本文選題：下腰痛 + 運動療法　； 參考：《中國人民解放軍軍事醫(yī)學(xué)科學(xué)院》2017年碩士論文

【摘要】：目的下腰痛是運動醫(yī)學(xué)及康復(fù)醫(yī)學(xué)中常見的脊柱疾病,也是我軍部隊官兵常見疾病,對軍人健康造成威脅,嚴重影響部隊戰(zhàn)斗力、官兵訓(xùn)練水平和生活質(zhì)量。運動療法是治療下腰痛最常用和最有效的方法之一,是現(xiàn)代臨床康復(fù)醫(yī)療的重要手段,但治療效果存在異議。本研究應(yīng)用徒手核心肌力訓(xùn)練和懸吊運動療法兩種運動療法對下腰痛患者實施干預(yù),分析和評價干預(yù)效果,以期為部隊下腰痛患者防治提供參考依據(jù)。方法按照下腰痛納入和排除標準,選擇空軍某場站2015年1月-2015年6月就診的符合條件的144例下腰痛官兵為研究對象,為保持職業(yè)均衡性,選取三種不同職業(yè)類型的下腰痛病例,包括空勤人員48例,地勤人員48例和其他保障人員48例。采用抽簽的方式將下腰痛病例隨機分為三組,第1組為徒手核心肌力組(徒手核心肌力訓(xùn)練+普通物理治療),第2組為懸吊運動療組(懸吊運動療法+普通物理治療),第3組為對照組(普通物理治療組),每組48例。按照試驗設(shè)計,通過對空軍某場站下腰痛患者應(yīng)用徒手核心力量訓(xùn)練及懸吊運動療法進行干預(yù),在干預(yù)前、干預(yù)2周、4周、6周后對三組病例發(fā)放調(diào)查問卷,通過問卷評分了解腰痛程度、腰椎功能狀況及活動度,同步測量三組病例的腰部肌力變化,收集并記錄每一個階段的資料。對所得結(jié)果進行分析比較,評價兩種運動療法對下腰痛患者干預(yù)效果。結(jié)果在干預(yù)過程中共有病例14例由于不良反應(yīng),退出干預(yù)試驗,占總數(shù)的9.72%,全程參與試驗的病例為130例,其中徒手核心肌力組43例,懸吊運動療法組43例,對照組44例。全程參與干預(yù)試驗的三組病例的平均年齡(F年齡=0.158,P=0.854)、體重(F體重=2.150,P=0.120)和疼痛時間(F腰痛時間=1.136,P=0.324)之間無顯著性差異(P0.05)。徒手核心肌力組和懸吊運動療法組評價指數(shù)中VAS評分(3.25 vs 3.30)、Roland評分(5.83vs5.93)、FFD評分(8.58vs8.10)無顯著性差異(P0.05),但均與對照組VAS評分(2.41)、Roland評分(3.03)和FFD評分(7.40)有顯著性差異(P0.05)。三組下腰痛干預(yù)有效率分別是90.90%、85.13%、46.82%。徒手核心肌力組與懸吊運動療法組組間的各項指標均無顯著性差異(P0.05),與對照組比較存在顯著性差異(P0.05)。干預(yù)治療結(jié)束后經(jīng)過為期3個月電話隨訪,徒手核心肌力組有7例復(fù)發(fā),懸吊運動療法組有9例復(fù)發(fā),對照組有14例復(fù)發(fā)。結(jié)論徒手核心肌力訓(xùn)練和懸吊運動療法對下腰痛病例均有明顯療效。建議部隊衛(wèi)生機構(gòu),可根據(jù)相應(yīng)的設(shè)施條件對下腰痛病例選用核心肌力訓(xùn)練或懸吊運動療法進行干預(yù),可有效緩解下腰痛癥狀和降低下腰痛發(fā)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.
【學(xué)位授予單位】：中國人民解放軍軍事醫(yī)學(xué)科學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R82

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