Comparative Study Of The Efficacy Of "Three Steps,Three Steps And Nine Methods" Combined With Core Stability Training In The Treatment Of Lumbar Disc Herniation

Objective: To observe the clinical efficacy and safety of "three steps,three methods and nine methods" combined with core stability training in the treatment of lumbar disc herniation,in order to provide new ideas for the treatment of lumbar disc herniation.Methods: The subjects of this study were 84 inpatients diagnosed with lumbar disc herniation in the Department of Rehabilitation Orthopaedics of the Affiliated Hospital of Gansu University of Traditional Chinese Medicine from October 2021 to November 2022.The study subjects were randomly divided into manipulation group,core stability training group and manipulation combined with core stability training group by using random number table method,and the manipulation group was treated with "three steps,three methods and nine methods" by Professor Song Guijie,the core stability training group was treated with SET core stability training,and the manipulation combined with core stability training group was treated with "three steps,three methods and nine methods" by Professor Song Guijie.The group was treated with "three steps,three methods and nine methods" combined with SET core stabilization training.In addition,all patients received medium frequency treatment as the basic treatment.The changes in the Japanese Orthopaedic Association Lumbar Spine Function Scale(JOA)scores,visual analog scale(VAS)scores,Barthel Index scores and changes in the angle of straight leg raising test were recorded before,after treatment and at the follow-up after 1month and 3 months after treatment to observe the adverse reactions that occurred during the treatment and to evaluate the clinical efficacy.Results:(1)A total of 84 patients were included in the study,4 cases were detached,and 80 cases were finally included,including 27 cases in the manipulation group,26 cases in the core stability training group,and 27 cases in the manipulation combined with core stability training group.There was no difference in the general data of the three groups in terms of gender,age,occupation,and origin(P > 0.05).(2)Before treatment,there was no statistically significant difference in the JOA scores of the three groups;the JOA scores of the three groups were significantly higher at 1 month and 3months after treatment compared with those before treatment,and the difference was statistically significant(P < 0.05);the JOA scores of the patients in the manual combined with core stabilization training group were significantly higher at 1 month and 3 months after treatment.The JOA scores of patients in the manipulation and core stability training groups were significantly higher than those in the manipulation and core stability training groups(P <0.05).(3)There was no statistical difference in the visual analog scale(VAS)scores of the three groups before treatment(P > 0.05);when the VAS scores of the three groups were evaluated again at 1 month and 3 months after treatment,they were significantly lower than those before treatment(P < 0.05);the visual analog scale(VAS)scores of the patients in the manipulation combined with core stabilization training group were significantly lower than those in the manipulation group at 1 month and 3 months after treatment(P < 0.05).VAS scores were significantly lower than those of the manipulation group and the core stability training group at1 month and 3 months after treatment(P < 0.05).(4)Before treatment,the Barthel Index(BI)scores were lower in all three groups and there was no significant difference between the groups(P > 0.05);when the BI scores were evaluated again at 1 month and 3 months after treatment,they were significantly higher than those before treatment(P < 0.05);meanwhile,when comparing the scores between the three groups,the Barthel Index(BI)scores of patients in the manipulation combined with core stabilization training group were significantly higher at 1 month and 3 months after treatment(P < 0.05).The BI scores of patients in the manipulation and core stabilization training groups were significantly higher than those in the manipulation and core stabilization training groups at 1month and 3 months after treatment(P < 0.05).(5)Before treatment,there was no statistically significant difference between the straight leg elevation test angles of the three groups(P>0.05);1 month and 3 months after treatment,the straight leg elevation angles of the three groups were higher than those before treatment,and the difference was statistically significant(P<0.05);meanwhile,1 month and 3 months after treatment,the straight leg elevation angles of the manipulation combined with core stability training group were higher than those of the manipulation group and core stability training group,and the difference was statistically significant(P<0.05).The difference was statistically significant(P < 0.05).(6)The efficacy of the three groups was evaluated after treatment,and the efficiency of the manipulation combined with core stabilization training group was 96.30%,which was higher than that of the manipulation group 74.07% and the core stabilization training group80.77%(P < 0.05).(7)Vital signs(respiration,pulse,heart rate,blood pressure)and 12-lead electrocardiogram were performed before and after treatment in all cases,and no significant abnormalities were observed.It was suggested that there were no significant adverse reactions during the treatment.Conclusion: The "three steps and three nines method" combined with core stabilization training was safe and effective in the treatment of lumbar disc herniation,and it could significantly improve the JOA score,straight leg raising test score,VAS score and Barthel index of low back pain.This method is a new idea in the treatment of lumbar disc herniation and is worthy of clinical promotion.