A Comparative Study Of The Effects Of Ai Chi And Core Stability Training On Patients With Chronic Low Back Pain

Objective:To investigate the effect of Ai Chi versus core stability exercises on pain,disability,trunk muscle activity in patients with chronic non-specific low back pain.Methods:Thirty-nine CNSLBP patients were randomly allocated into Ai Chi group and core stability training group.The subjects received 6 weeks of Ai Chi（19）and core stability training（20）respectively.Before and after training,the visual analog pain scale（VAS）and Roland Morris Disability Questionnaire（RMDQ）were used to evaluate the rehabilitation effect.Surface electromyography was used to collect the patients’bilateral erector spinae,multifidus and extra-abdominal muscles during four functional tasks.SEMG signal of oblique muscles to assess core muscles activity level.Outcome measures:RMS of bilateral external oblique,erector spinae,and multifidus muscles,pain,and dysfunction index scales.The processed EMG signals and other data were statistically analyzed and compared.Results:There is no significant difference between the two group in VAS and RMDQ score before training（P>0.05）.After treatment,（1）Score of dysfunction:comparing with before,there was no statistically significant difference,the Ai Chi group（P=0.007）and the core stability training group（P=0.001）reduced and there was a significant difference.However,there was no significant difference between the two groups（P=0.501）;（2）Score of pain:The VAS scores of subjects in Ai Chi group（P<0.001）and core stability training group（P<0.001）were lower than before the intervention and there was a significant difference,but there was no significant difference in pain between the two groups（P=0.614）;（3）Muscle activity:（1）For the sitting task,the standardized RMS value of the left multifidus muscle in the Ai Chi group was significantly reduced（P=0.046）;comparison between groups found that the standardized RMS value of the left multifidus muscle in the core stability training group significantly higher than the water Ai Chi group（P=0.013）;（2）For the stand-up task,there was no significant difference in the standardized RMS value of core muscles between the Ai Chi and the core stability training group;（3）For the picking task,the right erector spinae of the core stability group（P=0.001）and the left multifidus（P<0.001）standardized RMS value increased significantly.Comparing the standardized RMS values,it found that the bilateral erector spinae in the core stabilization training group(P_left=0.047,P_right=0.015),the multifidus laterals （P=0.001）and the external oblique muscles（P=0.020）were significantly higher than those of the Ai Chi group.（4）For the loading task,the standardized RMS value of the right external oblique muscle in the Ai Chi group was significantly reduced （P=0.013）;the right vertical spine（P=0.006）and bilateral external oblique muscles in the core stability training group(P_left=0.001,P_right<0.001)The standardized RMS value increased significantly;comparisons between groups found that the standardized RMS value of bilateral external oblique muscles in the core stabilization training group was significantly higher than that in the Ai Chi group(P_left<0.001,P_right=0.030).Conclusions:Both Ai Chi and core stability training may alleviate the pain and dysfunction of CNSLBP patients;core stability training can improve the contractility of these three groups of core muscles.Compared with Ai Chi,it has a better effect on the left and right multifidus muscles and external oblique muscles;the two kinds of training can improve the contraction imbalance of the bilateral erector spinae in patients with CNSLBP to a certain extent.