Efficacy Of Motor Control Exercise Combined With Acupuncture Myofascial Trigger Points In The Treatment Of Chronic Non-specific Low Back Pain

Chronic non-specific low back pain is a low back pain syndrome of unknown etiology.Because of its unclear etiology,long duration,prognosis and recurrence,it has caused great confusion to clinicians and patients.Due to the relationship between pain-related symptoms and fear-avoidance beliefs,pain may be exacerbated in a vicious circle,causing huge medical and economic burden to society.There is currently no specific treatment for chronic non-specific low back pain.The clinical practice guidelines of the American College of Physicians recommend exercise therapy as the preferred non-drug treatment method.However,exercise therapy is of long duration and limited effectiveness,Exercise therapy combined with other pain control methods may achieve better results.Objective:To observe the clinical efficacy of motor control exercise combined with acupuncture myofascial trigger points in chronic non-specific low back pain,and to study whether motor control exercise combined with acupuncture myofascial trigger points can effectively relieve pain,improve dysfunction and reduce fear-avoidance beliefs in patients with chronic non-specific low back pain than single motor control exercise.To provide objective basis for the effect of motor control exercise combined with acupuncture myofascial trigger point on chronic non-specific low back pain.Method: In this study,patients with chronic non-specific low back pain were enrolled in a randomized controlled trial design.From March to May 2021,48 subjects were recruited from the society,and 40 subjects were finally included and randomly divided into motor control exercise combined with acupuncture myofascial trigger point group(experimental group)and single motor control exercise group(control group),20 people in each group.The frequency of interventions was 4 times a week for 4 weeks.Pain intensity,dysfunction,and fear-avoidance beliefs were assessed by visual analog scale(VAS),Oswestry Disability Index(ODI),and fear-avoidance beliefs Questionnaire(FABQ)before treatment,2 weeks after treatment,4 weeks after treatment,and 1 month after treatment.Results: Comparison within groups: In the VAS outcome indicators,there were statistically significant differences between the experimental group and the control group in the middle of treatment,4 weeks and 1 month after treatment compared with before treatment(P<0.05);Compared with the mid-term,there were statistically significant differences between the experimental group and the control group after 4weeks of treatment and 1 month of follow-up(P < 0.05).There was no statistical difference between the two groups after 4 weeks of treatment and 1 month of follow-up(P > 0.05).In ODI outcome indicators,there were significant differences between the experimental group and the control group before treatment and the follow-up visits after treatment,4 weeks and 1 month(P < 0.05).There were statistically significant differences between the two groups in the middle of treatment and the follow-up visits after 4 weeks and 1 month(P < 0.05).There was no significant difference in ODI index between the two groups after 4 weeks of treatment and 1 month of follow-up(P > 0.05).In FABQ outcome indicators,there were statistically significant differences between the two groups before treatment and the follow-up visits after treatment,4 weeks and 1 month(P < 0.05).There were statistically significant differences between the experimental group and the control group in the middle of treatment and the follow-up after 4 weeks and 1 month(P <0.05).There was no statistical difference between the two groups after 4 weeks of treatment and 1 month of follow-up(P > 0.05).Comparison between groups: There were no significant differences between the two groups in gender,age,height,weight,BMI,disease course and pain side at baseline(P > 0.05).In VAS results,there was no statistical difference between the experimental group and the control group before and during treatment(P > 0.05).The two groups were followed up at two time points after 4 weeks of treatment and one month,and there were statistically significant differences between the two groups(P <0.05).In ODI outcome indicators,there was no statistical difference between the experimental group and the control group before treatment(P > 0.05).There were statistically significant differences in ODI values between the experimental group and the control group at the middle stage of treatment,4 weeks after treatment and 1month after follow-up(P < 0.05).In FABQ results,there was no statistical significance between the experimental group and the control group at each time node of follow-up before treatment,in the middle of treatment,4 weeks after treatment and one month after treatment(P > 0.05).Conclusions:Motor control exercise combined with acupuncture myofascial trigger points and single motor control exercise can effectively relieve pain-related symptoms in patients with chronic non-specific low back pain,which is a safe,effective and feasible treatment method.The improvement of pain and dysfunction in patients with chronic non-specific low back pain by motor control exercise combined with acupuncture myofascial trigger points was significantly better than that by motor control exercise alone and was maintained one month after treatment.Motor control exercise combined with acupuncture myofascial trigger points and single motor control exercise had positive effects on the fear-avoidance beliefs of patients with chronic non-specific low back pain,and the improvement effect of both was similar.