The Effects Of Core Stability Training Combined With Self-myofascial Release On Nonspecific Low Back Pain In Female College Students

Objective:The prevalence of nonspecific low back pain（NLBP）is a common problem worldwide.NLBP not only has a high incidence,but can also seriously affect daily life.In this study,through core stability training combined with myofascia relaxation,functional exercise and rehabilitation treatment were performed on female college students with NLBP,and the improvement degree of the intervention program was observed,in order to provide new diagnosis and treatment ideas for the rehabilitation of female college students with NLBP,and provide theoretical basis for the intervention program.Methods:A total of 53 female college students with NLBP were screened and randomly divided into core stability training group（H）,myofascial relaxation group（J）and binding group（H+J）.（1）Group H received 3 times a week,a total of 6 weeks of core stability training program,including Swiss ball straight arm forward extension,straight arm back extension,abdominal curl,upper and lower limb alternating extension and shoulder bridge;（2）Group J was given a myofascial relaxation program 3 times a week for a total of 6 weeks,including the relaxation of the thoracolumbar fascia,the gluteus maximus on both sides and the biceps femoris fascia.（3）Group H+J underwent myofascial relaxation immediately after core stability training.The core stability training program was the same as group H,and the myofascial relaxation training program was the same as group J,3 times a week for a total of 6 weeks.Visual analog scale（VAS）was used to evaluate pain before and after intervention.Roland-morris Dysfunction Questionnaire（RMDQ）was used to assess dysfunction before and after intervention.The Japanese Orthopaedic Association Low back Pain Quality of Life Scale（JOA）was used to evaluate the quality of life before and after intervention.The range of motion of the lumbar spine before and after the intervention was evaluated with a range of motion protractor.Isokinetic muscle strength test and back muscle endurance test were used to evaluate lumbar flexion and extension muscle strength and back muscle endurance before and after intervention.Y-balance test was used to evaluate dynamic balance ability before and after intervention.SPSS25.0 was used to process the data.One-way analysis of variance and rank-sum test were used for comparison between groups,and paired sample T test was used for comparison within groups,with P<0.05 as the level of significant difference,P<0.01 as the level of very significant difference.Results:（1）A total of 46 subjects completed the intervention and evaluation of the whole experiment,including 15 in group H,15 in group J and 16 in group H+J.There was no statistical significance in baseline values of the three groups before intervention（P>0.05）.（2）Pain assessment:（1）Compared with before intervention,VAS scores in the three groups were significantly decreased（P<0.01）.（2）After 6 weeks of intervention,VAS score of group J was lower than that of group H（P<0.05）;VAS score of group H+J was significantly lower than that of group H（P<0.01）.（3）Dysfunction evaluation:（1）Compared with before intervention,RMDQ scores in three groups were significantly decreased（P<0.01）.（2）After 6 weeks of intervention,RMDQ score of group J was lower than that of group H（P<0.05）;RMDQ score of group H+J was significantly lower than that of group H and group J（P<0.01）.（4）Quality of life assessment:（1）Compared with before intervention,JOA scores in three groups were significantly increased（P<0.01）.（2）After 6 weeks of intervention,the JOA score of group H+J was higher than that of group H（P<0.05）.（5）Comparison of lumbar motion:（1）Compared with before intervention,lumbar ROM in all directions was increased in the three groups（P<0.05）.（2）After 6weeks of intervention,the ROM of anterior flexion,left rotation and right rotation in group J was higher than that in group H（P<0.05）.The ROM of group H was higher than that of group J（P<0.05）.The ROM of group H+J was higher than that group H except for hind extension（P<0.05）.The ROM of H+J group was higher than of that of J group（P<0.05）.（6）Lumbar flexion and extension force evaluation:（1）Compared with before intervention,average work and peak torque of lumbar flexion and extension in three groups were significantly increased（P<0.01）.（2）After 6 weeks of intervention,the average work and peak torque of lumbar flexion and extension in group H and group H+J were higher than those in group J（P<0.05）;There was no significant difference in the improvement degree of average work and peak torque of lumbar flexion and extension between group H and group H+J（P>0.05）.（7）Lumbar and back muscle endurance evaluation:（1）Compared with before intervention,lumbar and back muscle endurance in three groups was significantly increased（P<0.01）.（2）After 6 weeks of intervention,the muscle endurance of group H+J was higher than that of group J（P<0.05）.（8）Dynamic balance assessment:（1）Compared with before intervention,Y balance values on the left and right sides of the three groups were significantly increased（P<0.01）.（2）Inter-group comparison,after 6 weeks of intervention,the left and right Y balance value of group H+J was significantly higher than that of group H and group J（P<0.01）.Conclusions:（1）Six weeks of core stability training,myofascial relaxation training,and core stability training combined with myofascial relaxation can significantly improve the pain,dysfunction,quality of life,lumbar motion,muscle function and dynamic balance ability of female college students with NLBP.（2）Six weeks of core stability training has significant effect on the improvement of muscle function level and extension ROM in female college students with NLBP;Myofascial relaxation training at six weeks was more focused on reducing pain and improving dysfunction,and significantly improved lumbar flexion,left rotation,and right rotation motion.（3）As opposed to core stability training or myofascial relaxation training,core stability training combined with myofascial relaxation improved the dysfunction,quality of life,lumbar motion in all directions and dynamic balance in female college students with NLBP within six weeks.