Macedo Luciana G, Latimer Jane, Maher Chris G, Hodges Paul W, Nicholas Michael, Tonkin Lois, McAuley James H, Stafford Ryan
Musculoskeletal Division, The George Institute for International Health, 341 George St, Sydney, NSW 2000, Australia.
BMC Musculoskelet Disord. 2008 May 5;9:65. doi: 10.1186/1471-2474-9-65.
Chronic low back pain remains a major health problem in Australia and around the world. Unfortunately the majority of treatments for this condition produce small effects because not all patients respond to each treatment. It appears that only 25-50% of patients respond to exercise. The two most popular types of exercise for low back pain are graded activity and motor control exercises. At present however, there are no guidelines to help clinicians select the best treatment for a patient. As a result, time and money are wasted on treatments which ultimately fail to help the patient.
This paper describes the protocol of a randomised clinical trial comparing the effects of motor control exercises with a graded activity program in the treatment of chronic non specific low back pain. Further analysis will identify clinical features that may predict a patient's response to each treatment. One hundred and seventy two participants will be randomly allocated to receive either a program of motor control exercises or graded activity. Measures of outcome will be obtained at 2, 6 and 12 months after randomisation. The primary outcomes are: pain (average pain intensity over the last week) and function (patient-specific functional scale) at 2 and 6 months. Potential treatment effect modifiers will be measured at baseline.
This trial will not only evaluate which exercise approach is more effective in general for patients will chronic low back pain, but will also determine which exercise approach is best for an individual patient.
ACTRN12607000432415.
慢性下腰痛在澳大利亚乃至全球仍然是一个主要的健康问题。不幸的是，针对这种疾病的大多数治疗效果甚微，因为并非所有患者对每种治疗都有反应。似乎只有25%至50%的患者对运动疗法有反应。治疗下腰痛最常用的两种运动疗法是分级活动和运动控制训练。然而，目前尚无指导方针帮助临床医生为患者选择最佳治疗方法。结果，时间和金钱都浪费在了最终无法帮助患者的治疗上。
本文描述了一项随机临床试验的方案，该试验比较了运动控制训练与分级活动计划对慢性非特异性下腰痛的治疗效果。进一步的分析将确定可能预测患者对每种治疗反应的临床特征。172名参与者将被随机分配接受运动控制训练计划或分级活动计划。在随机分组后的2个月、6个月和12个月获取结果测量数据。主要结局指标为：随机分组后2个月和6个月时的疼痛（过去一周的平均疼痛强度）和功能（患者特定功能量表）。潜在的治疗效果调节因素将在基线时进行测量。
该试验不仅将评估哪种运动疗法总体上对慢性下腰痛患者更有效，还将确定哪种运动疗法对个体患者最适用。
ACTRN12607000432415。
