Clinical Observation On The Curative Effect Of Rehabilitation Training In Patients With Chronic Nonspecific Low Back Pain Under The Guidance Of Surface Electromyography Biofeedback

Chronic nonspecific low back pain(CNLBP)is a chronic pain syndrome characterized by pain at the waist,lumbosacral and hip,discomfort,and lack of clear etiology,lasting more than 3 months.CNLBP is one of the common clinical diseases,the incidence rate is high,seriously affecting the patient's daily life and work.It has been reported that lumbar pain can restrict the intensity and range of lumbar muscle movement to varying degrees,This pain can cause a decrease in muscle contraction,an increase in fatigue,to a large extent,will make the local muscle atrophy,and the core stable muscle group function decline,will seriously affect the stability of the spine,leading to the intervertebral facet joint disorder and intervertebral disc damage,resulting in further deterioration of the pain.For its treatment,CNLBP patients increase local muscle strength,improve muscle contraction ability is mainly the lumbar core muscle stability training,although it has a certain clinical therapeutic effect,but it can not accurately measure and increase the strength of the target muscle.Surface electromyography(sEMG)into the biofeedback system,the sEMG signal after conversion and amplification,with visual and auditory feedback to the subjects,the subjects of self training,so as to make the target muscle relaxation or enhancement.Based on the conventional rehabilitation treatment of CNLBP patients,this study was supplemented with sEMGBF guided rehabilitation training,and monitor that changes of erector spinae and multifidus muscle signal before and after treatment,so as to provide reference data for guiding the clinical treatment of patients with low back pain.Objective:To explore the therapeutic effect of rehabilitation training under the guidance of sEMGBF in patients with CNLBP.Methods:1 Fifty patients with CNLBP were selected from January,2016 to April,2017 in the Department of Rehabilitation Medicine,Affiliated Hospital of Chengde Medical College.The patients were divided into experimental group(n =25)and control group(n = 25)by random number table.2 The control group was given routine rehabilitation therapy and core muscle group stability training.The experimental group received rehabilitation training and routine rehabilitation under the guidance of sEMGBF.The frequency and time of treatment in both groups were once a day,6 times a week for 3 consecutive weeks.Before treatment and after 3 weeks of treatment,erector spinae and multifidus muscle signals were collected.The mean square root value(RMS)of time domain index and the median frequency(MF)of frequency domain index were analyzed.At the same time,the visual analogue scoring method(VAS)and the lower back pain scoring system of Japanese orthopedic society(JOA)were used to evaluate the curative effect of the two groups.Result:1 Changes of EMG signal in erector Spinae and multifidus muscle of patients in each GroupsEMG signal analysis: After 3 weeks of treatment,sEMG signals were found in both groups,Experimental group pain side vertical erector Spinae,multifidus muscle RMS(33.65±6.43?V?28.46±4.54?V)Pain side MF(77.45± 13.08 Hz ? 68.30 ± 7.61Hz);Control group pain side erector Spinae,multifidus muscle RMS(18.24±3.54?V?19.37±5.81?V),Pain side MF(85.01±7.69Hz?92.36±15.35Hz);RMS of pain side in both groups was significantly higher than before treatment,MF was significantly lower than before treatment(P<0.05);RMS of pain side erector Spinae and multifidus muscle in experimental group were higher than that in control group,MF in pain side was lower than that in control group,and the difference between the two groups was statistically significant(P<0.05).2 Effects of sEMGBF guided rehabilitation training on pain in patients with CNLBPPain VAS score: The score of the experimental group was 6.36±1.04 before treatment and decreased to 2.04±0.61 after treatment.The control group before treatment was 6.40±1.22 points,after treatment decreased to 2.64±0.81 points,both groups were improved than before treatment(P<0.05).The improvement degree of the experimental group was higher than that of the control group,and the difference was statistically significant(P<0.05).3 Effect of rehabilitation training guided by sEMGBF on lumbar function in patients with CNLBPJOA score: The experimental group was 16.96±0.79 points before treatment and 25.76±1.20 points after treatment,the improvement rate was 73.64±9.78 %.The control group was 16.84±1.07 points before treatment,increased to 23.40±1.58 points after treatment,the improvement rate was 53.84±13.27 %.The patients in both groups were improved compared with those before treatment(P<0.05).The improvement degree of the experimental group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion:Conventional rehabilitation therapy combined with core muscle group stability training can improve CNLBP,while sEMGBF under the guidance of rehabilitation training combined with conventional rehabilitation therapy can effectively reduce the degree of pain in CNLBP patients,enhance the control ability of the waist core muscle group,increase the stability of the spine,significantly improve the rehabilitation treatment effect.