ObjectiveTo explore the effect of dynamic neuromuscular stabilization technique for chronic non-specific low back pain. MethodsFrom July 2019 to June 2020, 60 patients with chronic non-specific low back pain who underwent rehabilitation at the outpatient clinic of Sir Run Run Shaw Hospital Affiliated to Zhejiang University School of Medicine were prospectively selected. All patients were divided into trial group and control group by random number table method. There were 30 cases in each group. The control group used rehabilitation education and core muscle strength training. The trial group used dynamic neuromuscular stabilization of chest and abdomen combined with breathing control training on the basis of the treatment plan of the control group. The Visual Analogue Scale (VAS) score, Oswestry Dability Index (ODI), abdominal pressure stability, xiphoid level thoracic mobility and axillary level thoracic mobility were compared between the two groups of patients. ResultsAll the 60 patients in this study completed the trial, and there was no recurrent case during treatment, after treatment or during follow-up. There was no statistically significant difference in age, gender, height, weight, body mass index, or course of disease between the two groups (P>0.05). Taking VAS score as the dependent variable, the result of generalized estimating equations showed that the difference in VAS score between the trial group and the control group was statistically significant (χ2=4.132, P=0.042), and the VAS scores at 12 weeks of follow-up and at 8 weeks of treatment differed significantly from that before treatment (χ2=1618.814, P<0.001; χ2=1573.419, P<0.001); the between-group comparisons at different time points showed that the difference in VAS score between the two groups at 12 weeks of follow-up was statistically significant (P<0.001), and the remaining between-group differences were not statistically significant (P>0.05). Taking ODI score as the dependent variable, the result of generalized estimating equations showed that the difference in total ODI score between the two groups was statistically significant (χ2=11.063, P=0.001), and the ODI scores at 12 weeks of follow-up and at 8 weeks of treatment differed significantly from that before treatment (χ2=524.694, P<0.001; χ2=717.236, P<0.001); the between-group comparisons at different time points showed that there were statistically significant differences between the two groups at 8 weeks of treatment and at 12 weeks of follow-up (P<0.001). After treatment, the improvement of stability value of abdominal pressure [(−4.93±8.14) vs. (−1.33±4.78) mm Hg (1 mm Hg=0.133 kPa)], the improvement of xiphoid level thoracic mobility [(1.87±0.62) vs. (1.52±0.70) cm] and the improvement of axillary level thoracic mobility [(1.78±0.62) vs. (0.92±0.45) cm] in the trial group were better than those in the control group (P<0.05).ConclusionThe dynamic neuromuscular stabilization technique can improve the dysfunction and relieve the symptoms of patients with chronic non-specific low back pain, and it is worthy of promotion.
Objective To observe the effects of extracorporeal shock wave therapy (ESWT) combined with kinesio taping (KT) on chronic non-specific low back pain (CNLBP). Methods CNLBP patients who visited the Department of Rehabilitation Medicine, the Second Affiliated Hospital of Nantong University between January 2021 and January 2022 were selected. The included patients were divided into ESWT group, KT group, and combined treatment group using a random number table method. All patients received conventional rehabilitation. The ESWT group was treated with ESWT, the KT group was given KT therapy, and the combined treatment group were treated with ESWT and KT with the same treatment frequency as before. Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), MOS 36-item Short form Health Survey (SF-36) and Self-rating Anxiety Scale (SAS) were used to evaluate pain severity, lumbar spine function, quality of life, and anxiety status in all groups before and 4 weeks after treatment, respectively. Results A total of 85 patients were included. Among them, there were 29 cases in the ESWT group, 28 cases in the KT group, and 28 cases in the combined treatment group. There was no adverse event in any group. The intra-group comparison results showed that the VAS, ODI, and SAS scores of the three groups after 4 weeks of treatment were lower than those before treatment (P<0.05), while the SF-36 scores in all dimensions were higher than those before treatment (P<0.05). Before treatment, there was no statistically significant difference in VAS, ODI, SAS, or SF-36 scores among the three groups (P>0.05). After 4 weeks of treatment, there were statistically significant differences in VAS, ODI, SAS, and SF-36 scores among the three groups (P<0.05). The results of multiple comparisons between groups showed that the VAS scores of the ESWT group and the combination therapy group were lower than those of the KT group (P<0.05); the ODI scores of the combination therapy group were lower than those of the ESWT group and the KT group (P<0.05); the SAS scores of the combination therapy group were lower than those of the KT group (P<0.05); the SF-36 scores of each dimension were compared in pairs among the three groups, and the differences were statistically significant (P<0.05); there was no statistically significant difference in pairwise comparison of other indicators between groups (P>0.05). Conclusion ESWT combined with KT can more effectively improve the pain and lumbar spine function of patients with CNLBP, and improve the quality of life of patients.
ObjectiveTo explore the predictive value of the nerve root sedimentation sign in the diagnosis of lumbar spinal stenosis (LSS). Methods Between January 2019 and July 2021, 201 patients with non-specific low back pain (NS-LBP) who met the selection criteria were retrospectively analyzed. There were 67 males and 134 females, with an age of 50-80 years (mean, 60.7 years). Four intervertebral spaces (L1, 2, L2, 3, L3, 4, L4, 5) of each case were studied, with a total of 804. The nerve root sedimentation sign was positive in 126 intervertebral spaces, and central canal stenosis was found in 203 intervertebral spaces. Progression to symptomatic LSS was determined by follow-up for lower extremity symptoms similar to LSS, combined with central spinal stenosis. Univariate analysis was performed for gender, age, visual analogue scale (VAS) score for low back pain at initial diagnosis, treatment, dural sac cross-sectional area at each intervertebral space, number of spinal stenosis segments, lumbar spinal stenosis grade, positive nerve root sedimentation sign, and number of positive segments between patients in the progression group and non-progression group, and logistic regression analysis was further performed to screen the risk factors for progression to symptomatic LSS in patients with NS-LBP. ResultsAll patients were followed up 17-48 months, with an average of 32 months. Of 201 patients with NS-LBP, 35 progressed to symptomatic LSS. Among them, 33 cases also had central spinal stenosis, which was defined as NS-LBP progressing to symptomatic LSS (33 cases in progression group, 168 cases in non-progression group). Univariate analysis showed that CSA at each intervertebral space, the number of spinal stenosis segments, lumbar spinal stenosis grade, whether the nerve root sedimentation sign was positive, and the number of nerve root sedimentation sign positive segments were the influencing factors for the progression to symptomatic LSS (P<0.05); and further logistic regression analysis showed that positive nerve root sedimentation sign increased the risk of progression of NS-LBP to symptomatic LSS (OR=8.774, P<0.001). ConclusionThe nerve root sedimentation sign may be associated with the progression of NS-LBP to symptomatic LSS, and it has certain predictive value for the diagnosis of LSS.