Calmels P, Jacob J F, Fayolle-Minon I, Charles C, Bouchet J P, Rimaud D, Thomas T
Service de médecine physique et de réadaptation, CHU de Saint-Etienne, hôpital Bellevue, 42055 Saint-Etienne cedex 2, France.
Ann Readapt Med Phys. 2004 Feb;47(1):20-7. doi: 10.1016/j.annrmp.2003.07.001.
To determine if the use of an isokinetic device for trunk exercise is more effective than standard physiotherapy in promoting motor disinhibition for patients with chronic low back pain.
chronic low back pain outpatients who are treated in a Rheumatology or PM & R unit within an academic hospital.
This is a prospective, controlled, randomized study, with two groups of treatment: one treated with isokinetic techniques and the other with standard physiotherapy, six sessions for each treatment during 2 weeks. Outcome measures include pain (VSA), trunk mobility (Schöber index, distance from fingers to floor), muscle extensibility and muscle strength (Biering-Sorensen and Shirado-Ito test), and functional capacity (Quebec scale).
Seventeen subjects were enrolled. The results suggest that both isokinetic exercise and physiotherapy result in improved range of motion, extensibility, muscle strength, and pain, without any significant superiority of one technique over the other. However, each technique has specific advantage.
Despite methodologic limitations, this study shows that isokinetic exercise is not better than physiotherapy in reversing motor inhibition in chronic low back pain. Our results are consistent with those of other studies in the literature, with regard to the absence of established overall superiority of one exercise technique or program over the other in this population, and with regard to partial benefits of specific exercise techniques.
The non-specific benefit of one technique indicates that further studies are needed to evaluate the benefit of combining exercise techniques in chronic low back pain, in order to address the multiple factors involved in this pathology.
确定使用等速运动设备进行躯干锻炼在促进慢性下腰痛患者运动抑制解除方面是否比标准物理治疗更有效。
在一所学术医院的风湿病科或物理医学与康复科接受治疗的慢性下腰痛门诊患者。
这是一项前瞻性、对照、随机研究,分为两组治疗:一组采用等速运动技术治疗,另一组采用标准物理治疗,每种治疗在2周内进行6次治疗。观察指标包括疼痛(视觉模拟评分法)、躯干活动度(施伯指数、手指到地面的距离)、肌肉伸展性和肌肉力量(比林-索伦森试验和白户-伊藤试验)以及功能能力(魁北克量表)。
共纳入17名受试者。结果表明,等速运动和物理治疗均能改善运动范围、伸展性、肌肉力量和疼痛,两种技术之间没有任何显著优势。然而,每种技术都有其特定优势。
尽管存在方法学上的局限性,但本研究表明,在逆转慢性下腰痛的运动抑制方面,等速运动并不优于物理治疗。我们的结果与文献中的其他研究一致,即在该人群中,没有一种运动技术或方案能确立总体上优于另一种,以及特定运动技术有部分益处。
一种技术的非特异性益处表明,需要进一步研究来评估在慢性下腰痛中联合运动技术的益处,以解决该病症中涉及的多种因素。