肌內效貼紮對下背痛及背部肌肉耐力的立即性效應於腰椎椎間盤退化病人的研究

Acute effects of Kinesio taping on low back pain and back muscle endurance in patients with lumbar disc degeneration : a controlled clinical trial

駱逸明(Yi-Ming Lo)

指導教授 ： 張乃仁

高雄醫學大學/醫學院/運動醫學系碩士在職專班/碩士(2016年)

摘要

背景與目的: 肌內效貼紮 (肌貼)雖然已被廣泛使用，然而其效益被應用在腰椎椎間盤退化尚未被研究。本研究目的探討肌貼應用於腰椎椎間盤退化患者在疼痛、失能程度與下背肌耐力之立即治療效應。
設計與方法: 31位病患 (12位女性，19位男性, 年齡範圍25至64歲) 經復健科醫師根據核磁共振影像檢查診斷出具腰椎椎間盤退化。肌貼 (Kinesio® Tex Tape)使用原則，達到具有止痛及促進腰椎旁肌肉收縮的方式貼紮。研究設計使用單組前後測 (single-group pretest and posttest design)。病患於貼紮前與貼紮後，進行疼痛指數視覺類比尺度 (visual analogue scale, VAS)、歐氏失能指數 (Oswestry Disability Index, ODI) 的評估。肌肉疲勞測試 (Biering-Sorensen test)評估時間於貼紮前、貼紮後立即、貼紮持續24小時。
結果: 31位病患(VAS介於2到8)，在疼痛指數方面，貼紮後(2.58 ± 1.34)比貼紮前(4.35 ± 1.84)明顯降低疼痛。前述所有31位病患中，有11位病患下背痛為輕微的疼痛程度(VAS介於2到3)，有20位病患下背痛為嚴重或中度的疼痛程度(VAS ≥ 4)，這20位較痛程度患者的疼痛指數在貼紮前(5.50 ± 1.15)比貼紮後(3.30 ± 1.08)有顯著降低，並達到最小臨床重要性的差異(VAS差異大於2)。 所有31位病患，在歐氏失能指數(ODI)方面，貼紮後(22.77 ± 9.93%)比貼紮前(27.03 ± 9.97%)有顯著的改善狀況。記錄所有31位病患的背部肌肉疲勞測試，貼紮後立即的測試為78.71秒， 在貼紮持續24小時的測試為78.77秒，分別比沒有貼紮情況時的測試為58.00秒，都有顯著性改善，而貼紮後立即與貼紮持續24小時的測試相比較，則沒有統計上的顯著差異。
結論:腰椎椎間盤退化的病患接受肌內效貼紮後，在疼痛指數、失能程度及背肌耐力方面都有統計上顯著改善的情形。特別在有嚴重或中度下背痛的這群腰椎椎間盤退化病患，肌內效貼紮能降低更多的疼痛。因此，肌內效貼紮或許可以當作一種輔助治療方法，但未來仍需做長期效應的驗證或合併核心運動治療後的效應。
關鍵詞: 肌內效貼紮、下背痛、腰椎椎間盤退化、背肌耐力

關鍵字

肌內效貼紮 ； 下背痛 ； 腰椎椎間盤退化 ； 背肌耐力

並列摘要

Introduction/Background: Kinesio taping (KT) has been widely used for low back pain. The effect of KT on lumbar disc degeneration patients has yet to be investigated. The aim of this study is to examine the acute effect of KT on pain, disability and back muscle endurance.
Materials/Methods: 31 patients (12 women and 19 men, aged 25-64 years) via using MRI examination were enrolled in this study. Kinesio® Tex Tape was applied for pain relief and facilitation of paraspinal muscle contracture. This study used a single group, pretest-posttest design. The visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to assess before and after taping. The Biering-Sorensen test were used to assess under three condition:no taping (T0); immediately after taping (T1); 24 hours after taping with the tapes remaining in situ (T2).
Results: 31 patients' mean score of the worst pain intensity (VAS) before taping was (4.35±1.84), while after taping was (2.58±1.34). The reduction in VAS was significant. Among 31 patients, 20 patients have moderate or severe pain intensity (VAS≥4). The VAS of these 20 patients before taping was (5.50±1.15). After taping, the VAS became (3.30±1.08). The reduction in VAS was significant and attained the minimal clinical important difference. 31 patients' mean score of ODI before taping was (27.03±9.97% ), while after taping was (22.77±9.93%). The ODI mean score reduced significantly. Patients' Biering-Sorensen test recorded of T0 was 58.00 seconds; whereas 78.71 seconds at T1; 78.77 seconds at T2. There was the significant difference not only between T0 and T1 but also between T0 and T2. Howerer, there was no statistically significant difference between T1 and T2.
Conclusion: Lumbar disc degeneration patients experienced statistically significant improvements in pain, disability and back muscle endurance after taping. Especially, KT reduced more pain in patients with severe or moderate pain. Thus, KT may be used as a complementary method in these patients. Further research is warranted on these patients' outcomes after KT applications for longer time periods or in combination with core exercise programme.
Key words: Kinesio taping, Low back pain, Lumbar disc degeneration, Back muscle endurance.

並列關鍵字

Kinesio taping, Low back pain, Lumbar disc degeneration, Back muscle endurance

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