Alfuth Martin, Welsink Dieter W
Faculty of Health Care (Therapeutic Sciences), Niederrhein University of Applied Sciences, Reinarzstr. 49, 47805, Krefeld, Germany.
medicoreha Welsink Rehabilitation GmbH, Ambulante Fachkliniken für Rehabilitation, Preußenstr. 84a, 41464, Neuss, Germany.
Orthopade. 2017 Jun;46(6):522-529. doi: 10.1007/s00132-017-3390-x.
Physiotherapy treatment programs are recommended in the rehabilitation of low back pain (LBP). Rehabilitation institutions are increasingly asked to demonstrate the outcomes of their intensive physiotherapy services.
To describe pain and functional outcome measures following a 6-month outpatient physiotherapy treatment program in patients with LBP.
A total of 85 patients were analysed after being treated with a combination of physiotherapeutic treatment modalities 2-3 days weekly. Pain and disability were measured before, 3 and 6 months after the onset of treatment. Isometric trunk muscle strength for flexion and extension and flexibility of dorsal trunk and thigh structures were measured before and 6 months after treatment.
After 6 months, pain at rest decreased from a median of 4.0 to 0.0 (p < 0.01) and pain during activity from a median of 5.5 to 2.0 on the numeric rating scale (p < 0.001). The Roland-Morris Disability (RMDQ) score decreased from a median of 7.0 to 3.0 (p < 0.001). Mean trunk muscle flexion strength increased from 133.7 to 156.0 Nm and for extension from 235.5 to 278.3 Nm (p < 0.001). Flexibility was improved from a mean of -5.9 to -1.4 cm (p < 0.001). A moderate correlation between pain at rest and RMDQ score was found after 3 (r = 0.532, p < 0.01) and 6 months (r = 0.508, p < 0.01).
Patients with LBP who were treated with the physiotherapeutic treatment program showed a clinically relevant reduction of pain and disability with improved trunk muscle strength and flexibility. Reductions in pain and disability do not seem to correlate with increased trunk muscle strength and flexibility. No conclusions can be declared about long-term changes after the intervention.
物理治疗方案被推荐用于腰痛（LBP）的康复治疗。康复机构越来越多地被要求展示其强化物理治疗服务的效果。
描述LBP患者在接受为期6个月的门诊物理治疗方案后的疼痛和功能结局指标。
共有85例患者在接受每周2 - 3天的多种物理治疗方式联合治疗后进行分析。在治疗开始前、治疗后3个月和6个月测量疼痛和残疾情况。在治疗前和治疗后6个月测量躯干等长屈伸肌力量以及背部躯干和大腿结构的柔韧性。
6个月后，静息时疼痛从数字评分量表上的中位数4.0降至0.0（p < 0.01），活动时疼痛从中位数5.5降至2.0（p < 0.001）。罗兰 - 莫里斯残疾（RMDQ）评分从中位数7.0降至3.0（p < 0.001）。平均躯干肌屈曲力量从133.7 Nm增加到156.0 Nm，伸展力量从235.5 Nm增加到278.3 Nm（p < 0.001）。柔韧性从平均 - 5.9 cm改善到 - 1.4 cm（p < 0.001）。在治疗3个月（r = 0.532，p < 0.01）和6个月（r = 0.508，p < 0.01）后，发现静息时疼痛与RMDQ评分之间存在中度相关性。
接受物理治疗方案治疗的LBP患者在疼痛和残疾方面有临床相关的减轻，同时躯干肌力量和柔韧性得到改善。疼痛和残疾的减轻似乎与躯干肌力量和柔韧性的增加无关。关于干预后的长期变化无法得出结论。
