| Non-specific low back pain is a pain that cannot be explained by a specific pathological factor,above the lower edge of the rib to the subgluteal fold,with or without radiation pain in the lower extremities.The prevalence of non-specific low back pain is increasing year by year,and it is easy to relapse,and its pathogenesis is still unclear.Studies have shown that chronic non-specific low back pain is associated with different degrees of lumbar muscle fatigue,abnormal neurological control patterns,and decreased muscle contractility,and causes a vicious circle.Studies have shown that monotherapy is not effective in the treatment of CNLBP.The combination of multiple therapies can improve the symptoms of patients to a certain extent,but the degree of improvement of symptoms and reduction of recurrence rate is limited.The functional training system is an organic whole formed by the connection of several functional training methods,motion assessment and corrective exercises.It consists mainly of activation and regeneration,functional training,functional actions and motion correction.The functional action system is the action evaluation system,including functional movement screen and selective functional movement assessment.SFMA is mainly used in the presence of sports injuries or abnormal movements.A comprehensive systemic functional status assessment for CNLBP patients can reveal weak links in their body functions,allowing for more targeted functional training of patients.At home and abroad,the functional training system is mainly used in the field of sports,and it is rarely used in clinical applications,especially for the application research of CNLBP.In this study,based on the routine rehabilitation of patients with chronic non-specific low back pain,a functional training system was comprehensively applied to observe the degree of pain,health and improvement of waist muscle contractility and fatigue,and with conventional rehabilitation.Patients with chronic non-specific low back pain supplemented with core stability training were compared to provide a reference for the selection of clinical treatment options.Objective:To explore the rehabilitation effect of functional training system in the treatment of CNLBP patients based on conventional rehabilitation therapy.Methods:1 Thirty-six patients with chronic non-specific low back pain were divided into observation group and control group by random number table method,18 cases in each group.2 The control group was given routine rehabilitation intervention and core stability training.On the basis of routine rehabilitation intervention,the observation group was assessed by the selective functional movement assessment and was given individualized activation and regeneration,action correction and functional training.The treatment of both groups was performed once a day,6 times a week for 2 weeks.The curative effect was evaluated before treatment,1 week of treatment and 2 weeks of treatment.The evaluation items included the surface erector spinae and multifidus muscle surface EMG signal detection,the MOS item short from health survey and McGill pain questionnaire score.Result:1 Changes of EMG signals on the surface of erector spinae and multifidus muscles in the two groupsSurface electromyography signal detection:the root mean square of the erector spinae in the control group and the observation group at 1 week of treatment[11.01(8.65,12.45)μV、11.87(9.33,12.99)μV]and the median frequency of the frequency domain index[94.29(90.12,104.48)Hz、90.43(85.11,107.48)Hz],multifidus muscle RMS[9.68(8.29,11.56)μV、10.43(9.63,13.35)μV]and M F[95.33(88.33,112.60)Hz、95.56(91.83,105.54)Hz] were significantly improved compared with before treatment(P<0.05),but the difference between the groups was not statistically significant(P>0.05).At 2 weeks of treatment,the erector muscle RMS[15.62(14.57,17.70)μV、20.05(16.31,20.85)μV]and MF[9 1.79(88.31,101.93)Hz、80.19(76.77,98.62)Hz],multifidus muscle RMS[14.98(12.15,17.44)μV、18.37(15.30,23.16)μV]and MF[89.31(81.30,108.49)Hz、80.1 2(75.82,86.50)Hz]in the control group and the observation group were significantly improved(P<0.05),and the differences between the groups were statistically significant(P<0.05).2 Changes in the MOS item short from health survey of the two groups of patientsThe MOS item short from health survey score:The physical function,role-physical,bodily pain,general health,vitality,social functioning,role-emotional and mental health of the two groups were improved at 1 week after treatment(P<0.05),but the difference between the groups was not statistically significant(P>0.05).The scores of the two groups were significantly improved(P<0.05)at 2 weeks after treatment.The improvement degree of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).3 Changes in pain in both groupsMcGill pain questionnaire score:The pain rating index,visual analogue score and present pain index of the two groups were lower than those before treatment(P<0.05),but the difference between the groups was not statistically significant(P>0.05).The scores of the two groups were significantly lower than those before treatment at 2 weeks of treatment(P<0.05),and the observation group was more significant than the control group,the difference was statistically significant(P<0.05).4 Comparison of recurrence rates between the two groupsAt 3 months follow-up,4 patients were relapsed in the control group,and the recurrence rate was 22.2%.No recurrence was observed in the observation group.The recurrence rate of the control group was significantly higher than that of the observation group.The difference between the two groups was statistically significant(P<0.05).Conclusion:1 In this study,patients with chronic non-specific low back pain were evaluated by SFMA,and some patients were found to have obstacles such as cervical vertebrae and ankle joints.These dysfunctions are far away from the painful part and are often not found or ignored in traditional treatment.This may be one of the reasons for the poor therapeutic effect and high recurrence rate of patients with chronic non-specific low back pain.2 On the basis of routine rehabilitation therapy,according to the results of selective functional movement assessment,personalized motion correction and functional training for patients with chronic non-specific low back pain can reduce pain of the patient and improve their physical function,role-emotional,social functioning and other health status,and improve waist muscle contractility,fatigue resistance.And its effect is better than conventional rehabilitation therapy combined with core stability training.3 On the basis of routine rehabilitation and comprehensive application of functional training system for 2 weeks,the recurrence rate of patients with chronic non-specific low back pain can be reduced within 3 months. |
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