Clinical Observation On The Effect Of Individualized Functional Exercise Of Psoas And Abdominal Muscles On Chronic Nonspecific Low Back Pain Of Qi Stagnation And Blood Stasis Type

Objective: To explore the feasibility and effectiveness of individualized functional exercise of psoas and abdominal muscles in relieving pain and improving lumbar function in patients with chronic non-specific low back pain of qi stagnation and blood stasis type,so as to provide reference for guiding patients to choose reasonable functional exercise.Methods: from March 2019 to December 2019,62 patients with chronic non-specific low back pain who met the diagnostic criteria and inclusion criteria were selected from the orthopedic outpatient department of the First Affiliated Hospital of Tianjin University of traditional Chinese medicine.The general data,pain and functional impairment scores,lumbar curve index,sacral tilt angle and other related indicators were collected,measured and sorted out.62 patients were divided into experimental group and control group.According to the changes of lumbar curve index and sacral inclination angle,31 cases in each group can be further divided into three categories: too large sacral inclination angle,shallow physiological curvature of lumbar spine and shallow physiological curvature of lumbar spine with too large sacral inclination angle.Two groups of patients in the same basic treatment on the implementation of different exercise programs.According to the changes of lumbar curve index and sacral tilt angle,the experimental group carried out "individualized" exercise program: too large sacral tilt angle,abdominal muscle exercise;lumbar physiological curvature becomes shallow: upper body "Flying Swallow" exercise;lumbar physiological curvature becomes shallow with too large sacral tilt angle: upper body "flying swallow" combined with abdominal muscle exercise.Control group exercise program: regular exercise of the back muscle.Exercise for 3 months.Observation indexes: VAS score,Roland Morris dysfunction score and clinical comprehensive efficacy evaluation;VAS score and Roland Morris dysfunction score of all patients were collected before exercise,for one month and for three months respectively,and the clinical comprehensive efficacy evaluation was conducted at the last follow-up.Spss19.0 was used for data statistical analysis.Results: 1.A total of 56 patients were followed up,20 males and 36 females,age 37.25 ±9.10 years old,course 9.00(3.00-24.00)months,VAS score 5.00(5.00-6.00),Roland Morris dysfunction score 7.00(6.00-9.75),lumbar curve index 0.82(0.69-1.29)cm,sacral tilt angle43.75(36.31-46.14)° during the whole follow-up,28 patients in the control group and the experimental group,respectively,two patients Three people in each group were removed.2.Spearman correlation analysis showed that lumbar curve index was positively correlated with sacral tilt angle(r = 0.615);VAS score was positively correlated with Roland Morris dysfunction score(r = 0.813);Roland Morris dysfunction score was positively correlated with gender,sacral tilt angle and VAS score(r = 0.311,0.304 and 0.813 respectively).3.There was no statistical difference between the control group and the experimental group(P > 0.05).4.There was no significant difference in VAS score and Roland Morris dysfunction score between the experimental group and the control group before exercise(P > 0.05),but the VAS score and Roland Morris dysfunction score of one month after exercise were lower than before exercise,but there was no significant difference between the two groups(P > 0.05),and the VAS score and Roland Morris dysfunction score of three months after exercise were lower than before exercise(P < 0.05)The difference was statistically significant(P < 0.05).5.After 3 months of exercise,the clinical efficacy of the experimental group was better than that of the control group(P < 0.05);Conclusion: 1.There is a positive correlation between sacral tilt angle and lumbar curve index;Roland Morris dysfunction score is related to gender,sacral tilt angle and VAS score;2.The individual waist abdominal muscle function exercise is better than the simple waist back muscle function exercise in relieving the pain of patients with chronic non-specific low back pain of qi stagnation and blood stasis type;3.Individualized lumbar and abdominal muscle functional exercise is better than simple lumbar and back muscle functional exercise in improving the dysfunction of patients with chronic non-specific low back pain of qi stagnation and blood stasis type,with good safety...