Kumar S, Negi M P S, Sharma V P, Shukla R, Dev R, Mishra U K
Department of Physical Medicine and Rehabilitation, Chatrapati Sahuji Maharaj Medical University, Lucknow, India.
J Back Musculoskelet Rehabil. 2009;22(3):179-88. doi: 10.3233/BMR-2009-0234.
Some occupations are more prone to low back pain (LBP) due to their static work postures and work place design. Multidisciplinary pain programs have shown their effectiveness in the management of LBP in general population but which treatment and which segment of the population will be benefited more was not investigated yet. This study determines the effect of two treatment protocols on five occupationally subgrouped male LBP patients.
A total of 102 occupational male, 20-40 yrs of age, with sub-acute or chronic nonspecific LBP were randomized and treated either with conventional treatment a combination of two electrotherapy (ultrasound and short wave diathermy) and one exercise therapy (lumbar strengthening exercises) or dynamic muscular stabilization techniques (DMST) an active approach of stabilizing training. At the end of the treatment, subjects of both the groups were further stratified in five subgroups on the basis of their occupation. The pain was the primary outcome measure while physical strength [back pressure changes (BPC) and abdominal pressure changes (APC)] the secondary.
The Pain, BPC and APC of all subgroups improved significantly (P < 0.01) in the both treatments but more in DMST. For each variable, improvement in subgroups differed within and between the treatments. Overall improvement in all assessed variables were evident on Desk workers followed by Shop keepers the most while BPC of Movement job, APC of Others and Pain of Sedentary and Shop keepers improved the least.
Study concluded that for the management of occupational LBP, DMST is more effective than conventional treatment. The Pain of Sedentary and Shopkeepers and physical strength of Movement job and Others may need more clinical attention. Findings of this study may be helpful in the management of occupational LBP.
由于某些职业的静态工作姿势和工作场所设计，这些职业更容易出现腰痛（LBP）。多学科疼痛项目已证明其在普通人群腰痛管理中的有效性，但尚未研究哪种治疗方法以及哪些人群受益更多。本研究确定两种治疗方案对五组职业分组的男性腰痛患者的效果。
共有102名年龄在20 - 40岁之间的职业男性，患有亚急性或慢性非特异性腰痛，被随机分组，并接受常规治疗（两种电疗法（超声和短波透热疗法）和一种运动疗法（腰部强化锻炼）的组合）或动态肌肉稳定技术（DMST，一种主动的稳定训练方法）治疗。在治疗结束时，两组受试者根据其职业进一步分为五个亚组。疼痛是主要结局指标，而体力[背部压力变化（BPC）和腹部压力变化（APC）]是次要指标。
在两种治疗中，所有亚组的疼痛、BPC和APC均有显著改善（P < 0.01），但DMST组改善更明显。对于每个变量，亚组内和治疗间的改善情况有所不同。所有评估变量的总体改善在办公室工作人员中最为明显，其次是店主，而运动工作者的BPC、其他职业者的APC以及久坐者和店主的疼痛改善最少。
研究得出结论，对于职业性腰痛的管理，DMST比传统治疗更有效。久坐者和店主的疼痛以及运动工作者和其他职业者的体力可能需要更多临床关注。本研究结果可能有助于职业性腰痛的管理。
