Kuukkanen Tiina, Mälkiä Esko, Kautiainen Hannu, Pohjolainen Timo
School of Health and Social Studies, Jyväskylä University of Applied Sciences, Jyväskylä, Finland.
Physiother Res Int. 2007 Dec;12(4):213-24. doi: 10.1002/pri.378.
Therapeutic exercise has been shown to be beneficial in decreasing pain and in increasing functioning in patients with chronic low back pain. However, longitudinal follow-up studies are small in number, and often limited in the numbers of subjects due to drop-outs. In addition there is a shortage of real control groups in most cases. The purpose of the present study was to describe long-term changes in intensity of low back pain and in functioning for two study groups five years after undertaking a home exercise programme.
This was a randomized follow-up study over five years. Fifty-seven subjects were reassessed with questionnaires five years after their initial recruitment for an intervention study. A home exercise group (n = 29), with training once a day, and a control group (n = 28), without exercise, were included in the present study protocol. The primary outcome measurements included a questionnaire on the intensity of low back pain (Borg CR-10 scale) and on functioning (Oswestry Disability Index; ODI). The confounding physical activity was controlled with metabolic unit (MET) values.
The CR-10 and ODI scores decreased during the first three months in both study groups. During the follow-ups, the corresponding indicators of the home exercise group remained below baseline values. The CR-10 score was significantly lower in the home exercise group (p = 0.01) during the last five-year follow-up session compared with the control group. Overall physical activity decreased slightly during the five-year follow-up, but there were no differences between the two study groups.
The present randomized study indicates that supervised, controlled home exercises lead to reduced low back pain, and that positive effects were preserved over five years.
治疗性运动已被证明有助于减轻慢性下腰痛患者的疼痛并提高其功能。然而,纵向随访研究数量较少,且由于失访,研究对象数量往往有限。此外,在大多数情况下,缺乏真正的对照组。本研究的目的是描述两个研究组在进行家庭锻炼计划五年后下腰痛强度和功能的长期变化。
这是一项为期五年的随机随访研究。57名受试者在最初被招募参加干预研究五年后通过问卷调查进行重新评估。本研究方案纳入了一个每天训练一次的家庭锻炼组(n = 29)和一个不进行锻炼的对照组(n = 28)。主要结局指标包括一份关于下腰痛强度(Borg CR - 10量表)和功能(Oswestry功能障碍指数;ODI)的问卷。通过代谢当量(MET)值控制混杂的体力活动。
两个研究组在最初三个月内CR - 10和ODI评分均下降。在随访期间,家庭锻炼组的相应指标仍低于基线值。在最后一次五年随访期间,家庭锻炼组的CR - 10评分与对照组相比显著更低(p = 0.01)。在五年随访期间总体体力活动略有下降,但两个研究组之间没有差异。
本随机研究表明,有监督、有控制的家庭锻炼可减轻下腰痛,且积极效果在五年内得以保持。