| 摘要: | 根據國內流行病學統計，慢性非特異性下背痛已是國人盛行率第一名，有60-80%的人一生中至少會發生一次下背痛，且根據勞工保險職業病統計，職業性下背痛佔勞保職業病給付亦是最高。而造成慢性非特異性下背痛之主要原因不明，最初大多是由於肌肉或韌帶損傷，後引發成三個月以上慢性傷害，六成以上的患者會反覆性的發作，不僅影響個人生活品質、增加健保醫療支出，甚者影響社會經濟生產體系，慢性非特異性下背痛的問題已引起公共衛生學界的密切關注。近年來，瑜珈及皮拉提斯雖已證實有助於非特異性下背痛患者，但這兩者主動治療方式需要經過長期的練習，且須具備基本的動作基礎才能夠實施。因此，結合瑜珈與皮拉提斯方法，且較安全有效並適用於各種體適能程度對象的「墊上核心訓練」課程，是否也能顯著增強慢性下背痛患者椎穩定肌抗疲勞、運動控制及日常生活功能是本計畫之主要研究目的。方法是以40名慢性非特異性下背痛患者為研究對象，所有前測項目（等速背伸耐力測驗、局部肌肉血流量測、本體感覺、背伸肌快速反應測驗及歐式失能量表等）均在墊上核心訓練執行前一週內完成。前測完成後將40名下背痛患者隨機分成墊上核心訓練組（mat core training, MCT）及不訓練組（C）二組，MCT組展開為期8週、一週2次、每次60分鐘之墊上核心訓練；再於8週訓練後一週內施予後測。所得資料以雙因子變異數分析（two-way ANOVA），分析介入8週墊上核心訓練對椎穩定肌抗疲勞、局部血流、運動知覺及功能障礙之進步幅度與控制組比較是否有顯著差異，以α = .05為顯著水準。本研究結果預期瞭解墊上核心訓練對椎穩定肌抗疲勞、局部血流、運動知覺及功能之影響情形。According to national epidemiological statistics, chronic non-specific low back pain is the most prevalent syndrome among our population. Sixty to eighty percent of the people have at least one low back pain in their life time. According to statistics of labor insurance in occupational diseases, the cost in occupation-related low back pain is the highest of all diseases. The cause of chronic non-specific low back pain is not clear. The onset of the pain is usually caused by damages in the muscle or ligaments and result in chronic injury for over 3 month. Sixty percent of the patients will experience repeated syndromes. The syndromes not only affect the quality of life, increase expense in health care, but also impact upon the social-economical system. The problem has drawn the attention of researchers in epidemiology. Recently, yoga and pilates had been proven to be helpful for patients with non-specific low back pain. However, these two therapies require long-term practice and are only effective among people who already possess the basic techniques. Thus, the current study will focus on the effects of the Mat Science program, which is suitable for people with different fitness levels, on anti-fatigue capability, motor control and daily life function of patients with non-specific low back pain. Forty patients with chronic non-specific patients will be recruited as subjects. All pre-tests including isokinetic back extension endurance test, measurement of local muscular blood flow, kinesthesia, back extensor reaction test and Oswestry disability questionnaire, will be carried out one week before core mat training program. After the pre-tests, the subjects will be randomly assigned into one of the two groups including the mat core training (MCT) group and the control group. The MCT group will receive two 60-minute sessions of training per week for 8 weeks. The post test will be carried out within one week from the termination of the training program. Data will be analyzed by two-way ANOVA in order to compare the anti-fatigue capability of lumbar stablizers, local blood flow, kinesthesia and functional disability between the mat core training group and the control group. An insight of the effects of mat core training on the anti-fatigue capability of lumbar stabilizers, local blood flow, kinesthesia and functional disability will be expected through this study. |
