目的 探讨普拉提运动联合疼痛护理在非特异性下腰痛(NLBP)患者中的应用效果。方法 选取2021年2月至2023年3月河南大学第一附属医院收治的100例NLBP患者开展随机对照试验，采用随机信封法将患者分为对照组(50例)与观察组(50例)。对照组男18例，女32例;年龄28～69(51。35±8。29)岁;病程4～36(20。26±3。08)个月;视觉模拟评分法(VAS)评分:4～6分35例，≥7分15例;采用常规护理+疼痛护理。观察组男20例，女30例;年龄30～72(52。06±8。84)岁;病程5～36(19。83±3。14)个月;VAS评分:4～6分32例，≥7分18例;在对照组基础上采用普拉提运动。两组均干预4周。比较两组干预前后疼痛程度(VAS评分)、Oswestry功能障碍指数(ODI)评分、运动参与动机[情境动机量表(SIMS)评分]、腰部肌电信号[竖脊肌、多裂肌的中位频率值(MF)和均方根值(RMS)]。采用独立样本t检验、配对样本t检验、方差分析和x2检验。结果 干预2周、4周后，观察组VAS 评分[(5。56±0。87)分、(3。25±0。38)分]均低于对照组[(6。13±1。02)分、(4。38±0。59)分](均P＜0。05);观察组 ODI 评分[(20。38±3。70)分、(17。76±3。09)分]均低于对照组[(24。65±3。64)分、(20。46±3。35)分](均P＜0。05)。干预4周后，观察组SIMS中的鉴别原则[(16。76±1。75)分]、外部动力[(13。26±2。02)分]、内部动力[(15。62±2。12)分]、缺乏动力[(9。35±1。78)分]评分均高于对照组[(15。03±2。03)分、(11。82±2。19)分、(13。08±1。96)分、(8。02±1。83)分](均 P＜0。05);观察组多裂肌和竖脊肌 MF[(91。05±8。94)Hz、(89。16±11。03)Hz]均低于对照组[(95。16±10。36)Hz、(94。08±12。64)Hz]，RMS[(13。82±2。36)µV、(16。52±3。04)μV]均高于对照组[(12。14±2。29)µV、(13。74±2。68)μV](均P＜0。05)。结论 疼痛护理联合普拉提运动能改善NLBP患者运动参与动机，减轻患者疼痛，促进肌肉功能和腰椎功能恢复。
Application of Pilates exercise combined with pain nursing in patients with nonspecific low back pain
Objective To investigate the efficacy of Pilates exercise combined with pain care in patients with nonspecific lower back pain(NLBP).Methods A total of 100 patients with NLBP admitted to the First Affiliated Hospital of Henan University from February 2021 to March 2023 were selected as the research subjects for a randomized controlled trial and were divided into a control group(50 cases)and an observation group(50 cases)using the random envelope method.In the control group,there were 18 males and 32 females,the age was 28-69(51.35±8.29)years old,the course of disease was 4-36(20.26±3.08)months,and the Visual Analog Scale(VAS)score was 4-6 points in 35 cases and ≥7 points in 15 cases.In the observation group,there were 20 males and 30 females,the age was 30-72(52.06±8.84)years old,the course of disease was 5-36(19.83±3.14)months,and the VAS score was 4-6 points in 32 cases and ≥7 points in 18 cases.The control group received routine nursing+pain nursing,and the observation group received Pilates exercise on the basis of the control group for 4 weeks.The pain degree(VAS score),Oswestry Disability Index(ODI)score,motivation to participate in exercise[Scale of Situational Motivation(SIMS)score],lumbar electromyographic(EMG)signals[median frequency value(MF)and root mean square value(RMS)of erector spinae and multifidus]were compared between the two groups before and after intervention.Independent sample t test,paired t test,ANOVA,and x2 test were used.Results After 2 and 4 weeks of intervention,the VAS scores of the observation group[(5.56±0.87)points and(3.25±0.38)points]were lower than those of the control group[(6.13±1.02)points and(4.38±0.59)points](both P＜0.05);the ODI scores of the observation group[(20.38±3.70)points and(17.76±3.09)points]were lower than those of the control group[(24.65±3.64)points and(20.46±3.35)points](both P＜0.05).After 4 weeks of intervention,the scores of identification principle[(16.76±1.75)points],external motivation[(13.26±2.02)points],internal motivation[(15.62±2.12)points],and lack of motivation of the SIMS[(9.35±1.78)points]in the observation group were higher than those in the control group[(15.03±2.03)points,(11.82±2.19)points,(13.08±1.96)points,and(8.02±1.83)points](all P＜0.05).The MF of erector spinae and multifidus[(91.05±8.94)Hz and(89.16±11.03)Hz]in the observation group were lower than those in the control group[(95.16±10.36)Hz and(94.08±12.64)Hz],but the RMS of erector spinae and multifidus[(13.82±2.36)μV and(16.52±3.04)μV]were higher than those in the control group[(12.14±2.29)μV and(13.74±2.68)μV](all P＜0.05).Conclusion Pain care combined with Pilates exercise can change the motivation of NLBP patients to participate in exercise,reduce their pain,and promote the recovery of muscle function and lumbar spine function.
Nonspecific lower back painPilates exercisePain carePain levelMotivation for sports participationLumbar electromyographic signal
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