Meng Xian-Guo, Yue Shou-Wei
From the Department of Physical Medicine & Rehabilitation, QiLu Hospital, Shandong University, Jinan, P.R. China (X-GM, S-WY); and Department of Rehabilitation Medicine, Shandong Medical College, Jinan, P.R. China (X-GM).
Am J Phys Med Rehabil. 2015 May;94(5):358-65. doi: 10.1097/PHM.0000000000000188.
A meta-analysis of relevant cohort studies was performed to investigate the efficacy of aerobic exercise for the treatment of patients with chronic low back pain (CLBP).
A range of electronic databases were searched: MEDLINE (1966-2013), the Cochrane Library Database (issue 12, 2013), EMBASE (1980-2013), CINAHL (1982-2013), Web of Science (1945~2013), and the Chinese Biomedical Database (1982-2013), without language restrictions. The Roland-Morris Disability Questionnaire, the Oswestry Disability Questionnaire, the McGill Pain Questionnaire, visual analog scale, and heart rate, sit-and-reach test, and maximum oxygen consumption were used to evaluate the efficacy of aerobic exercise. Meta-analysis was performed with the use of the STATA statistical software. The standardized mean difference (SMD) with its corresponding 95% confidence interval (CI) was calculated. Eight clinical cohort studies with a total of 310 CLBP patients were included in the meta-analysis.
The results of this meta-analysis indicated that CLBP patients exhibited positive decreases in scores on the Roland-Morris Disability Questionnaire (SMD, 0.44; 95% CI, 0.20-0.68; P < 0.001), Oswestry Disability Questionnaire (SMD, 1.03; 95% CI, 0.67-1.39; P < 0.001), Hospital Anxiety and Depression Scale (SMD, 1.35; 95% CI, 0.34-2.37; P = 0.009), and McGill Pain Questionnaire (SMD, 0.32; 95% CI, 0.07-0.56; P = 0.011) after aerobic exercise. It was also observed that aerobic exercise could markedly reduce the visual analog scale score for pain of CLBP patients (SMD, 0.75; 95% CI, 0.48-1.02; P < 0.001). Nevertheless, this study's findings showed that aerobic exercise had no effects on heart rate, sit-and-reach test, and maximum oxygen consumption of CLBP patients (all P > 0.05).
The current meta-analysis provides reliable evidence that aerobic exercise could effectively diminish pain intensity and improve the physical and psychologic functioning of CLBP patients. Thus, aerobic exercise may be a good choice in the treatment for CLBP.
进行一项相关队列研究的荟萃分析，以探讨有氧运动治疗慢性下腰痛（CLBP）患者的疗效。
检索了一系列电子数据库：MEDLINE（1966 - 2013年）、Cochrane图书馆数据库（2013年第12期）、EMBASE（1980 - 2013年）、CINAHL（1982 - 2013年）、科学引文索引（1945 - 2013年）以及中国生物医学数据库（1982 - 2013年），无语言限制。采用罗兰·莫里斯残疾问卷、奥斯威斯残疾问卷、麦吉尔疼痛问卷、视觉模拟评分以及心率、坐位体前屈测试和最大耗氧量来评估有氧运动的疗效。使用STATA统计软件进行荟萃分析。计算标准化平均差（SMD）及其相应的95%置信区间（CI）。八项临床队列研究共纳入310例CLBP患者进行荟萃分析。
该荟萃分析结果表明，有氧运动后CLBP患者在罗兰·莫里斯残疾问卷（SMD，0.44；95%CI，0.20 - 0.68；P < 0.001）、奥斯威斯残疾问卷（SMD，1.03；95%CI，0.67 - 1.39；P < 0.001）、医院焦虑抑郁量表（SMD，1.35；95%CI，0.34 - 2.37；P = 0.009）和麦吉尔疼痛问卷（SMD，0.32；95%CI，0.07 - 0.56；P = 0.011）上的得分呈显著下降。还观察到有氧运动可显著降低CLBP患者疼痛的视觉模拟评分（SMD，0.75；95%CI，0.48 - 1.02；P < 0.001）。然而，本研究结果显示有氧运动对CLBP患者的心率、坐位体前屈测试和最大耗氧量无影响（所有P > 0.05）。
当前的荟萃分析提供了可靠证据，表明有氧运动可有效减轻疼痛强度，改善CLBP患者的身体和心理功能。因此，有氧运动可能是CLBP治疗的一个良好选择。
