康复学报 (Oct 2024)
Efficacy of Shock Wave Therapy Combined with Core Stability Training on Non-Specific Low Back Pain after Stroke
Abstract
ObjectiveTo investigate the clinical efficacy of shock wave therapy combined with core stability training on non-specific low back pain (NLBP) after stroke.MethodsA total of 70 patients with post-stroke NLBP who visited Suzhou Xiangcheng People's Hospital from January 2022 to November 2023 were selected as the subjects of the study. They were randomly assigned to control group and experimental group, wich 35 cases in each group. The control group received conventional treatment, which included infrared and pulse-modulated medium-frequency electrical stimulation, 20 minutes per session; as well as regular rehabilitation training for muscle strength of upper and lower limbs, sitting and standing balance, activities of daily living (ADL), and walking, 40 minutes per session, 5 times per week, for a total of 3 weeks. The experimental group, in addition to the conventional treatment of the control group, received shock wave therapy, 2 times per week for a total of 3 weeks; followed by core stability training, 30 minutes per session, once a day, 5 days per week, for a total of 3 weeks. Visual analogue scale (VAS) for pain, Berg balance scale (BBS) were assessed before treatment, after the first treatment, and after 3 weeks of treatment in both groups, and changes in the stiffness of waist muscles (E-mean) assessed by ultrasound real-time shear wave elastography were compared before treatment and after 3 weeks of treatment in both groups. Additionally, gait parameters were measured using footprint gait analysis to compare the therapeutic effects of the two groups.ResultsCompared with those before treatment, VAS scores of both groups decreased at rest and during walking after the first treatment and after 3 weeks of treatment, with the experimental group showing significantly lower VAS scores than the control group (P<0.05). Compared with the control group, the VAS scores of the experimental group decreased significantly after the first treatment and 3 weeks of treatment (P<0.05), and the VAS scores of the experimental group decreased significantly after the first treatment (P<0.05) and after 3 weeks of treatment (P<0.001). After 3 weeks of treatment, the hardness of the quadratus lumborum, erector spinae, and psoas major muscles, BBS scores, and gait parameters (average step length, step width, and walking speed on the affected side) of both groups improved compared to those before treatment, with the experimental group showing a significantly greater improvement than the control group (P<0.05).ConclusionThe combination of shock wave therapy and core stability training can effectively alleviate pain symptoms in patients with post-stroke NLBP, significantly reduce the stiffness of the lumbar and back muscles, and markedly improve balance ability and walking performance.
