Verfaille S, Delarue Y, Demangeon S, Beuret-Blanquart F
Centre régional de médecine physique et de réadaptation ( les Herbiers ), CHU de Rouen, 111, rue Herbeuse, 76230 Bois-Guillaume, France.
Ann Readapt Med Phys. 2005 Mar;48(2):53-60. doi: 10.1016/j.annrmp.2004.08.008. Epub 2005 Jan 12.
To assess at four years follow-up the efficiency of exercise therapy for chronic low back pain in terms of pain, physical ability, quality of life and return to work.
Patients who graduated from a functional restoration program between April 1997 and June 1999, answered a questionnaire at one year follow-up. The patients who had answered this questionnaire were evaluated 48 months later: they first answered another questionnaire and then most underwent a clinical examination assessing pain on a visual analogue scale, flexibility by use of the Schöber index and the finger-ground distance test, endurance of abdominal and spinal muscles, and quality of life as assessed by the Dallas pain questionnaire.
Thirty-four patients graduated from the program; 26 were studied at four-year follow-up. Pain intensity was significantly reduced. Improvement in flexibility after the program remained at four-year follow-up, whereas improvement in endurance did not. Scores on the Dallas pain questionnaire remained as improved as those at one-year follow-up. Initially, 23 of the 26 patients had a job; 19 were on sick leave for an average of 35 weeks. At four-year follow-up, 16 patients were still working, and 56% had changed jobs. Six patients pursued a regular activity before entering the program; at four-year follow-up, 17 were regularly active. No significant relationship was found between the pursuit of physical activity and return to work. Nevertheless, a significant relationship was found between having a regular physical activity and improvement of the finger-ground distance and endurance of spinal muscles. This observation was not true for the Dallas pain questionnaire scores.
Despite the lack of a control group, this study seems to favour a benefit in the functional restoration program.
在四年随访期评估运动疗法对慢性下腰痛患者在疼痛、身体能力、生活质量和重返工作方面的效果。
1997年4月至1999年6月间从功能恢复项目毕业的患者在一年随访时回答了一份问卷。回答了这份问卷的患者在48个月后接受评估：他们首先回答另一份问卷，然后大多数人接受了临床检查，包括用视觉模拟量表评估疼痛、用Schöber指数和手指-地面距离测试评估灵活性、评估腹部和脊柱肌肉耐力以及用达拉斯疼痛问卷评估生活质量。
34名患者从该项目毕业；26名患者接受了四年随访研究。疼痛强度显著降低。项目结束后的灵活性改善在四年随访时仍保持，而耐力改善则没有。达拉斯疼痛问卷得分保持与一年随访时同样的改善程度。最初，26名患者中有23人有工作；19人休病假，平均35周。在四年随访时，16名患者仍在工作，56%更换了工作。6名患者在进入项目前有规律活动；在四年随访时，17人有规律活动。未发现进行体育活动与重返工作之间有显著关系。然而，发现有规律体育活动与手指-地面距离改善和脊柱肌肉耐力改善之间存在显著关系。达拉斯疼痛问卷得分情况并非如此。
尽管缺乏对照组，但本研究似乎支持功能恢复项目有益。
