بررسی ضخامت اولتراسونیک عضلات دیواره طرفی شکم در بیماران با کمردرد مزمن غیراختصاصی بر اساس زیرگروه‌های پرسش‌نامه STarT

نوع مقاله : مقاله پژوهشی

نویسندگان

1 دانشیار گروه فیزیوتراپی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

2 گروه فیزیوتراپی، دانشکده توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

3 استاد آمار زیستی، گروه علوم پایه، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

4 استاد گروه فیزیوتراپی، دانشکده علوم توانبخشی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران

چکیده

مقدمهواهداف
پرسش­نامه STarT به عنوان ابزاری برای تصمیم­گیری بالینی و انتخاب نوع درمان در بیماران با کمردرد مزمن غیراختصاصی معرفی شده است. هدف پژوهش حاضر مقایسه ضخامت اولتراسونیک عضلات دیواره طرفی شکم بین زیرگروه­های کمردرد مزمن غیراختصاصی بر اساس پرسش­نامه STarT بود.
مواد و روش­ ها
17 بیمار مرد مبتلا به کمردرد مزمن غیراختصاصی که بر اساس پرسش­نامه STarT 10 نفر در گروه خفیف و 7 نفر در گروه متوسط قرار داشتند، در این مطالعه تحلیلی شرکت کردند. ضخامت اولتراسونیک عضلات دیواره طرفی شکم بیماران در حالت استراحت و انقباض در وضعیت طاق‌باز اندازه‌گیری شد. از آزمون‌های شاپیرو-ویلک، تحلیل پراکندگی با اندازه‌گیری مکرر و t زوجی برای تحلیل داده‌ها استفاده گردید. در تمامی آزمون‌ها سطح معنادار 05/0>p در نظر گرفته شد.
یافته‌ها
در بررسی ارتباط متقابل بین زیرگروه کمردردی و ضخامت اولتراسونیک عضلات دیواره طرفی شکم، تفاوت معناداری نه در ضخامت استراحت (149/0=p ,318/2F=) و نه در ضخامت انقباض (065/0p= ,965/3F=) عضلات مورد بررسی مشاهده نگردید. در بررسی ارتباط متقابل گروه و وضعیت (استراحت و انقباض)، در هر دو گروه، سه عضله مایل داخلی،عرضی شکم و مایل خارجی در وضعیت انقباض ضخامت بالاتری نسبت به استراحت داشتند (02/0=p ،001/0=p و 007/0=p). در هیچ یک از عضلات مورد بررسی تفاوت معناداری بین ضخامت در سمت چپ و راست، چه در وضعیت استراحت و چه در وضعیت انقباض مشاهده نگردید (05/0<p).
نتیجه‌ گیری
با توجه به عدم مشاهده تفاوت در ضخامت اولتراسونیک عضلات دیواره طرفی شکم بین زیرگروه‌های بیماران کمردرد مزمن غیراختصاصی بر اساس پرسش­نامه STarT، توصیه می شود استفاده از این پرسش­نامه جهت تعیین نوع درمان قبل از شروع برنامه درمانی، بر اساس یافته­های حاصل از ارزیابی­های بالینی انجام گیرد.

کلیدواژه‌ها

موضوعات


عنوان مقاله [English]

Ultrasonic Thickness of Abdominal Wall Muscles in Non-Specific Chronic Low Back Pain Patients based on STarT Questionnaire

نویسندگان [English]

  • Farideh Dehghan Manshadi 1
  • Younes Amiri 2
  • Najmeh Sedighimehr 2
  • Alireza Akbarzadeh Baghban 3
  • Asghar Rezasoltani 4
1 Ph.D, Associate professor in Physiotherapy , Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Physiotherapy Department, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Professor, Department of Basic Sciences, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Ph.D, Professor in Physiotherapy , Department of Physiotherapy, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran
چکیده [English]

Background and Aim: The Multidimensional STarT Questionnaire is an index of clinical decision making and the choice of treatment type in patients with Nonspecific Chronic Low Back Pain (NSCLBP). The aim of the present study was to compare the ultrasonic thickness of abdominal wall muscles between NSCLBP subgroups based on StarT Questionnaire.
Materials and Methods: A total of 17 male patients with NSCLBP participated in the current analytical study. Based on the STarT Questionnaire, 10 participants were placed in the mild subgroup and 7 in the moderate subgroup. The ultrasonic thickness of abdominal wall muscles was measured at rest and contraction in the supine position. Kolmogorov-Smirnov tests, spatial analysis with repeated measure, and paired t-test were used for data analysis. Values p< 0.05 were considered statistically significant.
Results: There was no significant difference in resting (F=2.318   p=0.149), and contraction (F= 3.965, p=0.065) thickness of abdominal wall muscles in two subgroups of NSCLBP patients. All three muscles (internal oblique, transversus abdominis, and external oblique) in contraction were thicker than in the rest condition (p=0.02, p=0.001, p=0.007, respectively). Moreover, there was no significant difference between the thickness of the left and right in either of the muscles, whether in the rest or in the contraction condition (p>0.05).
Conclusion: Considering no difference in ultrasonic thickness of the abdominal wall muscles between the NSCLBP subgroups based on the STarT Questionnaire, it is recommended that the findings of clinical examinations be used to determine the approach of treatment in the subgroups of NSCLBP patients.

کلیدواژه‌ها [English]

  • Chronic non-specific low back pain
  • STarT Questionnaire
  • Ultrasonography
  • lateral abdominal wall muscles
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