【摘要】：目的:開發(fā)坦克乘員腰痛的運(yùn)動(dòng)療法,并行初步療效評(píng)價(jià)。方法:觀察于2005-01/08在西北高寒區(qū)某坦克部隊(duì)駐地完成。由專科醫(yī)生詢問病史、體檢,選擇該師男性現(xiàn)役全訓(xùn)坦克乘員128人,均自愿參加觀察。隨機(jī)分為3組,低強(qiáng)度運(yùn)動(dòng)治療組43人,強(qiáng)度遞增運(yùn)動(dòng)治療組43人,對(duì)照組42人。設(shè)計(jì)運(yùn)動(dòng)治療8步法,即箭步屈髖、直腿抬高、膝胸運(yùn)動(dòng)、頸肩提升、提髖抬背、屈背運(yùn)動(dòng)、俯臥伸背及挺胸伸髖。聯(lián)系坦克乘員實(shí)際,低強(qiáng)度、強(qiáng)度遞增運(yùn)動(dòng)治療組分別采用兩種強(qiáng)度不同的治療方案。①低強(qiáng)度運(yùn)動(dòng)治療組每次治療需重復(fù)完成整套動(dòng)作中的每步動(dòng)作10次,3次/周,共治療12周。②強(qiáng)度遞增運(yùn)動(dòng)治療組的動(dòng)作與低強(qiáng)度運(yùn)動(dòng)治療組相同,3次/周,但除第1周每步動(dòng)作重復(fù)10次外,以后每周每步動(dòng)作重復(fù)次數(shù)遞增5次,至第5周增加至30次,持續(xù)至第12周。③對(duì)照組采用超短波電療儀,微熱量,20min/次,3次/周,共治療12周。分別于治療前(基線)、治療后第4,12周(干預(yù)期)及24周(隨訪期)進(jìn)行以下癥狀、疼痛程度及治療滿意程度評(píng)估:①改良中文版Oswestry腰痛評(píng)價(jià)表:由觀察對(duì)象自評(píng),總分0～50分,總分值越高,表示因腰痛造成的失能越重。②改良中文版Roland-Morris腰痛失能問卷:總分0～24分,總分值越高,提示被評(píng)價(jià)對(duì)象填表當(dāng)日因腰痛造成失能越重。③10cm標(biāo)準(zhǔn)目測(cè)類比疼痛評(píng)分表:由觀察對(duì)象主觀按疼痛程度在表上直接標(biāo)記,范圍0～10cm,標(biāo)記長度越長代表疼痛越重。④治療措施滿意程度:分5級(jí),5非常滿意;1很不滿意。⑤癥狀減輕程度:分5級(jí),5幾乎消失;1加重惡化。結(jié)果:除對(duì)照組1人因工作調(diào)動(dòng)失隨訪外,其余所有觀察對(duì)象均進(jìn)入結(jié)果分析。各組患者各量表評(píng)分、治療滿意程度及主觀癥狀減輕程度比較:在干預(yù)結(jié)束(12周)、隨訪時(shí)(24周),低強(qiáng)度運(yùn)動(dòng)治療組和強(qiáng)度遞增運(yùn)動(dòng)治療組患者的改良Oswestry腰痛評(píng)分、Roland-Morris腰痛失能評(píng)分、目測(cè)類比疼痛評(píng)分均顯著低于對(duì)照組(t=-3.46～2.35,P≤0.05～0.01);低強(qiáng)度運(yùn)動(dòng)治療組和強(qiáng)度遞增運(yùn)動(dòng)治療組的治療措施滿意程度、主觀癥狀減輕程度等均顯著優(yōu)于對(duì)照組(t=3.23～5.05,P0.01)。而低強(qiáng)度運(yùn)動(dòng)治療組、強(qiáng)度遞增運(yùn)動(dòng)治療組兩個(gè)實(shí)驗(yàn)組在不同評(píng)價(jià)時(shí)間各項(xiàng)指標(biāo)比較,差異均無顯著性意義(P0.05)。結(jié)論:運(yùn)動(dòng)治療8步法可以顯著緩解坦克乘員的腰部疼痛,改善其腰部運(yùn)動(dòng)功能,是一種實(shí)用性強(qiáng)、治療順應(yīng)好、療效較為肯定的方法,但其內(nèi)容仍需完善,療效尚需基礎(chǔ)實(shí)驗(yàn)及設(shè)計(jì)嚴(yán)格的臨床實(shí)驗(yàn)進(jìn)一步闡明。
[Abstract]:Objective: to develop the exercise therapy for low back pain of tank crew and evaluate the curative effect. Methods: the observation was carried out in August 2005 in a tank army station in the Northwest Hilly region. Asked by the specialist medical history, physical examination, the division selected 128 men in active training tank crew, all volunteer to participate in the observation. They were randomly divided into three groups: low intensity exercise group (43 cases), intensity increasing exercise group (43 cases) and control group (42 cases). Design exercise treatment 8 steps, namely arrow step flexion hip, straight leg raise, knee chest movement, neck and shoulder lift, lift hip lift back, flexion back exercise, prone to stretch back and stretch chest and extend hip. According to the actual situation of tank crew, the treatment group with low intensity and increasing intensity respectively used two kinds of treatment schemes with different intensities. The treatment group of low intensity exercise need to repeat each step of the whole action for 10 times and 3 times a week per week. After 12 weeks of treatment, the movement of the exercise group was the same as that of the low intensity exercise group, but the number of repeat of each step was increased 5 times per week and increased to 30 times per week, except for 10 times per step in the first week, and increased to 30 times per week after 12 weeks of treatment. The control group was treated with ultrashort wave electrotherapy for 12 weeks. Before treatment (baseline), 4 weeks after treatment (intervention period) and 24 weeks (follow-up period), the following symptoms, pain degree and treatment satisfaction were evaluated by the modified Chinese version of Oswestry low back pain scale: Self-rated by the subjects. The total score was 0 ~ 50, the higher the total score was, the more serious the disability caused by low back pain was. 2. 2. 2 improved Chinese version Roland-Morris low back pain disability questionnaire: the total score was 0 ~ 24 points, the total score was higher. It was suggested that the subjects who were evaluated were directly marked by subjective pain according to the degree of pain in the standard visual analogue pain scale, which was caused by low back pain on the same day. The range was 0 ~ 10 cm, the longer the marker length was, the more severe the pain was. 4 the satisfactory degree of treatment measures: 5 grades, 5, 5, very satisfactory, 1, 1, very unsatisfactory, and 5, grade 5, almost disappeared and aggravated. Results: all the subjects were involved in the result analysis except that one person in the control group was followed up because of job mobility loss. The scores of each group were as follows: Comparison of degree of satisfaction and relief of subjective symptoms: at the end of the intervention (12 weeks) and at the follow-up of 24 weeks, the improved Oswestry low back pain score and the Roland-Morris low back pain disability score were evaluated in the low intensity exercise treatment group and the intensity increasing exercise treatment group. The scores of visual analogue pain were significantly lower than those of the control group (t = 3.46 鹵2.35 P 鈮，

本文編號(hào)：2146145