慢性非特异性腰痛患者足底压力特征分析和平衡研究
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河北省医学适用技术跟踪项目(GL201628)


Analysis on Characteristics of Plantar Pressure and Balance in Patients with Chronic Nonspecific Low Back Pain
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    摘要:

    目的 探究慢性非特异性腰痛( chronic nonspecific low back pain, CNLBP)患者和健康受试者的平衡能力差异,以及患者疼痛症状、腰椎灵活性、腹肌耐力、总体功能、生存质量和恐惧逃避心理与平衡能力的相关性,从而指导临床康复评价。 方法 选取 34 例 CNLBP 患者作为实验组,另选取 34 例无腰痛史健康志愿者作为对照组,使用足底压力测量系统采集两组受试者静止站立时前足/ 后足压力比、足底压力中心位移路径长度( L)、前后向位移长度(LAP )、侧向位移长度(LML )、平均速度(v)、前后向位移速度( vAP )、侧向位移速度( vML )、椭圆摆动面积( S)。 另外,实验组采用视觉模拟评分法(visual analogue scale,VAS)、指地距离(finger floor distance, FFD)、1 min 卷腹个数、Oswestry 功能障碍指数问卷表(Oswestry disability index,ODI)、健康状况调查简表(36-item short form survey,SF-36)和恐惧-回避信念问卷(fear avoidance beliefs questionnaire,FABQ) 进行评估,并与足底压力参数进行相关性分析。结果 两组受试者各项足底压力指标均有显著性差异(P<0. 05),其中实验组前足/ 后足压力比显著低于对照组(P<0. 05),L、LAP 、LML 、v、vAP 、vML 和 S 显著高于对照组(P<0. 05)。 在睁闭眼时,实验组 VAS 评分和 L、LAP 、LML 呈正相关关系(P<0. 05),FFD、FABQ 评分分别和 L、LML 正相关关系(P<0. 05);睁眼时,ODI 和 L、LAP 、LML 呈正相关关系(P<0. 05),SF-36 评分和 L、 LML 呈负相关关系( P < 0. 05);闭眼时,1 min 卷腹个数和 LAP 、 S 呈负相关关系(P<0. 05),ODI 和 L、LML 呈正相关关系(P<0. 05),SF-36 评分和 L 呈负相关关系(P<0. 05)。 结论 CNLBP 患者的静态平衡能力下降,且与疼痛症状、腰椎功能、生存质量和心理状态有一定的相关性。 研究结果可为功能活动的评估提供参考。

    Abstract:

    Objective To explore the difference of balance ability between patients with chronic nonspecific low back pain ( CNLBP) and healthy individuals, and the correlation between patients’ pain symptoms, lumbar flexibility, abdominal muscle endurance, overall function, quality of life and fear of avoidance with balance ability, so as to guide clinical rehabilitation evaluation. Methods A total of 34 patients with CNLBP were selected as the experimental group, and 34 healthy volunteers without history of low back pain were selected as control group. The plantar pressure measurement system was used to collect the ratio of forefoot to hindfoot pressure, pathlength ( L) of plantar center of pressure ( COP), displacement length in anteroposterior direction ( LAP ), displacement length in mediolateral direction (LML ), mean velocity (v), displacement velocity in anteroposterior direction (vAP ), displacement velocity in mediolateral direction (V-ML) and elliptical swing area (S). In addition,the experimental group was assessed by the visual analogue scale (VAS), the finger floor distance (FFD), the number of sit-ups in 1 minute, the Oswestry disability index (ODI), the 36-item short form survey (SF-36) and the fear avoidance beliefs questionnaire (FABQ), and correlated with plantar pressure parameters. Results All plantar pressure parameters were significantly different between the two groups ( P < 0. 05). The the ratio of forefoot to hindfoot pressure in experimental group was significantly lower than that in control group (P<0. 05), and the parameters L, LAP , LML , v, vAP , vML and S were significantly higher than those of control group (P<0. 05). With eyes open or closed, the VAS score of experimental group was positively correlated with L, LAP , LML(P<0. 05), and FFD and FABQ scores were positively correlated with L and LML , respectively (P< 0. 05). With eyes open, ODI was positively correlated with L, LAP and LML (P< 0. 05), and SF-36 score was negatively correlated with L and LML(P<0. 05). With eyes closed, the number of 1-min sit-ups was negatively correlated with LAP and S (P<0. 05), ODI was positively correlated with L and LML(P<0. 05), and the SF-36 score was negatively correlated with L (P<0. 05). Conclusions The static balance ability of patients with CNLBP is decreased, and it is correlated with pain symptoms, lumbar function, quality of life and psychological status. The result can provide references for the assessment of functional activities.

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杨倩倩,孟宪中,颜雯婷,任 凤,胡文清.慢性非特异性腰痛患者足底压力特征分析和平衡研究[J].医用生物力学,2023,38(1):176-181

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  • 收稿日期:2022-04-27
  • 最后修改日期:2022-05-17
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  • 在线发布日期: 2023-02-28
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