Staal J Bart, Rainville James, Fritz Julie, van Mechelen Willem, Pransky Glenn
Department of Epidemiology, Maastricht University, 6200 MD, PO Box 616, Maastricht, The Netherlands.
J Occup Rehabil. 2005 Dec;15(4):491-505. doi: 10.1007/s10926-005-8030-3.
There is a body of literature that indicates that physical exercise interventions, with a primary focus on improvement of functioning instead of pain relief, might be effective to stimulate return to work and improve function in workers who are absent from work due to low back pain (LBP). Successful application and implementation of these interventions however, depends on multiple factors that need to be addressed carefully in clinical practice as well as research.
Descriptive literature review, to identify an overview of current knowledge with respect to the safety, content- and context-related aspects of physical exercise interventions, issues relating to timing, the influence of treatment confidence and patient expectations, and the process of changing provider and employer behavior.
Physical exercises are not associated with an increased risk for recurrences. The effects of interventions may vary depending on content-related factors (i.e., type of exercises, dosage, frequency, skills of the healthcare providers, etc.) and contextual factors (i.e., treatment setting, compensation system, etc.). Treatment confidence and patients' expectations also significantly influence outcomes of physical exercise interventions. Timing is also important; interventions targeting return to work, applied during the acute phase of work absenteeism, compete with a high rate of spontaneous recovery and may therefore be inefficient.
Despite numerous studies, more quantitative and qualitative investigations are needed to further clarify the requirements for a successful application and implementation of physical exercise interventions for disabled workers with low back pain.
有大量文献表明，以改善功能而非缓解疼痛为主要重点的体育锻炼干预措施，可能对因腰痛（LBP）缺勤的工人刺激重返工作岗位和改善功能有效。然而，这些干预措施的成功应用和实施取决于多个因素，在临床实践以及研究中都需要仔细考虑。
描述性文献综述，以确定关于体育锻炼干预措施的安全性、与内容和背景相关的方面、与时间相关的问题、治疗信心和患者期望的影响以及改变提供者和雇主行为的过程的现有知识概述。
体育锻炼与复发风险增加无关。干预措施的效果可能因与内容相关的因素（即锻炼类型、剂量、频率、医疗保健提供者的技能等）和背景因素（即治疗环境、补偿系统等）而异。治疗信心和患者期望也会显著影响体育锻炼干预措施的结果。时间安排也很重要；针对重返工作岗位的干预措施，在工作缺勤急性期实施，会与较高的自发恢复率竞争，因此可能效率低下。
尽管有大量研究，但仍需要更多的定量和定性研究，以进一步明确成功应用和实施针对腰痛残疾工人的体育锻炼干预措施的要求。
