PDF(Pubmed)
Abstract：
The importance of incorporating lumbo-pelvic stability core and controlling motor exercises in patients with chronic low back pain (CLBP) reinforces the use of strategies to improve biopsychosocial beliefs by reducing biomedical postulations. However, clinical practice guidelines recommend multimodal approaches incorporating exercise and manual therapy (MT), and instead reject the application of kinesiotape (KT) in isolation. Therefore, the objectives of this study were to analyze the effects of 12 weeks of exercises combined with MT or KT on perceived low back pain using the visual analog scale (VAS) and muscle electric activity measured with electromyography (EMG) of the rectus abdominis and multifidus in CLBP (mild disability) and to explore the relationship between the rectus abdominis and multifidus ratios and pain perception after intervention. A blinded, 12-week randomized controlled trial (RCT) was carried out, involving three parallel groups of patients with CLBP. The study was registered at Clinicaltrial.gov and assigned the identification number NCT05544890 (19/09/22). The trial underwent an intention-to-treat analysis. The primary outcome revealed a multimodal treatment program supplemented by additional therapies such as MT and KT, resulting in significant reductions in perceived low back pain. The subjective assessment of individuals with CLBP indicated no discernible distinction between exclusive core stability exercises and control-motor training when combined with MT or KT. Notably, our findings demonstrated positive alterations in both the mean and peak EMG values of the right rectus abdominis in the exercise group, suggesting a beneficial impact on muscle activation. This study focused on assessing the activation levels of the trunk musculature, specifically the rectus abdominis (RA) and multifidus (MF), in individuals with CLBP exhibiting mild disability according to the Oswestry Disability Index. Importantly, improvements in the VAS values were observed independently of changes in muscle electrical activity.
摘要：
在慢性下腰痛（CLBP）患者中纳入腰骨盆稳定核心和控制运动锻炼的重要性加强了通过减少生物医学假设来改善生物心理社会信念的策略的使用。然而,临床实践指南推荐结合运动和手动治疗(MT)的多模式方法，相反，孤立地拒绝应用kinsiotape（KT）。因此,本研究的目的是使用视觉模拟量表(VAS)分析12周运动联合MT或KT对CLBP(轻度残疾)中腹直肌和多裂肌肌电图(EMG)测量的感觉下腰痛的影响,并探讨干预后腹直肌和多裂比率与疼痛感知之间的关系.一个盲人，进行为期12周的随机对照试验(RCT),涉及三个平行的CLBP患者组。该研究已在Clinicaltrial.gov注册，并分配了标识号NCT05544890（19/09/22）。该试验进行了意向治疗分析。主要结果揭示了多模式治疗计划，辅以额外的治疗方法，如MT和KT，导致感觉下腰痛显著减少。对CLBP个体的主观评估表明，与MT或KT结合使用时，独家核心稳定性练习和控制运动训练之间没有明显区别。值得注意的是,我们的研究结果表明，在运动组中，右腹直肌的平均和峰值EMG值都发生了积极的变化，表明对肌肉激活的有益影响。这项研究的重点是评估躯干肌肉组织的激活水平，特别是腹直肌(RA)和多裂肌(MF)，根据Oswestry残疾指数，CLBP表现出轻度残疾的个体。重要的是,观察到VAS值的改善与肌肉电活动的变化无关.
