| 摘要: | 研究背景及目的：
下背痛發生率高已造成公共衛生負擔，產生了大量的失能問題及醫療成本，甚至影響工作績效，已有文獻指出，復健治療能有效的改善下背疼痛及失能的問題，但在台灣以電療及運動治療下背部疼痛與失能的研究並不多，此外，亦有文獻指出，治療的遵從度對下背庝痛及失能程度的改善有顯著的相關性。因此本研究目的在探討不同復健治療模式及施予頻率，對於下背痛病人的療效，故本研究可作為未來下背痛病人治療的建議。
研究方法：
本研究收集南部某地區醫院復健科門診下背痛初診病患，依施予治療模式分為單純電療及同時接受運動治療與電療兩組，自變項為治療遵從度及治療模式；依變項為視覺類比量表（Visual analogue scale, VAS）、歐氏下背痛功能評估量表（Oswestry low back pain disability questionnaire, OLBPDQ）、羅蘭－摩理斯下背痛生活障礙問卷（Roland-Morris low back pain disability questionnaire, RMDQ）、髖屈肌肌力及髖伸肌肌力；控制變項為性別、年齡、身高、體重、身體質量指數（BMI）。使用皮爾森相關係數、獨立樣本Ｔ檢定及逐步迴歸進行統計分析。
研究結果：
本研究共收集32位下背痛患者，平均年齡為55.34±16.64歲，平均BMI為23.96±3.73Kg/m2，包括男性12人（37.5％），女性20人（62.5％）。接受純電療與同時接受電療及運動治療之患者，在VAS、髖屈肌及髖伸肌肌力、RMQD及OLBPDQ皆有改善，但未達顯著差異。治療遵從度與VAS的改善兩者間未達顯著相關；RMDQ失能分數、OLBPDQ失能分數、髖屈肌及髖伸肌肌力改善與治療遵從度達顯著相關。患者年齡與治療前髖伸肌肌力、髖屈肌肌力、RMQD、OLBPDQ皆達顯著相關，但與改善程度無相關。患者性別與治療前髖伸肌肌力、髖屈肌肌力、RMQD、OLBPDQ皆達顯著差異，但與改善程度無顯著差異。患者BMI與治療前的VAS、髖伸肌肌力、髖屈肌肌力、RMQD及OLBPDQ皆無顯著相關，但BMI與VAS及OLBPDQ的改善皆有顯著相關，
結論：
綜合以上結果表示，患者的治療的遵從度及BMI是影響問題改善的顯著因素。
Back ground
Low back pain has caused public health problem, and cause disability and medical costs, even effect work performance. Rehabilitation treatment can effectively improve low back pain and disability. However, there are not many studies on low back pain and disability with electric stimulation in Taiwan. In addition, there are also many literatures indicating that patients’ adherence has a significant correlation with the improvement of low back pain and disability. Therefore, the aim of this study was to determine the association between the treatment effect and patients’ adherence, and the association between the treatment effect and different treatment mehtod. As a suggestion for the treatment of patients with low back pain in the future.
Materials and Methods
The study subjects were the newly diagnosed patients with low back pain in a hospital in the south. The patients were divided into two groups. One group was used electrotherapy only, the other group was exercise therapy and electrotherapy.in the same time. Independent variables are adherence and treatment method. dependent variables are Visual analogue scale(VAS), Oswestry low back pain disability questionnaire(OLBPDQ), and Roland-Morris low back pain disability questionnaire(RMDQ), hip flexor muscle strength, hip extensor muscle strength. control variables are gender, age, height, weight, and BMI. The statistical methods used were Pearson’s correlation coefficient, independent sample T test, and multiple regression.
Results
32 patients with low back pain were recruited. The average age was 55.34±16.64 years. The average BMI was 23.96±3.73 Kg/m2, 12 men (37.5%) and 20 women (62.5%) . Patients who received pure electrotherapy and received both electrotherapy and exercise therapy showed improvement in VAS, hip flexor and hip extensor muscle strength, RMQD, and OLBPDQ, but the improvement was not significant between the two groups. Adherence is not significantly associated with VAS, but is significantly associated with RMDQ, OLBPDQ and hip flexors and hip extension muscles strength. Age and gender are significantly associated with initial hip flexors muscles strength, hip extension muscles strength, RMQD, and OLBPDQ, but no significantly with improvement. BMI is not significantly associated with initial VAS, hip flexors muscles strength, hip extension muscles strength, RMQD, and OLBPDQ, but significantly with improvement of VAS and OLBPDQ.
Conclusion
As a result, patients’ adherence and BMI are the main factors affecting the improvement. |
