腰椎薦椎化併下背痛患者－冰敷對腰椎活動度表現之影響

The Effect of Ice Pack on Lumbar Range of Motion in Patients with Low Back Pain and Lumbar Sacralization

林士傑(Shih-Chieh Lin) ； 洪儀君(Yi-Chun Hung) ； 林瀛洲(Yin-Chou Lin) ； 張韡瀚(Wei-Han Chang) ； 杜育才(Yu-Tsai Tu) ； 周適偉(Shih-Wei Chou)

《台灣復健醫學雜誌》 40卷3期 (2012/09) Pp. 141-146

https://doi.org/10.6315/2012.40(3)03

摘要

目的：在探討冰敷對於腰椎薦椎化併下背痛患者的腰椎活動度表現的影響。方法：以24位受試者進行測試，12位腰椎薦椎化併下背痛患者為實驗組，另外12位為年齡、身高、體重相稱的一般健康者為控制組，分別接受腰椎活動度前測；隨後進行腰部20分鐘冰敷，待皮膚回溫後再次進行後測。本研究採用曼－惠特尼檢定（Mann-Whitney test）比較兩組前測的四個關節活動度，以威爾考森符號排序檢定（Wilcoxon signed rank test）進行冰敷前後的差異比較。下背疼痛程度以疼痛視覺指數量表（visual analogue scale）評估，並以弗里德曼檢定（Friedman test）進行冰敷前後下背疼痛程度的比較。結果：本研究結果顯示，冰敷前實驗組腰椎前屈曲活動角度皆較控制組來得差；冰敷後，實驗組前屈曲及左側彎活動角度達顯著差異。實驗組在冰敷後下背疼痛程度減緩達顯著差異。結論：腰椎薦椎化併下背痛患者，腰椎活動度較一般健康人來得差，冰敷有利於腰椎薦椎化患者腰椎活動度的改善。因此建議冰敷可以暫時改善腰椎薦椎化併下背痛患者的腰椎活動度及疼痛感。

關鍵字

下背痛 ； 腰薦變形椎體 ； 腰椎薦椎化 ； 冰敷 ； 關節活動度

並列摘要

Purpose: This research was designed to investigate the short-term effect of an ice pack on lumbar range of motion in patients. Patients with low back pain caused by sacralized fifth lumbar spine were selected after clinical diagnosis.Method: Twenty-four subjects were recruited for this study. Twelve subjects with low back pain who were diagnosed with sacralized fifth lumbar spine were selected as the experimental group, and twelve healthy subjects were selected as the control group. The age, body height, and weight of the patients in the two groups were compared. Measurements of lumbar range of motion were used as the pretest baseline for the two groups. All the subjects were then administered 20-min of ice pack treatment on the lumbar area. After ice pack treatment, a post-test was performed when the subjects reported a moderate temperature recovery. The extent of low back pain in the experimental group was measured with visual analogue scale.Results: With respect to the pretest baseline data, results of the Mann-Whitney test showed that the experimental group had limited lumbar flexion. Results of the Wilcoxon signed rank test showed that the experimental group exhibited an increase in lumbar range of motion; this result was significant with respect to flexion and left side-bending. Friedman test revealed significant reduction of pain sensation in the experimental group after ice pack.Conclusions: Low back pain patients with sacralized fifth lumbar spine have relatively limited lumbar flexion than their healthy counterparts. Ice pack application might temporarily benefit patients with sacralized fifth lumbar spine with respect to lumbar flexion and left side-bending. Ice pack application might also decrease the sensation of pain in patients with sacralized fifth lumbar spine.

並列關鍵字

low back pain ； lumbosacral transitional vertebra ； lumbosacralization ； ice pack ； range of motion