摘要
目的从身体、行为、心理三方面进行多学科整体干预,阐释非特异性腰背痛(non-specific low back pain,NSLBP)的内在机制。方法收集易筋经特定动作“卧虎式”治疗NSLBP的相关表面肌电(surface electromyography,sEMG)信号、三维步态分析系统信号、心理量表结论等,将收集数据通过结构方程方法分析、建模,形成“多裂肌-运动功能-生活质量”特征模型,以期阐述易筋经“卧虎式”训练治疗NSLBP的作用机制。结果NSLBP患者腰部L5~S1多裂肌sEMG信号与治疗前相比显著增加(P<0.05)。患者治疗后步幅、步频、步速、髋屈曲最大角度、膝屈曲最大角度均显著增加(P<0.05);支撑相、摆动相、踝跖屈最大角度均显著降低(P<0.05)。“卧虎式”训练前后患者SF-36评分生理、心理、精神、情感差异均有统计学意义(P<0.05);结构方程模型(structural equation model,SEM)表明平均肌电(average electromyography,AEMG)、步长对于Roland-Morris评分、SF-36评分均产生0.001水平的显著影响;AEMG、步长对于Roland-Morris评分、SF-36评分产生正向的影响关系;标准化载荷系数均大于0.6,模型拟合效果良好。结论SEM模型拟合效果良好,模型结果可靠,能够多层面有效阐述易筋经特定动作“卧虎式”治疗NSLBP的作用原理。
Objective To conduct a multidisciplinary holistic intervention considering physical,behavioral,and psychological aspects to explain the internal mechanism of non-specific low back pain(NSLBP).Methods Surface electromyography(sEMG)signals,three-dimensional(3D)gait analysis system signals,and psychological scale conclusion related to the‘crouching tiger’treatment of NSLBP by Yijinjing were collected.The collected data were analyzed and modeled using the structural equation method.A multifidus muscle-motor function-quality of life(QOL)model was developed to elucidate the mechanism of action of NSLBP treatment using Yijinjing‘crouching tiger’training.Results The sEMG signals from the L5-S1 multifidus muscles of patients with NSLBP were significantly increased after treatment(P<0.05).After treatment,the patients’step length,step frequency,step speed,maximum hip flexion angle,and maximum knee flexion angle significantly increased(P<0.05).The support,swing,and maximum ankle dorsiflexion angles significantly decreased(P<0.05).The SF-36 physiological,psychological,spiritual,and emotional scores of the patients before and after the‘crouching tiger’training were statistically significant(P<0.05).Structural equation model(SEM)showed that average electromyography(AEMG)and step size significantly impacted the Roland Morris and SF-36 scores at a level of 0.001.AEMG and step size had a positive impact on Roland-Morris and SF-36 scores.The standardized load coefficients were greater than 0.6,and the model fit was good.Conclusions The SEM model has good fitting effects and reliable results and can effectively describe the mechanism of NSLBP treatment by Yijinjing‘crouching tiger’training at multiple levels.
作者
李翔
李超
汤炳煌
张少伟
李天骄
LI Xiang;LI Chao;TANG Binghuang;ZHANG Shaowei;LI Tianjiao(Rehabilitation Medicine College,Fujian University of Traditional Chinese Medicine,Fuzhou 350122,China;Xiamen Humanity Rehabilitation Hospital,Xiamen 361000,Fujian,China)
出处
《医用生物力学》
CAS
CSCD
北大核心
2024年第2期299-304,共6页
Journal of Medical Biomechanics
基金
福建省自然科学基金项目(2016J01378)
国家自然科学基金项目(81102627)
福建省科技厅社会引导性项目(2016Y0050)
中国出土医学文献与文物中心项目(2020C05)。
关键词
易筋经
非特异性腰背痛
结构方程模型
步态分析
表面肌电
Yijinjing
non-specific low back pain(NSLBP)
structural equation model(SEM)
gait analysis
surface electromyography(sEMG)
作者简介
通信作者:李天骄,副主任医师,副教授,E-mail:dr.tina@aliyun.com。
