生物回饋輔助脊椎穩定運動訓練於慢性下背痛病人之療效

The Effects of Biofeedback-Assisted Spine Stability Exercise Training for Patients with Chronic Lower Back Pain

脊椎穩定度運動訓練對於慢性下背痛病人，有很好的實證療效，然而臨床上病人時常無法正確執行訓練運動；本研究目的是比較即時超音波影像，與壓力生物回饋儀，於脊椎治療性運動的訓練效益，並探討訓練後的症狀改善程度與深層核心肌群的活化程度、居家運動依從性是否存在相關性，並從中分析可能的解釋因子。從骨科門診轉介到物理治療中心的下背痛病人中收案，隨機分組，除了常規的治療性運動訓練外，進行為期4週、每週1次的即時超音波，或壓力生物回饋輔助的脊椎核心訓練。結果顯示，兩種生物回饋輔助下的脊椎穩定運動訓練，皆能改善下背痛病人的症狀與功能，但兩組無顯著差異；訓練前、後的腹橫肌活化程度，與治療成效有顯著相關性與中等程度解釋力。臨床上若慢性下背痛病人，無法正確收縮核心肌群，則可選擇搭配生物回饋輔助進行訓練。

There is good evidence-based effectiveness on spinal stability exercise for patients with chronic low back pain; however, patients usually could not perform it correctly in clinical setting. The goal of this study is to compare the training effect of using real-time ultrasound image (RUSI) and pressure biofeedback unit (PBU) to assist in spinal stability exercise training. Additionally, the study investigates whether there is a correlation between the improvement of symptoms after training and the degree of activation of the deep core muscles, as well as adherence to home exercise, and to analyze whether there are potential explanatory factors. We recruited participants from patients with low back pain in Physical Therapy Center, referred from Orthopedic Department. Participants were randomized into RUSI and PBU group, receiving biofeedback assisted spinal stability exercise once a week for 4 weeks, as well as regular therapeutic exercise training. The results indicate that spinal stability exercise assisted by either biofeedback can improve symptoms and function in individuals with low back pain, but no significant between-group differences. The degree of activation of deep core muscles before and after training is significantly correlates to the symptoms improvements, and has a moderate explanatory power. In clinical settings, biofeedback-assisted training can be a valuable option for patients with chronic low back pain who are unable to perform core muscle contractions correctly.