本文選題：核心肌群穩(wěn)定訓(xùn)練 + 腰椎術(shù)后綜合征��； 參考：《福建中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:通過對(duì)比腰椎術(shù)后綜合征患者堅(jiān)持核心肌群穩(wěn)定訓(xùn)練時(shí)間長(zhǎng)度的不同對(duì)患者功能康復(fù)的影響,明確核心肌群穩(wěn)定訓(xùn)練法獲得明顯臨床療效的時(shí)間,探討長(zhǎng)期堅(jiān)持核心肌群穩(wěn)定訓(xùn)練的必要性,為腰椎術(shù)后綜合征患者康復(fù)計(jì)劃的制定提供參考。方法:來源于2015年6月-2015年12月期間來我院骨科門診患者,曾因診斷為"腰椎間盤突出癥",并明確為行腰椎減壓融合內(nèi)固定術(shù)治療出院后出現(xiàn)腰椎術(shù)后綜合征病例60例,隨機(jī)分成三組:3個(gè)月組(始堅(jiān)持規(guī)范的核心肌群穩(wěn)定訓(xùn)練3個(gè)月)20例;6個(gè)月組(堅(jiān)持規(guī)范的核心肌群穩(wěn)定訓(xùn)練6個(gè)月)20例;1年組(堅(jiān)持規(guī)范的核心肌群穩(wěn)定訓(xùn)練1年)20例。以參加訓(xùn)練前及末次隨訪兩個(gè)時(shí)間段進(jìn)行腰椎不穩(wěn)調(diào)查問卷及腰椎MRI檢查,及使用PACS軟件測(cè)量病變節(jié)段多裂肌的橫截面積,記錄患者多裂肌面積變化率。以訓(xùn)練前、訓(xùn)練后3個(gè)月、6個(gè)月及1年四個(gè)時(shí)間段進(jìn)行VAS評(píng)分、ODI評(píng)分收集并拍攝腰椎過伸過屈X片。結(jié)果:全部符合納入標(biāo)準(zhǔn)并完成1年隨訪時(shí)間的患者訓(xùn)練前的病程、年齡、體重等基本資料無差異。三組患者訓(xùn)練前VAS評(píng)分、腰椎不穩(wěn)前期癥狀問卷調(diào)查、ODI評(píng)分不存在明顯統(tǒng)計(jì)學(xué)差異(P0.05),末次隨訪時(shí)所有患者進(jìn)行VAS評(píng)分、腰椎不穩(wěn)前期癥狀問卷調(diào)查、ODI評(píng)分存在明顯統(tǒng)計(jì)學(xué)差異(P0.05)。訓(xùn)練后與訓(xùn)練前比較VAS評(píng)分、ODI評(píng)分都有明顯下降。3個(gè)月組停止核心肌群穩(wěn)定訓(xùn)練后VAS評(píng)分、ODI評(píng)分未見明顯改善,與另外兩組比較都有明顯差異(P0.05);訓(xùn)練6個(gè)月組較訓(xùn)練3個(gè)月組停止核心肌群穩(wěn)定訓(xùn)練后VAS評(píng)分、ODI評(píng)分具有下降趨勢(shì);1年與組與訓(xùn)練6個(gè)月組在1年的時(shí)間段VAS評(píng)分、ODI評(píng)分比較有差異(P0.05)。三組患者在訓(xùn)練前3個(gè)月、6個(gè)月、1年四個(gè)時(shí)間段均無影像學(xué)上的腰椎不穩(wěn)情況。三組患者多裂肌面積變化率不同,其中3個(gè)月組多裂肌面積增加最少,6個(gè)月組次之,1年組增加最多。三組患者的腰椎不穩(wěn)前期癥狀調(diào)查結(jié)果明顯地具有統(tǒng)計(jì)學(xué)差異(P0.05),3個(gè)月組訴有腰椎不穩(wěn)前期癥狀的患者人數(shù)最多。結(jié)論:1.腰椎術(shù)后綜合征患者堅(jiān)持3個(gè)月規(guī)范的核心肌群穩(wěn)定訓(xùn)練可有效緩解病情;2.腰椎術(shù)后綜合征患者堅(jiān)持1年的核心肌群穩(wěn)定訓(xùn)練對(duì)于臨床癥狀的改善具有持續(xù)效果;3.腰椎術(shù)后綜合征患者長(zhǎng)期堅(jiān)持規(guī)律的核心肌群穩(wěn)定訓(xùn)練是必要的,對(duì)于遠(yuǎn)期腰椎不穩(wěn)定的預(yù)防具有一定意義。
[Abstract]:Objective: to compare the effects of different duration of core muscle stabilization training on functional rehabilitation in patients with lumbar postoperative syndrome, and to determine the time of clinical effect of core muscle stabilization training. To explore the necessity of long-term stable training of core muscle group and to provide reference for the establishment of rehabilitation plan for patients with lumbar postoperative syndrome. Methods: from June 2015 to December 2015, 60 cases of lumbar postoperative syndrome were treated with lumbar decompression and fusion internal fixation because of the diagnosis of lumbar disc herniation. They were randomly divided into three groups: 3-month group (3-month group), 6-month group (6-month group) and 1-year group (1-year group). The lumbar spine instability questionnaire and lumbar MRI examination were performed before and at the last follow-up period, and the cross sectional area of the diseased segmental polyfissure muscle was measured by PACS software to record the change rate of the area of the patient's polyfissure muscle. VAS score and ODI score were collected before, 3 months, 6 months and 1 year after training. Results: there was no significant difference in course, age and body weight of all patients who met the inclusion criteria and completed 1 year follow-up. There was no significant difference in VAS score before training and ODI score in pre-unstable lumbar spine symptom questionnaire (P0.05), but VAS score in all patients at the last follow-up, and ODI score in pre-unstable lumbar spine symptom questionnaire (P0.05). VAS scores and ODI scores were significantly decreased after training compared with those before training, but VAS scores and ODI scores did not improve significantly after 3 months of steady training of core muscle groups, and no significant improvement was found in the scores of VAS scores and ODI scores after training. Compared with the other two groups, the VAS scores and ODI scores in the 6-month group decreased compared with those in the 3-month group, and the VAS scores in the 1-year and 6-month groups were evaluated in one year. The score of ODI was different (P0.05). Three groups of patients had no imaging instability in 3 months, 6 months, 1 year and 4 periods before training. The change rate of polyfissure muscle area in the three groups was different. The polyfissure area increased the least in 3 months group, the second in 6 months group, and the most in 1 year group. The results of investigation on the pre-instability symptoms of lumbar vertebrae in the three groups were significantly different (P0.05). The most patients in the 3-month group complained of pre-instability symptoms of lumbar vertebrae. Conclusion 1. Patients with lumbar postoperative syndrome can be effectively relieved by 3 months standard core muscle stability training. One year of core muscle stability training in patients with lumbar postoperative syndrome has a lasting effect on the improvement of clinical symptoms. It is necessary for the patients with lumbar postoperative syndrome to persist in regular training of core muscle group, which is of significance for the prevention of long term lumbar vertebrae instability.
【學(xué)位授予單位】：福建中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R687.3

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 賈杰海;喬晉琳;丁宇;張靜;付本升;崔洪鵬;向東東;杜薇;;射頻等離子體針刀聯(lián)合臭氧治療腰椎術(shù)后綜合征的臨床觀察[J];中國(guó)中醫(yī)急癥;2016年04期

2 肖偉;孫俊剛;王浩;袁宏;;腰椎術(shù)后并發(fā)腰椎術(shù)后綜合征與手術(shù)原因的相關(guān)分析[J];中國(guó)骨與關(guān)節(jié)損傷雜志;2015年05期

3 嚴(yán)清;鮑海星;;經(jīng)椎間孔入路腰椎間融合術(shù)(TLIF)治療腰椎術(shù)后綜合征療效分析[J];頸腰痛雜志;2014年05期

4 李小金;韓秀蘭;成守珍;;下肢生物力學(xué)矯正聯(lián)合脊柱區(qū)核心肌群訓(xùn)練治療慢性非特異性下腰痛[J];中國(guó)骨科臨床與基礎(chǔ)研究雜志;2014年04期

5 孔勝建;代新年;閆瑋娟;;銀質(zhì)針療法聯(lián)合核心肌群訓(xùn)練治療軍事訓(xùn)練性下腰痛的療效分析[J];中國(guó)療養(yǎng)醫(yī)學(xué);2014年06期

6 熊國(guó)才;羅健;葉立漢;董洪伶;鄧振興;;核心肌群穩(wěn)定性訓(xùn)練治療40例慢性腰痛患者的臨床研究[J];中國(guó)民族民間醫(yī)藥;2014年12期

7 溫優(yōu)良;李智;鄧衛(wèi)兵;梁興森;;骶管注射配合核心肌群穩(wěn)定性訓(xùn)練治療老年腰椎間盤突出癥的療效觀察[J];中國(guó)全科醫(yī)學(xué);2014年18期

8 王志明;楊雄健;劉永恒;吳俊哲;陳敢峰;;腰椎術(shù)后綜合征的原因探析及舒脊方的臨床療效觀察[J];四川中醫(yī);2014年06期

9 鐘燕彪;徐海珊;李建華;;不同病程腰椎間盤突出癥患者腰部多裂肌橫截面面積研究[J];全科醫(yī)學(xué)臨床與教育;2014年03期

10 耿笑微;孫垂國(guó);;腰椎固定融合術(shù)后患者居家康復(fù)運(yùn)動(dòng)與術(shù)后癥狀改善的相關(guān)性研究[J];中國(guó)康復(fù)醫(yī)學(xué)雜志;2014年01期

相關(guān)會(huì)議論文 前1條

1 胡志軍;范順武;方向前;趙鳳東;;單側(cè)腰痛病例腰椎多裂肌萎縮的相關(guān)因素研究[A];2009年浙江省骨科學(xué)學(xué)術(shù)年會(huì)論文匯編[C];2009年

，

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