ABSTRACT
Objective To explore the difference of balance ability between patients with chronic nonspecific low back pain ( CNLBP) and healthy individuals, and the correlation between patients’ pain symptoms, lumbar flexibility, abdominal muscle endurance, overall function, quality of life and fear of avoidance with balance ability, so as to guide clinical rehabilitation evaluation. Methods A total of 34 patients with CNLBP were selected as the experimental group, and 34 healthy volunteers without history of low back pain were selected as control group. The plantar pressure measurement system was used to collect the ratio of forefoot to hindfoot pressure, pathlength ( L) of plantar center of pressure ( COP), displacement length in anteroposterior direction ( LAP ), displacement length in mediolateral direction (LML ), mean velocity (v), displacement velocity in anteroposterior direction (vAP ), displacement velocity in mediolateral direction (V-ML) and elliptical swing area (S). In addition,the experimental group was assessed by the visual analogue scale (VAS), the finger floor distance (FFD), the number of sit-ups in 1 minute, the Oswestry disability index (ODI), the 36-item short form survey (SF-36) and the fear avoidance beliefs questionnaire (FABQ), and correlated with plantar pressure parameters. Results All plantar pressure parameters were significantly different between the two groups ( P < 0. 05). The the ratio of forefoot to hindfoot pressure in experimental group was significantly lower than that in control group (P<0. 05), and the parameters L, LAP , LML , v, vAP , vML and S were significantly higher than those of control group (P<0. 05). With eyes open or closed, the VAS score of experimental group was positively correlated with L, LAP , LML(P<0. 05), and FFD and FABQ scores were positively correlated with L and LML , respectively (P< 0. 05). With eyes open, ODI was positively correlated with L, LAP and LML (P< 0. 05), and SF-36 score was negatively correlated with L and LML(P<0. 05). With eyes closed, the number of 1-min sit-ups was negatively correlated with LAP and S (P<0. 05), ODI was positively correlated with L and LML(P<0. 05), and the SF-36 score was negatively correlated with L (P<0. 05). Conclusions The static balance ability of patients with CNLBP is decreased, and it is correlated with pain symptoms, lumbar function, quality of life and psychological status. The result can provide references for the assessment of functional activities.
ABSTRACT
OBJECTIVE@#To compare the clinical efficacy and possible mechanism of warming acupuncture combined with "three steps and seven methods" of tuina and simple "three steps and seven methods" of tuina in treatment of chronic nonspecific low back pain (NLBP) of yang deficiency and cold-dampness blockage.@*METHODS@#A total of 138 patients were randomized into an observation group (69 cases, 5 cases dropped off) and a control group (69 cases, 7 cases dropped off). In the control group, "three steps and seven methods" of tuina was applied. On the basis of the treatment in the control group, warming acupuncture was applied at Shenshu (BL 23), Yaoyangguan (GV 3), Mingmen (GV 4), Weizhong (BL 40) and ashi points. The treatment was given once a day, 6 times a week for 3 weeks in both groups. Before and after treatment, the short form of McGill pain questionnaire (SF-MPQ) score, Oswestry disability index (ODI) score, finger-to-floor distance (FFD), Schober test distance, fear-avoidance beliefs questionnaire (FABQ) score and yang deficiency and cold-dampness blockage score were observed, the serum levels of tumor necrosis factor-α (TNF-α), interleukin (IL)-1β, IL-6 and thromboxane B2 (TXB2) were detected in both groups. The recurrence rate was evaluated in follow-up of 6 months after treatment.@*RESULTS@#After treatment, the scores of PRI, PPI, VAS, ODI, FABQ and FFD, yang deficiency and cold-dampness blockage scores were decreased compared before treatment in both groups (P<0.01), and those in the observation group were lower than the control group (P<0.01); the Schober test distances were increased compared before treatment in both groups (P<0.01), and that in the observation group was larger than the control group (P<0.01). After treatment, the serum levels of TNF-α, IL-1β, IL-6 and TXB2 were decreased compared before treatment in both groups (P<0.01), and those in the observation group were lower than the control group (P<0.01). In follow-up, the recurrence rate was 12.8% (6/47) in the observation group, which was lower than 34.3% (12/35) in the control group (P<0.05).@*CONCLUSION@#Warming acupuncture combined with "three steps and seven methods" of tuina can effectively alleviate pain in patients with chronic NLBP of yang deficiency and cold-dampness blockage, improve activity and dysfunction of waist, the clinical efficacy is superior to simple "three steps and seven methods" of tuina, its mechanism may be relate to the inhibition of inflammatory reaction.
Subject(s)
Humans , Acupuncture Points , Acupuncture Therapy , Interleukin-6 , Low Back Pain/therapy , Treatment Outcome , Tumor Necrosis Factor-alpha , Yang Deficiency/therapyABSTRACT
Objective:To observe the effects of pain relief after acupuncture on walking speed, step length and ground reaction force (GRF) of patients with chronic nonspecific low back pain (CNLBP) during walking. Methods:From May to December, 2019, 28 CNLBP patients were randomly divided into waiting list group (n = 14) and acupuncture group (n = 14). The acupuncture group received acupuncture, 30 minutes a time, three times a week, for four weeks. The waiting list group only received health education after enrollment until four weeks later. Gait analysis was performed with three-dimensional motion system for both groups after enrollment and one month later. The walking speed, step length and GRF characteristic values were recorded and compared, as well as Visual Analogue Score (VAS) for pain. Results:After intervention, The VAS decreased in both groups (t > 2.956, P < 0.05), and was lower in the acupuncture group than in the waiting list group (t = -2.844, P = 0.004). No significant difference in walking speed, step length and GRF characteristic values was found after intervention in both groups (P > 0.05). Conclusion:One month-acupuncture could relief the pain of CNLBP patients, however, it could not improve the performance during walking.
ABSTRACT
Objective:To analyze the contractile properties of the lumbar erector spinae in patients with chronic nonspecific low back pain (CNLBP), and to explore their correlation with pain and dysfunction. Methods:From January to June, 2020, 24 patients with CNLBP in the outpatient and the ward of geriatric rehabilitation medicine department and 26 asymptomatic volunteers were included. Their contractile properties of the lumbar erector spinae were measured with tensiomyography, including maximum radial muscle displacement (Dm), contraction time (Tc), delay time (Td), sustain time (Ts), half-time relaxation (Tr) and lateral symmetry (LS). The contraction velocity (VC) was calculated. Potential associations of tensiomyography parameters to Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) were assessed using correlation analysis. Results:No significant differences were found in Td, Ts, Tc, Tr and LS between two groups (P > 0.05). Dm and Vc were significantly lower in both sides of CNLBP group than in the control group (t > 2.058, P < 0.01). Dm or Vc were not correlated with VAS and ODI (P > 0.05). Conclusion:Erector spinae are stiff and fatiguable in patients with CNLBP, however, they are not associated with pain and dysfunction. Tensiomyography could be used for accurate diagnosis and treatment of CNLBP.
ABSTRACT
At present, three-dimensional gait analysis has been used in the diagnosis, treatment and rehabilitation of chronic non-specific low back pain. Existing researches have conducted systematic cross-sectional studies on the gait of patients with chronic non-specific low back pain from the aspects of space-time parameters, kinematics parameters, dynamic parameters and surface EMG, but few are about efficacy evaluation with three-dimensional gait analysis, which may be a topic in the future.
ABSTRACT
Objective:To observe the effect of sling exercise therapy on chronic nonspecific low back pain. Methods:From February, 2017 to February, 2018, 84 patients with chronic nonspecific low back pain were randomly divided into control group and observation group, with 42 cases in each group. The observation group was treated with the combination of the sling exercise therapy and acupuncture, and the control group only received acupuncture. They were assessed with Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) before treatment, one month after treatment and at three-month follow-up. Results:Before treatment, there was no statistically significant difference in the scores of VAS and ODI between two groups (t < 1.638, P > 0.05). One month after treatment and at three-month follow-up, the scores of VAS and ODI decreased in both groups (P < 0.01). Compared with one month after treatment, the scores of VAS and ODI increased in the control group at three-month follow-up (t > 2.219, P < 0.05), however, no difference was found in the observation group (t < 1.738, P > 0.05). One month after treatment, the scores of VAS and ODI were lower in the observation group than in the control group (t > 3.535, P < 0.001). Conclusion:Sling exercise therapy combined with acupuncture is superior to simple acupuncture in treating chronic nonspecific low back pain, and the curative effect is persistent.
ABSTRACT
@#Objective To observe the effects of different health education patterns on chronic nonspecific low back pain (CNLBP). Methods From September, 2016 to April, 2017, 75 patients with CNLBP after rehabilitation were randomly divided into control group (n=45) and Back School group (n=30). The Back School group received group teaching including physiological and anatomy of lumbar spine, ergonomics, healthy posture and function exercise, once a week for four weeks. While the control group received the booklets including the same contents. They were self-assessed with Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and the 36-item Short Form (SF-36) before education, and one and three months of follow-up in clinics, or with call back services and Wechat. The recur-rence frequency was recorded. Results The score of VAS increased in both groups in the follow-up, but increased less in the Back School group (Z>2.645, P<0.01). The recurrence frequency was less in the Back School group (Z=-2.082, P<0.05), with more ODI score (Z=2.265, P<0.05) after three months of follow-up. The bodily pain score of SF-36 was more in the Back School group after one and three months of follow-up (t>2.273, P<0.05). Conclusion Health education with Back School may benefit to maintain the curative effects and function, reduce recur-rence, and improve the quality of life of CNLBP patients.
ABSTRACT
Objective To evaluate the value of ultrasonic elastography for diagnosis of chronic nonspecific low back pain. Methods From March to September, 2016, 32 patients diagnosed as chronic nonspecific low back pain and other 32 healthy people (controls) were measured lumbar erector spinae with ultrasonic elastography, and calculated Yang's modulus. The correlation between Yang's modulus and Visual Analogue Scale (VAS) or Japanese Orthopaedic Association (JOA) score in the patients were investigated with Pearson's analysis. Re-sults There was no significant difference in Yang's modulus between bilateral lumbar erector spinae in both the patients and the controls (t0.05), but it was more in the patients than in the controls (t=9.931, P<0.001). The Yang's modulus was positively correlated with VAS score in the patients (r=0.614, P<0.001), but not with the JOA score (r=-0.243, P=0.180). Conclusion Ultrasonic elastography can be applied to differentiate low back pain from the healthy, and measure the intensity of pain.
ABSTRACT
STUDY DESIGN: Clinical pilot study. PURPOSE: To objectively evaluate the compliance rate of lumbar-support use in patients with chronic nonspecific low back pain, as well as to assess low back pain intensity, disability, and fear-avoidance beliefs. OVERVIEW OF LITERATURE: Wearing time is an important factor in the assessment of the efficacy of lumbar-support use in patients with chronic nonspecific low back pain. Previous studies have measured lumbar-support wearing time based on subjective assessment, and these evaluations are not easily verifiable and are usually overestimated by subjects. METHODS: Twelve subjects with chronic nonspecific low back pain who had been wearing semirigid lumbar supports for 6 weeks were evaluated. Compliance was objectively monitored using temperature sensors integrated into the semirigid lumbar supports. Subjects wore their lumbar supports for 8 hour/day on workdays and 3 hour/day on holidays during the first 3 weeks. During the next 3 weeks, subjects were gradually weaned off the lumbar supports. Pain intensity was measured using a numerical rating scale. The Oswestry disability index was used to assess the subjects' disability. Fear-avoidance behavior was evaluated using a fear-avoidance beliefs questionnaire. RESULTS: The mean compliance rate of the subjects was 78.16%±13.9%. Pain intensity was significantly lower in patients with a higher compliance rate (p=0.001). Disability index and fear-avoidance beliefs (functional outcomes) significantly improved during the second 3-weeks period of the treatment (p<0.001, p=0.02, respectively). CONCLUSIONS: The compliance rate of patients wearing lumbar supports is a determining factor in chronic low back pain management. Wearing semirigid lumbar supports, as advised, was associated with decreased pain intensity, improved disability index scores, and improved fear-avoidance beliefs in patients with chronic nonspecific low back pain.
Subject(s)
Humans , Compliance , Holidays , Low Back Pain , Pilot ProjectsABSTRACT
@#Objective To investigate the changes of surface electromyographic signal during lumbar flexion-extension after sling exercise therapy (SET) in patients with chronic nonspecific low back pain (CNLBP). Methods 30 patients with CNLBP received SET, 3 times a week for 4 weeks. The surface electromyographic signals of erector spinae and multifidus of both sides were collected, when they were in erect position, flexion motion, maximum voluntary flexion, and back to erect position, before and after intervention. The average electromyogram (AEMG) was analyzed, and the flexion-relaxion ratio (FRR) was compared. Results The FRRs of both erector spinae and multifidus were lower in the painful side than in the healthy side before intervention (P<0.05). There was no significant difference in the FRRs of both erector spinae and multifidus between 2 sides after intervention. Conclusion SET may improve the active motion function of the erector spinae and multifidus of the painful side and recovery of flexion-relaxation phenomenon.
ABSTRACT
Objective To investigate the changes of surface electromyographic signal during lumbar flexion-extension after sling exer-cise therapy (SET) in patients with chronic nonspecific low back pain (CNLBP). Methods 30 patients with CNLBP received SET, 3 times a week for 4 weeks. The surface electromyographic signals of erector spinae and multifidus of both sides were collected, when they were in erect position, flexion motion, maximum voluntary flexion, and back to erect position, before and after intervention. The average electro-myogram (AEMG) was analyzed, and the flexion-relaxion ratio (FRR) was compared. Results The FRRs of both erector spinae and multifi-dus were lower in the painful side than in the healthy side before intervention (P<0.05). There was no significant difference in the FRRs of both erector spinae and multifidus between 2 sides after intervention. Conclusion SET may improve the active motion function of the erec-tor spinae and multifidus of the painful side and recovery of flexion-relaxation phenomenon.
ABSTRACT
@#ObjectiveTo explore the relationship between rotary strength of trunks and stability of the low back in patients with nonspecific low back pain. MethodsBefore sling exercise therapy (SET), 22 patients with chronic nonspecific low back pain were measured the rotary strength of core muscles of trunks with Proxomed Tergumed functional spinal evaluation and training system and the core stability of the low back with SET system. Their correlation was analyzed. ResultsThe core rotary strength was positively correlated with the local stability in patients with chronic nonspecific low back pain (r=0.876, P<0.001). ConclusionIncreasing the rotary strength of trunks is important to improve local stability in patients with chronic nonspecific low back pain.