| Research purposes:With the development of society,the incidence of nonspecific low back pain(NLBP)has become increasingly widespread,and the incidence is higher in countries around the world.NLBP has a high incidence and seriously affects patients’ quality of life.In NLBP prevention and treatment,exercise therapy can relieve low back pain and be relatively low cost.As an adjunctive treatment,breathing training is used in combination with core training or other techniques to activate the deep stabilizing muscles of the trunk through breathing,establish appropriate intra-abdominal pressure,and then perform strength training for weak muscles to maintain the balance and stability of the spine,which may have a good effect on the treatment of NLBP.However,there is still a lack of comparative studies on formulating respiratory training prescriptions in treating NLBP and the efficacy of different respiratory training modalities.Therefore,the purpose of this study is to conduct rehabilitation function training for NLBP patients through other breathing training methods combined with core stability training,observe the therapeutic effect of different breathing training methods on the pain and function of NLBP patients,and find a respiratory training program that is more conducive to NLBP patients.Methods:In this study,a total of 60 patients with NLBP were screened to participate in this trial according to the inclusion criteria through a randomized controlled trial method and randomly divided into an abdominal breathing group,reverse abdominal breathing group,and diaphragmatic breathing group,each group intervened 3 times a week,and the intervention plan was the same except for different breathing pattern training,for a total of 12 weeks.The pain of the three groups before,during,and after the intervention was assessed by a visual analog scale(VAS)score.The Oswestry Disability Index(ODI)was used for lumbar function assessment before,during,and after the intervention;The lumbar muscle strength test before and after the intervention was carried out using Edburg handheld muscle strength tester(HP～10K thrust meter);The evaluation of lumbar range of motion before,during and after the intervention was carried out by indirect measurement method,and the satisfaction of treatment was evaluated by questionnaire.Finally,the primary information data of the results were tested for normality,and the observation index data were compared using repeated measurement variance.Results:(1)A total of 57 patients completed the evaluation and intervention of the entire study,19 cases in the abdominal breathing group,18 cases in the reverse abdominal breathing group,and 20 cases with diaphragmatic breathing,and the basic information of patients and baseline assessment were not statistically significant(P>0.05).Compared with the pre-intervention period,VAS was significantly reduced in all three groups(6.526± 0.964,6.444± 0.856,6.300± 0.923 vs.3.000±0.667,2.889±0.832,2.350±0.489,P<0.05),and the VAS values in both abdominal and reverse abdominal breathing groups at weeks 6 and 12 were significantly higher than those in the diaphragmatic breathing group.There was a statistically significant difference(P<0.05).ODI was significantly reduced in all three groups(57.54± 8.04,57.53±7.58,54.56± 6.473 vs.3.1±6.45,32.16±7.69,27.06±4.33,P<0.05)compared with preintervention.The ODI values of abdominal breathing and reverse abdominal respiration at weeks 6 and 12 were significantly higher than those of the diaphragmatic breathing group.There was a statistically significant difference(P<0.05).Compared with the pre-intervention period,the muscle strength of the lower back was significantly improved in all three groups(145.842±46.116,141.333±39.076,148.890±43.695 vs.180.353±45.301,181.283±45.298,216.365±37.097,P<0.05)At weeks 6 and 12,the lower back muscle strength(N)values of the abdominal breathing and reverse abdominal breathing groups were significantly lower than the low back muscle strength(N)values of the diaphragmatic breathing group,with a statistically significant difference(P<0.05);The right flexion range of motion was significantly reduced(P<0.05),and at weeks 6 and 12,the forward flexion(cm)value of abdominal breathing and reverse abdominal breathing group was significantly lower than that of the diaphragmatic breathing group.There was a statistical difference(P<0.05).(2)In the distribution of satisfaction evaluation of the effect of this treatment,a total of 4 people were very dissatisfied,accounting for 7.0%;9 people were dissatisfied,accounting for15.8%;6 people were uncertain,accounting for 10.5%,21 people were satisfied,accounting for 36.8%,and 17 people were delighted,accounting for 29.8%.In the distribution of satisfaction evaluation of the treatment process,a total of 4 people were very dissatisfied,accounting for 7.0%;7 people were indignant,accounting for 12.3%;9people were uncertain,accounting for 15.8%,10 people were satisfied,accounting for17.5%,and 27 people were delighted,accounting for 47.4%.(2)In the distribution of satisfaction evaluation of the effect of this treatment,a total of 4people were very dissatisfied,accounting for 7.0%;9 people were indignant,accounting for15.8%;6 people were uncertain,accounting for 10.5%,21 people were satisfied,accounting for 36.8%,and 17 people were delighted,accounting for 29.8%.Conclusion:The three training methods all had an excellent rehabilitation effect on the patients.The VAS score and ODI score of the patients were reduced,the muscle strength of the waist and back was improved,and the joint range of motion was increased;The whole diaphragmatic breathing group had a better improvement effect than the other two respiratory training groups,and the patients are satisfied with the overall treatment effect.It is recommended that diaphragmatic breathing training is preferred in the treatment plan of NLBP patients. |
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