| Background: Chronic low back pain(CLBP)is one of the most common musculoskeletal problems in clinic,which consumes huge medical resources over the years.Traditionally,it is believed that lack of exercise is related to the emergence and onset of CLBP.Therefore,therapeutic exercise is one of the most commonly used treatments at present.Transversus abdominis muscle training is a representative core muscle training method,which is widely used in the treatment of chronic low back pain.However,some researchers believe that the amount of activity in the CLBPpopulation is no less than that in the asymptomatic population,and there is no direct correlation between physical activity level and pain intensity or dysfunction.At present,it is not clear the specific effects of different intensity of transverse abdominal muscle training on CLBP.Objective: To evaluate the effect of transversus abdominis muscle training on different muscle pressure pain thresholds(PPT)in people with chronic low back pain,What is the difference between these people and the asymptomatic people,and what is the difference between the two groups in terms of social psychological factors.Whether there is a correlation between social psychological factors and muscle PPT,and whether it will affect the change of PPT.Complement the previous studies to provide a theoretical basis for the clinical treatment and diagnosis of CLBP.Methods: 39 patients with chronic low back pain and 45 healthy subjects were recruited.The CLBP group were divided into sham training group(n=12),low intensity group(n=12)and high intensity group(n=15).The healthy group were divided into sham training group(n=15),low intensity group(n=14)and high intensity group(n=16).Using pressure biofeedback(PBU)instrument,they were given one-time transverse abdominal muscle training intervention: high intensity 30 180 mm Hg abdominal transverse muscle contraction training for 10 minutes,low intensity abdominal transverse muscle contraction training for 5 minutes 15 100 mm Hg.The evaluation indexes were muscle tenderness threshold,simplified Mc Gill pain questionnaire and body surface pain radiogram.Cross-sectional comparison indicators are: baseline data and corresponding social psychological indicators.Results: Transverse abdominal muscle training can increase the tenderness domain of the core muscles of the waist.After high intensity training,the PPT with significant differences from post-exercise to pre-exercise were as follows: CLBP group [iliopsoas muscle(0.69 kgf,p=0.020),psoas quadratus muscle(0.84 kgf,p=0.012),erector spine muscle(0.66 kgf,p=0.011),transversus abdominis muscle(0.70 kgf,p= 0.04),gluteus medius muscle(0.47 kgf,p=0.027)].Normal people [iliopsoas muscle(0.46 kgf,p=0.012),quadratus lumborum muscle(0.89 kgf,p=0.002),erector spine muscle(1.02 kgf,p=0.000),transversus abdominis muscle(0.60 kgf,p=0.000),gluteus medius muscle(0.68 kgf,p=0.000)].There were significant differences in the tenderness threshold between 24 hours after exercise and before exercise: the CLBP group: quadratus lumborum muscle(0.65 kgf,p=0.018).Normal population: transversus abdominis muscle(0.44 kgf,p=0.030).After low-intensity training,the muscles with significant differences immediately after exercise and before exercise are: CLBP group [Psoas quadratus muscle(0.62 kgf,p=0.015),transversus abdominis muscle(0.57 kgf,p=0.008),piriformis muscle(0.65 kgf,p=0.013)];normal population [erector spinae muscle(0.71 kgf,p=0.001),transversus abdominis muscle(0.46 kgf,p=0.016),gluteal muscles(0.68 kgf,p=0.000).It can reduce the radiation range of lumbar pain.Immediately after training low intensity group:-4.33[95%CI,(-0.27 to 1.26),p= 0.005];Immediately after training low intensity group-10.87[95%CI,(-17.51 to-4.22),p=0.003].The chronic low back pain group had a larger range of pain radiation than the normal population(T=-2.824,p=0.006),and the residual pain time was longer(T=-2.188,p=0.032).In terms of sociopsychological factors,women in the chronic low back pain group have significantly more tension-anxiety(T=-2.392,p=0.022),anger-hostility(T=2.080,p=0.044),and confusion compared with men in the chronic low-back pain group.(T=-2.710,p=0.010);Chronic low back pain group is more prone to state anxiety than normal people(T=-2.496,p=0.015);Sleep quality of chronic low back pain group is worse than normal people(T=-2.628,p=0.010).There is a significant low positive correlation between gender,height,weight,training habit and muscle pain threshold,the muscle pain threshold of male was higher than that of female.There is a significant low to moderate negative correlation between general emotional disorder,state anxiety,trait anxiety,pain disaster,pain fear,sleep quality and muscle pain threshold.Conclusion: Transverse abdominal muscle training can increase the tenderness value of the core muscles of the waist and reduce the radiation range of waist pain in people with chronic low back pain.Compared with low intensity training,high intensity training can activate more waist core muscles,and the benefits of high intensity training are better than low intensity training.People with CLBP use different muscles compared to normal people during training.People with chronic low back pain may not use the transverse abdominal muscles properly and use the square muscles for compensation,which may be the cause of low back pain.People with CLBP are more likely to have state anxiety than normal people,and their sleep quality is worse than that of normal people.Women with chronic low back pain have significantly more stress-anxiety,anger-hostility,and confusion-chaos than those with low-back pain men and normal women.Men's muscle tenderness value is higher than women's,and body mass index(BMI)has a certain effect on tenderness value. |
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