目的:基于肌骨超声技术实时评估慢性非特异性腰痛(non-specific low back pain,NLBP)患者相关肌肉特征指标,并分析与视觉模拟评分法(visual analogue scale,VAS)及Oswestry功能障碍指数问卷表(Oswestry disability in-dex,ODI)的相关性.方法:选取2022年12月-2023年6月期间福州市第二医院康复科确诊的慢性非特异性腰痛患者180例,同时将同时间段体检的健康受试者120例作为对照组.采用VAS和ODI问卷对两组对象进行评分,基于肌骨超声技术实时检测腹横肌与多裂肌安静位与收缩位的肌肉厚度.最后对NLBP患者肌骨超声实时肌肉特征监测指标与VAS及ODI评分进行相关性分析.结果:VAS评分结果显示,健康组为(0.58±0.73)分,NLBP组为(3.29±0.42)分,两组VAS评分比较具有显著差异(t=40.729,P＜0.001).ODI评分结果显示,健康组为(4.25±0.36)分,NLBP组为(14.41±1.63)分,两组ODI评分结果差异具有显著性(t=-67.162,P＜0.001).腹横肌检测结果显示,安静位时,健康组的厚度为(3.89±0.31)mm,NLBP组的厚度为(2.85±0.26)mm.收缩位时,健康组的厚度为(5.18±0.35)mm,NLBP组的厚度为(3.64±0.29)mm.多裂肌检测结果显示,安静位时,健康组的厚度为(2.19±0.14)cm,NLBP组的厚度为(1.82±0.16)cm;收缩位时,健康组的厚度为(3.15±0.22)cm,NLBP组的厚度为(2.41±0.21)cm.与健康组相比,NLBP组无论在安静位还是收缩位,其腹横肌肌肉厚度(t=-31.401,-48.751;P＜0.001)和多裂肌肌肉厚度(-20.610,-29.335;P＜0.001)均显著降低.相关性分析结果显示,安静位时,VAS评分与腹横肌厚度(r=-0.69,P＜0.001)、多裂肌厚度(r=-0.45,P＜0.001)间存在显著负相关.收缩位时,VAS评分与腹横肌厚度(r=-0.59,P＜0.001)、多裂肌厚度(r=-0.31,P＜0.001)间存在显著负相关.而安静位时,ODI评分与腹横肌厚度(r=-0.58,P＜0.001)、多裂肌厚度(t=-0.36,P＜0.001)间存在显著负相关.收缩位时,VAS评分与腹横肌厚度(r=-0.54,P＜0.001)、多裂肌厚度(r=-0.22,P=0.0029)间存在显著负相关.结论:肌骨超声检查可作为实时检测方法来评估NLBP患者的相关肌肉特征指标.
The ultrasonic morphological changes and correlation with pain and lumbar function of core muscles in patients with chronic nonspecific low back pain
Objective:To utilize usculoskeletal ultrasound technology for real-time assessment of related muscle characteris-tics in patients with chronic nonspecific low back pain(NLBP)and to analyze the correlation with visual ana-logue scale(VAS)and Oswestry disability index questionnaire(ODI).Method:A total of 180 patients diagnosed with chronic NLBP in the department of rehabilitation of the Sec-ond Hospital in Fuzhou from December 2022 to June 2023 were selected as NLBP group,and 120 healthy subjects who underwent physical examination at the same time period were selected as the control group.VAS and ODI questionnaires were used to assess the two groups of subjects.Based on musculoskeletal ultrasound technology,the muscle thickness and elastic modulus of transverse abdominal muscle and multifidus muscle in resting and contraction positions were detected in real time.Finally,the correlation analysis was performed be-tween the real-time muscle characteristics monitoring indexes of musculoskeletal ultrasound and the VAS and ODI scores in NLBP patients.Result:The VAS score showed that the healthy group was 0.58±0.73 and the NLBP group was 3.29±0.42.There was a significant difference in VAS score between the two groups(t=40.729,P＜0.001).The ODI score showed that the healthy group was 4.25±0.36 and the NLBP group was 14.41±1.63.The difference of ODI score between the two groups was statistically significant(t=-67.162,P＜0.001).The transverse abdominal muscle test showed that the thickness of the healthy group was 3.89±0.31 mm,and the thickness of the NLBP group was 2.85±0.26 mm.At the contraction position,the thickness of the healthy group was 5.18±0.35 mm,and the thickness of the NLBP group was 3.64±0.29 mm.The multifidus muscle test showed that the thickness of the healthy group was 2.19±0.14 cm,and the thickness of the NLBP group was 1.82±0.16 cm.At the contraction position,the thickness of the healthy group was 3.15±0.22 cm,and the thickness of the NLBP group was 2.41±0.21 cm.Compared with the healthy group,the muscle thickness of the transverse abdominis of the NLBP group(t=-31.401,-48.751;P＜0.001)and multifidus muscle thickness were significantly reduced(t=-20.610,-29.335;P＜0.001).The correlation analysis showed that there was a significant negative correlation between VAS score and transverse abdominal muscle thickness(r=-0.69,P＜0.001)and multifidus muscle thickness(r--0.45,P＜0.001)at rest.There was a significant negative correlation between the VAS score and the thickness of the transverse abdominal muscle(r=-0.59,P＜0.001)and the thickness of the multifidus muscle(r=-0.31,P＜0.001).At rest,there was a significant negative correlation between ODI score and transverse abdominal muscle thickness(r=-0.58,P＜0.001)and multifidus muscle thickness(r=-0.36,P＜0.001).In the contractile position,there was a significant negative correlation between the VAS score and the thickness of the transverse abdominal muscle(r=-0.54,P＜0.001)and the thickness of the multifidus muscle(r=-0.22,P=0.0029).Conclusion:Musculoskeletal ultrasonography can be used as a real-time detection method to evaluate the rele-vant characteristic indexes of NLBP in subjects.
musculoskeletal ultrasoundmuscle thicknessnon-specific low back paincorrelation analysis
万方数据
维普
