Efficacy Of Hip Muscle Group Training Combined With Fascial Release In Patients With Nonspecific Low Back Pain

1 ObjectiveLow back pain is a musculo-skeletal system disease with the highest incidence of motor dysfunction.It not only affects the daily life of patients,but also brings a huge economic burden to the country and society.About 90% of low back pain is non-specific low back pain.Exercise training and fascia relaxation are common treatments for low back pain.The hip joint plays a vital role in maintaining the stability of the pelvis and spine,as well as the tension balance of the fascia chain.Patients with non-specific low back pain often have the wrong order of activation of hip muscles and muscle weakness.This study compares the effects of hip muscle group training combined with fascia relaxation and hip muscle group training,aiming to explore a better exercise intervention model for low back pain.2 MethodsRandomly divide 43 subjects with chronic non-specific low back pain into two groups,one is the hip muscle training combined with fascia relaxation group(n = 21),and the other is the hip muscle training group(n = 22).The two groups were trained 3 times a week for 6 weeks.Among them,the hip muscle group training combined with fascia release group released the fascia once a week.The fascia release sites were the iliopsoas muscle,thoracolumbar fascia,Sacrotuberous ligament,adductor muscle.The test data of the subjects were collected before and after training.The test indicators are:(1)Basic physical parameters: age,height,body mass index;(2)The activation sequence of hip muscles: the activation sequence of hip extensors is gluteus maximus and hamstrings,Contralateral erector spinae,ipsilateral erector spinae;the order of activation of hip abductors is gluteus medius,tensor fascia lata,quadratus lumborum;(3)muscle strength and endurance of hip muscles: gluteus maximus,Gluteus medius,adductor muscle;(4)Hip joint movement angle: hip extension angle,hip abduction angle,hip adduction angle,hip external rotation angle,hip internal rotation angle;(5)pain degree: VAS pain scale;(6)body function : Oswesry low back pain dysfunction questionnaire,functional stretch test,five sitting and standing tests,two-minute high-leg raise test.3 Results3.1 Changes in the pain degree of subjects in the hip muscle training combined with fascia relaxation group and hip muscle training group:(1)Compared with the six weeks before training,the hip muscle training combined with fascia relaxation group was tested The pain degree of the subjects was significantly reduced(p<0.05),and the pain degree of subjects in the hip muscle training group was reduced,but there was no significant difference(p>0.05);(2)After six weeks of intervention,it was similar to the hip muscle training group.Compared with the hip muscle group training combined with fascia relaxation group,the pain degree was reduced,but there was no significant difference(p>0.05).3.2 Physical function changes of subjects in the hip muscles training combined with fascia relaxation group and hip muscle training group:(1)Compared with the six weeks before training,the hip muscles training combined with fascia relaxation group has dysfunction The degree was very significantly reduced(p<0.01),the number of high-leg raises in two minutes was significantly increased(p<0.05),and the five sitting test time was significantly reduced(p<0.05),but there was no significant difference in the functional stretch test(p>0.05);Compared with six weeks before training,the degree of dysfunction in the hip muscle training group was significantly reduced(p<0.05),the number of high-leg raises in two minutes was significantly increased(p<0.05),five sitting and standing tests,functional stretch tests No significant difference(p>0.05);(2)After six weeks of intervention,compared with the hip muscle training group,the hip muscle training combined with fascia relaxation group had a significant reduction in the five sitting test time(p<0.05)),but there were no significant differences in the degree of dysfunction,the number of high leg lifts in two minutes,and the functional stretch test group(p>0.05).3.3 Changes in the activation sequence of hip muscles of subjects in the hip muscles training combined with fascia relaxation group and hip muscle training group: Compared with the six weeks before training,the hip muscles training combined with fascia relaxation group received The correct rate of activation of hip extensors and hip abductors in the test subjects increased significantly(p<0.05),and the normal rate of activation of the right hip extensors was significantly different(p<0.01);compared with that before six weeks of training In the hip muscle group training group,the correct rate of activation order of unilateral hip abductor muscle group increased significantly(p<0.05),and the correct rate of activation order of hip extensor muscle group increased,but there was no significant difference(p>0.05).(2)After six weeks of intervention,compared with the hip muscle training group,the correct rate of hip extensor muscles in the hip muscle training combined with fascia relaxation group was significantly increased(p<0.01),and the hip abductor muscles The correct rate of activation sequence increased,but there was no significant difference(p<0.05).3.4 Hip muscle training combined with fascia relaxation group and hip muscle training group hip muscle group changes:(1)Compared with the six weeks before training,hip muscle training combined with fascia release group The adductor and gluteus maximus muscle strength increased significantly(p<0.05),there was no significant difference in gluteus medius muscle strength(p>0.05),and the muscle endurance increased,but there was no significant difference(p>0.05);compared with six weeks Compared with before training,the adductor muscle strength of the subjects in the hip muscle training group increased significantly(p<0.05),and there was no significant difference in the muscle strength of the gluteus maximus and gluteus medius(p>0.05),and there was no significant difference in muscle endurance.Difference(p>0.05);(2)After six weeks of intervention,compared with the hip muscle training group,the hip muscle training combined with fascia relaxation group had all the strengths of the gluteus maximus,gluteus medius,and adductor muscles.Increase,but no significant difference(p>0.05),no significant difference between the muscle endurance groups(p>0.05).3.5 Hip muscle training combined with fascia relaxation group and hip muscle training group hip joint angle changes:(1)Compared with the six weeks before training,the hip muscle training combined with fascia relaxation group received Participants’ active and passive hip extension angles,hip abduction angles,hip adduction angles,as well as unilateral passive hip adduction angles and passive hip external rotation angles increased significantly(p<0.05),active hip external rotation on both sides,There was no significant difference in hip internal rotation angle(p>0.05);compared with before six weeks of training,subjects in the hip muscle training group had unilateral active and passive hip extension angles,as well as unilateral hip abduction and hip adduction angles Significant increase(p<0.05),no significant difference in the angles of hip external rotation and hip internal rotation on both sides(p>0.05);(2)After six weeks of intervention,compared with hip muscle training group,hip muscle training Combined with fascia release group,unilateral passive hip extension angle was significantly increased(p<0.05),bilateral active hip extension,hip abduction,hip adduction,hip external rotation angle was larger,hip internal rotation angle was smaller,but the group There was no significant difference between them(p>0.05).4 Conclusion4.1 Hip muscle training combined with fascia relaxation and hip muscle training group can improve hip muscle strength,endurance and joint angle of patients with chronic non-specific low back pain,but there is no significant difference.4.2 Hip muscle training combined with fascia relaxation and hip muscle training groups can improve the physical function and pain symptoms of patients with chronic non-specific low back pain,but hip muscle training combined with fascia relaxation can improve more effectively The patient’s physical coordination ability is related to the improvement of the activation sequence of the hip muscles.