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半强化多学科门诊康复方案治疗慢性下腰痛的效果。

Effectiveness of a semi-intensive multidisciplinary outpatient rehabilitation program in chronic low back pain.

机构信息

Department of Motricity Sciences, Liege University, ISEPK, B21, allée des Sports 4, 4000 Liège, Sart-Tilman, Belgium.

出版信息

Joint Bone Spine. 2010 Jan;77(1):58-63. doi: 10.1016/j.jbspin.2009.11.003. Epub 2009 Dec 23.

Abstract

OBJECTIVES

To evaluate the efficacy of a semi-intensive multidisciplinary outpatient program complying with the requirements of the Belgian National Institute for Health and Disability Insurance and intended for patients with chronic low back pain.

METHODS

We included 262 patients with nonspecific chronic low back pain, among whom 136 (73 women and 63 men) with a mean pain duration of 11.3 years completed the outpatient program (36 sessions each lasting 2h). The program consisted of education about back-sparing techniques, interventions by an occupational therapist and psychologist, and physical reconditioning. Three sessions (sessions 1, 18, and 36) were used to evaluate pain intensity, functional impairment, kinesiophobia, cognitive knowledge, knowledge of appropriate spinal movement technique, and physical performance (trunk muscle strength and endurance, mobility of the pelvis and lumbar spine, and aerobic capacity).

RESULTS

All study variables were significantly improved at study completion compared to baseline: pain intensity was decreased by 44%, functional impairment by 40%, and kinesiophobia by 11% whereas knowledge was improved by 59%, back-sparing technique by 95%, trunk muscle strength by 40% on average, trunk extensor muscle endurance by 90%, mobility by 8%, and aerobic capacity by 18%.

CONCLUSIONS

A semi-intensive multidisciplinary outpatient program was beneficial in patients with chronic low back pain. Careful patient selection and increased patient involvement in the program may help to improve adherence.

摘要

目的

评估符合比利时国家健康和残疾保险研究所要求的半强化多学科门诊项目对慢性下腰痛患者的疗效。

方法

我们纳入了 262 例非特异性慢性下腰痛患者,其中 136 例(73 名女性和 63 名男性)完成了门诊项目(每次 2 小时,共 36 次),平均疼痛持续时间为 11.3 年。该项目包括关于脊柱保护技术的教育、职业治疗师和心理学家的干预以及身体康复。三次治疗(第 1、18 和 36 次)用于评估疼痛强度、功能障碍、运动恐惧、认知知识、适当脊柱运动技术的知识和身体表现(躯干肌肉力量和耐力、骨盆和腰椎的活动度以及有氧能力)。

结果

与基线相比,所有研究变量在研究结束时均显著改善:疼痛强度降低了 44%,功能障碍降低了 40%,运动恐惧降低了 11%,而知识提高了 59%,脊柱保护技术提高了 95%,躯干肌肉力量平均提高了 40%,躯干伸肌耐力提高了 90%,活动度提高了 8%,有氧能力提高了 18%。

结论

半强化多学科门诊项目对慢性下腰痛患者有益。仔细选择患者并增加患者对项目的参与可能有助于提高依从性。

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