腰椎斜扳治疗小关节紊乱的多种运动下肌电研究△

Surface electromyography in multi- exercises for facet disorder before and after lumbar oblique wrench manipulation

摘要:

[目的]定量评价腰椎斜扳治疗小关节紊乱患者在多种运动下的肌电变化。[方法]2020 年 9 月—2021 年 12 月上海交通大学医学院附属瑞金医院推拿科的小关节紊乱患者 15 例，和相匹配的正常人 10 例纳入本研究。采用临床量表评分和表面肌电图对腰椎斜扳治疗前后的小关节紊乱患者和正常人进行几种运动的状态下检测，比较临床状态与运动过程中腰背肌的肌电活动差异。[结果] 与治疗前相比，治疗后 1 个月患者 VAS 评分显著减少 [(6.2±0.9), (1.5±0.6), P＜0.05]，而 JOA 评分显著增加 [(11.9±1.4), ( 22.7±3.3), P＜0.05]。肌电检测方面，患者在常态行走、右足跨越障碍行走、左足跨越障碍行走、弯腰、弯腰提物等不同运动方式下，治疗后 1 个月患者左右竖脊肌、左右多裂肌的平均肌电振幅和中位频率均较治疗前显著降低（P＜0.05），治疗后左右竖脊肌、左右多裂肌的平均肌电振幅和中位频率与正常人相比差异无统计学意义（P＞0.05）。[结论]腰椎斜扳治疗小关节紊乱可以缓解疼痛，降低竖脊肌和多裂肌的异常电活动。

Abstract:

[Objective] To quantitatively evaluate the surface electromyography (sEMG) changes in multi-exercises for facet disorder before and after lumbar oblique wrench manipulation. [Methods] From September 2020 to December 2021, 15 patients with facet disorder and 10 matched normal subjects were included in this study in the Department of Tuina, Ruijin Hospital affiliated to Shanghai Jiao Tong Uni- versity. The clinical score evaluation and sEMG under several exercise states were conducted before and after lumbar oblique wrench manip- ulation. The difference in clinical state and the myoelectric activity of lumbar muscles were compared before and after lumbar oblique wrench manipulation in the patient with the normal subject. [Results] Compared with those before treatment, the VAS score for pain signifi- cantly reduced [(6.2±0.9), (1.5±0.6), P＜0.05], while the JOA score significantly increased [(11.9±1.4), (22.7±3.3), P＜0.05] 1 month after treatment in the patients. In terms of sEMG, the mean amplitude and median frequency of the right and left erector, as well as the left and right multifidus significantly decreased 1 month after treatment compared with those before treatment under different exercise modes, includ- ing normal walking, right foot over obstacle, left foot over obstacle, bending and bending load (P＜0.05). After treatment, the mean sEMG am- plitude and median frequency of right and left erector and left and right multifidus were not significantly different from those of normal peo- ple (P＞0.05). [Conclusion] Lumbar oblique wrench manipulation does relieve pain and reduce the abnormal electrical activity of erector and multifidus muscles in patients with facet disorders.