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促进腰痛患者的身体活动:一项随机对照试验的六个月随访,比较多组分干预与低强度干预。

Promoting physical activity in low back pain patients: six months follow-up of a randomised controlled trial comparing a multicomponent intervention with a low intensity intervention.

作者信息

Schaller Andrea, Dintsios Charalabos-Markos, Icks Andrea, Reibling Nadine, Froboese Ingo

机构信息

Institute of Health Promotion and Clinical Movement Science, German Sport University Cologne, Cologne, Germany IST-University of Applied Sciences, Duesseldorf, Germany

IST-University of Applied Sciences, Duesseldorf, Germany.

出版信息

Clin Rehabil. 2016 Sep;30(9):865-77. doi: 10.1177/0269215515618730.

Abstract

OBJECTIVE

To assess a comprehensive multicomponent intervention against a low intensity intervention for promoting physical activity in chronic low back pain patients.

DESIGN

Randomised controlled trial.

SETTING

Inpatient rehabilitation and aftercare.

SUBJECTS

A total of 412 patients with chronic low back pain.

INTERVENTIONS

A multicomponent intervention (Movement Coaching) comprising of small group intervention (twice during inpatient rehabilitation), tailored telephone aftercare (twice after rehabilitation) and internet-based aftercare (web 2.0 platform) versus a low level intensity intervention (two general presentations on physical activity, download of the presentations).

MAIN MEASURES

Physical activity was measured using a questionnaire. Primary outcome was total physical activity; secondary outcomes were setting specific physical activity (transport, workplace, leisure time) and pain. Comparative group differences were evaluated six months after inpatient rehabilitation.

RESULTS

At six months follow-up, 92 participants in Movement Coaching (46 %) and 100 participants in the control group (47 %) completed the postal follow-up questionnaire. No significant differences between the two groups could be shown in total physical activity (P = 0.30). In addition to this, workplace (P = 0.53), transport (P = 0.68) and leisure time physical activity (P = 0.21) and pain (P = 0.43) did not differ significantly between the two groups. In both groups, physical activity decreased during the six months follow-up.

CONCLUSIONS

The multicomponent intervention was no more effective than the low intensity intervention in promoting physical activity at six months follow-up. The decrease in physical activity in both groups is an unexpected outcome of the study and indicates the need for further research.

摘要

目的

评估一种综合多成分干预措施与低强度干预措施相比,对促进慢性腰痛患者身体活动的效果。

设计

随机对照试验。

地点

住院康复及后续护理。

研究对象

共412例慢性腰痛患者。

干预措施

一种多成分干预措施(运动指导),包括小组干预(住院康复期间两次)、个性化电话随访(康复后两次)和基于互联网的随访(网络2.0平台),与低强度干预措施(关于身体活动的两次一般性讲座、讲座资料下载)进行对比。

主要测量指标

使用问卷测量身体活动情况。主要结局指标为总体身体活动;次要结局指标为特定场景下的身体活动(交通、工作场所、休闲时间)及疼痛程度。在住院康复6个月后评估两组间的差异。

结果

在6个月随访时,运动指导组92名参与者(46%)和对照组100名参与者(47%)完成了邮寄的随访问卷。两组在总体身体活动方面无显著差异(P = 0.30)。除此之外,两组在工作场所身体活动(P = 0.53)、交通身体活动(P = 0.68)、休闲时间身体活动(P = 0.21)及疼痛程度(P = 0.43)方面也无显著差异。在两组中,身体活动在6个月随访期间均有所下降。

结论

在6个月随访时,多成分干预措施在促进身体活动方面并不比低强度干预措施更有效。两组身体活动的下降是该研究未预料到的结果,表明有必要进一步开展研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9df7/4976660/2e2f106c4e4e/10.1177_0269215515618730-fig1.jpg

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