Chatzitheodorou Dimitris, Mavromoustakos Savvas, Milioti Styliani
Department of Physical Therapy, Technological Educational Institute of Thessaloniki, Sindos, Greece.
Clin Rehabil. 2008 Apr;22(4):319-28. doi: 10.1177/0269215507079858.
To investigate the effects of high-intensity aerobic exercise on adrenocortical responsiveness and on standard outcome measures in patients with chronic low back pain.
Controlled clinical trial.
Physical therapy department of a university general hospital.
Sixty-four patients with chronic low back pain were randomly allocated into positive and negative suppression test groups and assigned to exercise protocol.
Subjects in the positive and negative dexamethasone suppression test groups received a 12-week high-intensity aerobic exercise programme.
Dexamethasone suppression test as an index of adrenocortical responsiveness, pain measured with the McGill Pain Questionnaire, functional status measured with the Roland Morris Disability Questionnaire, and psychological strain measured with the Hospital Anxiety and Depression Scale.
Data analysis in the positive group identified a significant reduction of pain by 30% (t(30) = 11.2, P<0.001), a recovery of the lost functioning by 34% (t(30) = 19.7, P<0.001), a reduction of anxiety/depression by 25% (t(30) = 10.2, P<0.001), and a change in adrenocortical responsiveness by 40% (t(30) = 14.1, P<0.001). In the dexamethasone suppression test negative group, data analysis identified a significant reduction of pain by 8% (t(31) = 4.2, P<0.001), a recovery of lost functioning by 10% (t(31) = 4.8, P<0.001), a reduction of anxiety/depression by 11% (t(31) = 5.0, P<0.001), and no change in adrenocortical responsiveness (t(31) = 1.2, P=0.22). In univariate analysis between-subject differences were significant for dexamethasone suppression test (F(61) = 163, P<0.001), and for anxiety/depression (F(61) = 21.3, P<0.001).
Exercise alleviated pain, functional disability and anxiety/depression, also improved adrenocortical responsiveness in patients with chronic low back pain with dexamethasone suppression test positive values.
探讨高强度有氧运动对慢性下腰痛患者肾上腺皮质反应性及标准结局指标的影响。
对照临床试验。
某大学综合医院理疗科。
64例慢性下腰痛患者被随机分为地塞米松抑制试验阳性组和阴性组，并分配至运动方案组。
地塞米松抑制试验阳性组和阴性组的受试者接受为期12周的高强度有氧运动计划。
用地塞米松抑制试验作为肾上腺皮质反应性指标，用麦吉尔疼痛问卷测量疼痛，用罗兰·莫里斯功能障碍问卷测量功能状态，用医院焦虑抑郁量表测量心理压力。
阳性组数据分析显示疼痛显著减轻30%（t(30)=11.2，P<0.001），功能丧失恢复34%（t(30)=19.7，P<0.001），焦虑/抑郁减轻25%（t(30)=10.2，P<0.001），肾上腺皮质反应性变化40%（t(30)=14.1，P<0.001）。在地塞米松抑制试验阴性组，数据分析显示疼痛显著减轻8%（t(31)=4.2，P<0.001），功能丧失恢复10%（t(31)=4.8，P<0.001），焦虑/抑郁减轻11%（t(31)=5.0，P<0.001），肾上腺皮质反应性无变化（t(31)=1.2，P=0.22）。单因素分析显示，地塞米松抑制试验（F(61)=163，P<0.001）和焦虑/抑郁（F(61)=21.3，P<0.001）的组间差异具有统计学意义。
运动可减轻慢性下腰痛患者的疼痛、功能障碍和焦虑/抑郁，对于地塞米松抑制试验阳性的慢性下腰痛患者，还可改善其肾上腺皮质反应性。
