| Objective: the incidence of chronic non-specific low back pain(NLBP)is high,and the etiology is unknown.The number of patients is increasing year by year,which takes up a lot of medical and health resources and has a great impact on the lives of patients.In this study,Mulligan manipulation combined with core stability training was used to treat patients with chronic non-specific low back pain,to observe and compare the efficacy of Mulligan manipulation and core stability training on NLBP patients,to provide new ideas for the rehabilitation of NLBP patients,and to provide theoretical basis for Mulligan dynamic joint mobilization and core stability training.Methods: sixty-five non-specific low back pain subjects were recruited,and 47 non-specific low back pain subjects were randomly divided into 3 groups: group K: blank non-intervention(nasty16);group J: core stability training(nasty 16);group M+J: Mulligan combined with core stability training(nasty 15).Intervention: group K did not receive any intervention during the 6-week treatment.Group J,according to the advanced training principle,chose 4 bridge movements with different difficulty in each treatment,each movement training 10 times per group,a total of 2 groups,rest between the groups for 15-30 s,each treatment for a total of 50 minutes,2 times per week,a total of 6weeks.Group M+J received Mulligan manipulation therapy at first,followed by core stability training(same as group J),each treatment for a total of 60 minutes,twice a week,a total of 6weeks.Evaluation methods: all the subjects in the three groups were evaluated before and 6 weeks after treatment,including pain(VAS)score;Oswestry dysfunction index questionnaire(ODI)score;trunk range of motion in all directions(ROM)and maximum isometric contractile muscle strength;lumbar and back isotonic contractile muscle strength;low back muscle endurance.The evaluation data were analyzed by SPSS24.0 version statistical software,and the evaluation results were expressed by mean ±standard deviation.T-test,one-way ANOVA and non-parametric test were used for mathematical statistical analysis.The results of analysis showed that there was significant difference,and P < 0.001 indicated that there was a very significant difference.Results:(1)there was no significant difference in the evaluation indexes of group K before and after treatment,but the evaluation indexes of NLBP subjects in the other two groups were significantly improved.(2)compared with those before treatment,the VAS score in group J and M+J decreased significantly,and the effect in group M+J was the best,and there was significant difference between group J and group M+J after treatment(P < 0.05).(3)compared with those before treatment,the ODI score in group J and M+J decreased significantly(P < 0.01),and there was no significant difference between group J and group M+J after treatment(P > 0.05).(4)compared with pre-treatment,trunk ROM evaluation: ROM in all directions increased significantly in J group and M+J group,and the effect of M+J group was better.There was significant difference in the direction of flexion and extension between the ROM,J group and the M+J group after treatment,but there was no significant difference between the J group and the M+J group after ROM,treatment in terms of the direction of flexion and rotation of the left and right sides.(5)compared with before treatment,the maximum isometric muscle strength of trunk in group J and M+J increased significantly in all directions,and the effect was better in group M+J.There was no significant difference between group J and group J after treatment(P > 0.05).(6)compared with those before treatment,the maximum peak moment of flexion and extension and the average work done in group J were significantly higher than those in group J(P < 0.05).The directions of flexion and extension in),M+J group were significantly higher than those in group J(P < 0.05),and there was no significant difference between group J and group M+J after treatment(P > 0.05).(7)muscle endurance: the muscle strength of maximal isometric contraction in all directions in group J and group M+J was significantly increased before and after treatment,and the effect was the best in group M+J.There was no significant difference between group J and group M+J after treatment.Conclusion:(1)Simple core stability training and Mulligan combined with core stability training can significantly improve the pain,trunk range of motion,dysfunction and muscle strength of NLBP.(2)Compared with core stability training alone,Mulligan combined with core stability training can effectively relieve the pain symptoms of NLBP and improve the range of trunk activity.(3)There was no significant difference in the improvement of muscle strength and muscle endurance between Mulligan combined with core stability training and core stability training alone. |
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