| 1.Objective:Nonspecific low back pain(NLBP)accounts for about 90% of the subjects with low back pain,which seriously hinders the daily life and work of the subjects.NLBP subjects are usually related to lumbar stability and weak three-dimensional breathing ability,and lumbar stability and three-dimensional breathing training can improve NLBP symptoms,but lumbar stability combined with three-dimensional breathing training on the efficacy of NLBP is rarely reported.The purpose of this study was to study the effect of three-dimensional breathing combined with lumbar stabilization training on NLBP and to explore a better intervention mode of NLBP.2.Methods:Forty-four male college students with nonspecific low back pain were recruited and randomly divided into two groups: lumbar stability training group(LSE,n=22)and lumbar stability + three-dimensional breathing training group(TDB,n=22).The training time is 10 weeks and the training frequency is 3 times a week.The data were collected before and 10 weeks after training,and the test indexes included:(1)Basic physical parameters: height,weight,blood pressure,heart rate and fat-free weight;(2)Stable muscles of lumbar vertebrae:diaphragm muscle strength,bifida muscle strength,inferior transverse muscle strength,superior transverse muscle strength,psoas muscle strength;(3)Questionnaire survey: visual pain scale(VAS),low back pain rating scale(JOA),low back pain score scale(ODI).(4)Lumbar functional parameters: anterior lumbar stability test,posterior lumbar stability test,lumbar lateral stability test.(lumbar anterior stability test,lumbar posterior stability test,lumbar lateral stability test).3.Results:3.1 The changes in the efficacy of LSE and TDB subjects:(1)Compared with the situation before training,JOA,ODI and VAS in LSE subjects decreased significantly,JOA in TDB subjects decreased significantly,VAS and ODI decreased significantly respectively.(2)Compared with LSE,the improvement effect of VAS in TDB subjects was better,but there was no significant difference in the scores of JOA and ODI between groups(P > 0.05).3.2 The changes of lumbar functional parameters in LSE and TDB subjects:(1)Compared with the situation before training,the posterior lumbar stability,anterior lumbar stability and joint function decreased significantly in LSE subjects,but there was no significant change in lumbar lateral stability,while in TDB subjects,posterior lumbar stability,lumbar lateral stability,anterior lumbar stability and joint function were significantly improved.(2)Compared with LSE,the improvement effect of lumbar lateral stability in TDB subjects was better(P < 0.05).There was no significant difference in posterior lumbar stability,anterior lumbar stability and joint function between lumbar stabilization training group and threedimensional breathing combined with lumbar stabilization training group.3.3 The changes of core muscle strength in LSE and TDB subjects:(1)Compared with the situation before training,the muscle strength of diaphragm,lower part of transverse abdominal,polyfida muscle and psoas major muscle of LSE subjects was significantly improved,but the muscle strength of upper part of transverse abdominis muscle had no significant change,while that of polyfida muscle,psoas major muscle,upper transverse muscle,lower part of abdominal transverse muscle and diaphragm decreased significantly in TDB subjects(P < 0.05).Compared with LSE,the muscle strength of diaphragm,psoas major muscle and lower transverse abdominis muscle of TDB subjects improved better(P < 0.05).3.4 Correlation among efficacy,core muscle strength and lumbar stability in LSE subjects:(1)Compared with the situation before training,the efficacy JOA of LSE subjects was related to the lower abdominal transverse muscle strength(P < 0.05,r=0.514),upper abdominal transverse muscle strength(P < 0.05,r=0.464),multifidus muscle strength(P < 0.05,r=0.523),and lumbar posterior stability(P < 0.05,r = 0.629).(2)ODI in LSE subjects was correlated with multifidus muscle strength(P < 0.05,r=0.627),superior transverse abdominal muscle strength(P < 0.05,r=0.545),diaphragmatic muscle strength(P < 0.05,r=0.474),and lumbar posterior stability(p < 0.05,r=0.588).(3)In LSE subjects,VAS was associated with multifidus muscle strength(P < 0.05,r=0.521),superior transverse abdominal muscle strength(P < 0.05,r=0.445),lumbar posterior stability(p < 0.05,r=0.588),and lumbar anterior stability(P < 0.05,r=0.444).3.5 Correlation among efficacy,core muscle strength and lumbar stability in TDB subjects:(1)Compared with those before training,the JOA in TDB subjects was related to the lower abdominal transverse muscle strength(P < 0.05,r=0.531),diaphragmatic muscle strength(P <0.05,r=0.533),psoas major muscle strength(P < 0.05,r=0.641),multifidus muscle strength(P< 0.05,r=0.669),lumbar lateral stability(P < 0.05,r=0.656),lumbar posterior stability(P <0.05,r=0.571),and lumbar anterior stability(P < 0.05,r = 0.656)(2)ODI in(2)TDB subjects was associated with lower abdominal transverse muscle strength(P < 0.05,r=0.752),diaphragmatic muscle strength(P < 0.05,r=0.645),lumbar posterior stability(P < 0.05,r=0.556),and lumbar anterior stability(P < 0.05,r=0.565);(3)In TDB subjects,VAS was associated with lower abdominal transverse muscle strength(P < 0.05,r=0.457),diaphragmatic muscle strength(P < 0.05,r=0.625),multifidus muscle strength(P < 0.05,r=0.407),lumbar lateral stability(P < 0.05,r=0.479),lumbar posterior stability(P < 0.05,r=0.649),and lumbar anterior stability(P < 0.05,r=0.462).3.6 Correlation between core muscle strength and lumbar stability in LSE subjects:(1)Compared with the situation before training,LSE subjects’ lumbar posterior stability was correlated with their psoas resistance(P < 0.05,r=0.580)and multifidus resistance(P <0.05,r=0.721).(2)In LSE subjects,lumbar anterior stability was correlated with multifidus muscle strength(P < 0.05,r=0.621),upper transverse abdominal muscle strength(P < 0.05,r=0.731),psoas major muscle strength(P < 0.05,r=0.677),and lumbar anterior stability(P <0.05,r=0.444).3.7 Correlation between core strength and lumbar stability in TDB subjects:(1)Compared with the situation before training,the stability of lumbar anterior side in TDB subjects was related to the lower abdominal transverse muscle strength(P < 0.05,r=0.647),diaphragmatic muscle strength(P < 0.05,r=0.618),psoas major muscle strength(P < 0.05,r=0.657),and multifidus muscle strength(P < 0.05,r=0.569).(2)In(2)TDB subjects,the posterior stability of lumbar spine was related to the lower abdominal transverse muscle strength(P < 0.05,r=0.652),diaphragmatic muscle strength(P < 0.05,r=0.477),multifidus muscle strength(P < 0.05,r=0.624),and psoas major muscle strength(P < 0.05,r=0.542).(3)Lateral stability of lumbar spine in(3)TDB subjects was related to lower abdominal transverse muscle strength(P < 0.05,r=0.632),diaphragmatic muscle strength(P < 0.05,r=0.567),and psoas major muscle strength(P < 0.05,r=0.731).4.Conclusion:4.1 Both lumbar stability and three-dimensional breathing combined training group have better curative effect on non-specific low back pain subjects,which is related to the improvement of lumbar stability and core muscle strength.4.2 The improvement of clinical symptoms in the three-dimensional breathing combined with lumbar training group is better,which is related to the muscle strength of the diaphragm and the lower part of the transverse abdominis,as well as the lateral,anterior and posterior stability of the lumbar spine. |
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