定性训练均能有效改善NSLBP老年人的功能和生活质量，且联合治疗的效果更为显著，值得临床推广应用。 |
| 英文摘要: |
| Objective To observe any effect of combining core stability exercise with fascia manipulation on non-specific low back pain in elderly individuals. Methods Ninety-seven elderly persons with chronic but non-specific low back pain were divided at random into a core stability exercise group (33 patients) who did 25min of core stability exercises three times per week for 12 weeks, a fascia manipulation group (32 patients) who received one weekly 25min session of fascia manipulation for 12 weeks, and a combination group (32 patients) who received fascia manipulation and did the core stability exercises on the same day once a week, then did only the core stability exercises at the other two weekly sessions. Before and after the experiment, all were assessed for physical functioning and quality of life using a visual analog scale (VAS), pressure pain thresholds (PPTs), and the Oswestry Disability Index (ODI). Results There were no significant differences among the three groups before the experiment. Afterward, the average VAS scores, PPT (L3, L5, TA), lumbar extensor endurance, and ODI had improved significantly in all 3 groups. There was then no significant difference in average PPT among the three groups, but the combination group′s average VAS score and ODI were significantly lower than those of the other two groups. The average lumbar extensor endurance in the exercise and combined groups was significantly higher than in the fascia manipulation group. And repeated-measures analysis of variance revealed significant time × group interaction effects for VAS, lumbar extensor endurance, and ODI, though not for PPT at any site. The combined group achieved the largest improvements in VAS (53.9% on average), lumbar extensor endurance (72.2%), ODI (51.8%), and PPT (20.0%-21.2%). Conclusions Fascia manipulation can effectively improve the physical functioning and life quality of elderly persons with non-specific low back pain, but combining it with core stability exercise yields even better results. This is worthy of clinical application. |
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