Clinical Study Of Proprioceptive Neuromuscular Facilitation In The Treatment Of Chronic Nonspecific Low Back Pain

Objective : To observe the effect of proprioceptive neuromuscular facilitation(PNF)on patients with chronic nonspecific low back pain(CNLBP).Methods:Forty-eight patients with CNLBP were collected and divided into observation group and control group according to random number table method,with 24 patients in each group.The control group received traditional rehabilitation therapy,including interferential current therapy and core muscle training,and the observation group received PNF training on the basis of control group.The duration of treatment was 4 weeks.Visual analogue scale(VAS),finger floor distance(FFD),Roland-morris disability questionnaire(RMDQ),36-item short form survey(SF-36)and fear avoidance beliefs questionnaire(FABQ)were used to evaluate the efficacy at pre-treatment,after 2 and 4 weeks of treatment.Before treatment and after 4 weeks of treatment,surface electromyography was used to assess the activation rates of erector spinae muscle,rectus abdominis and obliquus externus abdominis,and flexion-relaxation ratio(FRR)of erector spinae muscle.The elliptical swing area and displacement velocity of plantar center of pressure(COP)were analyzed by the plantar pressure measurement system.Results:1.Before treatment,there was no significant difference in each index between 2 groups(P>0.05).2.VAS score: after 2 and 4 weeks of treatment,the index of 2 groups was significantly reduced(P<0.05).In the observation group,the index was significantly lower than that of control group(P<0.05).3.FFD: after 2 and 4 weeks of treatment,the index of 2 groups was significantly reduced(P<0.05).In the observation group,the index was significantly lower than that of control group(P<0.05).4.RMDQ score: after 2and 4 weeks of treatment,the index of 2 groups was significantly reduced(P<0.05).In the observation group,the index was significantly lower than that of control group(P<0.05).5.SF-36 score: after 2 weeks of treatment,the index of observation group was significantly increased(P<0.05),but no significant difference was found in other indexes(P>0.05).After 4 weeks of treatment,the index of 2 groups was significantly increased(P<0.05).In the observation group,the index was significantly higher than that of the control group(P<0.05).6.FABQ score: after 2 and 4 weeks of treatment,the index of 2groups was significantly reduced(P<0.05),but there was no significant difference between two groups(P>0.05).7.Surface EMG characteristics: after4 weeks of treatment,activation rates of erector spinae muscle and rectus abdominis in 2 groups were significantly increased(P<0.05).In the observation group,the index was significantly higher than that of control group(P<0.05).The activation rate of obliquus externus abdominis in the observation group was significantly increased(P<0.05),but no significant difference was found in other indexes(P>0.05).In addition,the FFR value of erector spinae muscle in 2 groups was significantly increased(P<0.05).In the observation group,the index was significantly higher than that of control group(P<0.05).8.Measurement of COP related parameters: after 4 weeks of treatment,elliptical swing area and displacement velocity of COP in 2 groups were significantly reduced(P<0.05).In the observation group,these indexes were significantly lower than those of the control group(P<0.05).Conclusions:On the basis of traditional rehabilitation therapy,PNF training may significantly relieve pain symptoms of patients with CNLBP,increase the activation rate and coordination of trunk muscle groups,improve range of motion of trunk,balance ability and other functional activities,and improve the quality of life.However,this study hasn’t found that PNF combined with traditional rehabilitation therapy have significant effect on patients’ fear avoidance beliefs compared with the latter.