Helmhout Pieter H, Harts Chris C, Viechtbauer Wolfgang, Staal J Bart, de Bie Rob A
Department of Training Medicine and Training Physiology, Personnel Command, Royal Netherlands Army, Utrecht, The Netherlands.
Arch Phys Med Rehabil. 2008 Sep;89(9):1675-85. doi: 10.1016/j.apmr.2007.12.050.
To evaluate the effectiveness of specific lumbar extensor training compared with regular physical therapy (PT) in workers with nonspecific nonacute low back pain (LBP).
A multicenter randomized controlled trial with 1-year follow-up.
PT department in (military primary care) health centers.
Predominantly male soldiers (N=129) with 4 weeks or more of low back complaints who were referred by the health center's general practitioner for PT (mean age, 35.9+/-10.8 y; range, 20-56 y), of whom 127 randomized participants were included in the analyses. One patient withdrew because of adverse effects during treatment.
Participants were assigned to 1 of 2 treatment programs: (1) a 10-week device-supported isolated lumbar extension training, twice a week, or (2) regular PT, mainly consisting of exercise therapy and aerobic activities.
Functional status (Roland-Morris Disability Questionnaire, Patient-Specific Functional Scale) and global perceived effect were assessed in the short term (5 wk, 10 wk) and long term (6 mo, 12 mo).
Both groups showed a favorable development in main outcomes over time: short-term improvements (after 10 weeks of treatment) remained stable or even slightly increased throughout the 12-month follow-up. No significant differences between the 2 groups were shown for any of the outcome measures, at any time.
Consistent with prior evidence, specific back strengthening does not seem to offer incremental benefits in LBP management compared with regular PT care that mainly consists of general exercise therapy. (ISRCTN identifier ISRCTN19334317.)
评估特定的腰椎伸肌训练与常规物理治疗（PT）相比，对非特异性非急性下背痛（LBP）工人的有效性。
一项为期1年随访的多中心随机对照试验。
（军事初级保健）健康中心的PT科室。
主要为男性士兵（N = 129），有4周或更长时间的下背疼痛主诉，由健康中心的全科医生转介接受PT治疗（平均年龄35.9±10.8岁；范围20 - 56岁），其中127名随机参与者纳入分析。1名患者因治疗期间出现不良反应而退出。
参与者被分配到2个治疗方案中的1个：（1）为期10周的器械辅助孤立腰椎伸展训练，每周2次，或（2）常规PT，主要包括运动疗法和有氧运动。
在短期（5周、10周）和长期（6个月、12个月）评估功能状态（罗兰-莫里斯残疾问卷、患者特定功能量表）和总体感知效果。
随着时间推移，两组在主要结局方面均呈现良好进展：短期改善（治疗10周后）在整个12个月随访期间保持稳定甚至略有增加。在任何时间点，两组在任何结局指标上均未显示出显著差异。
与先前证据一致，与主要由一般运动疗法组成的常规PT护理相比，特定的背部强化训练在LBP管理中似乎并未提供额外益处。（国际标准随机对照试验编号ISRCTN19334317。）
