Cai Congcong, Yang Yifan, Kong Pui W
1Physical Education and Sports Science Academic Group, National Institute of Education, Nanyang Technological University, SINGAPORE; and 2Physiotherapy, Rehabilitation Department, Ng Teng Fong General Hospital, Jurong Health Services, SINGAPORE.
Med Sci Sports Exerc. 2017 Dec;49(12):2374-2384. doi: 10.1249/MSS.0000000000001396.
This single-blind randomized trial was conducted to compare the treatment effect of lower limb (LL) exercises versus conventional lumbar extensor (LE) and lumbar stabilization (LS) exercises in recreational runners with chronic low back pain (cLBP), because there is currently no specific protocol for managing runners with cLBP.
Eighty-four recreational runners with cLBP were allocated to three exercise groups (LL, LE, LS) for an 8-wk intervention. Outcome measures included self-rated pain and running capability, LL strength, back muscle function, and running gait. Participants were assessed at preintervention, mid-intervention, and end-intervention; selected outcomes also followed up at 3 and 6 months. Generalized estimating equation was adopted to examine group-time interaction.
The LL group improved 0.949 points per time point in Patient-Specific Functional Scale (P < 0.001), which was higher than the LE (B = -0.198, P = 0.001) and LS groups (B = -0.263, P < 0.001). All three groups improved on average 0.746 points per time point in Numeric Pain Rating Scale for running-induced pain (P < 0.001). Knee extension strength increased 0.260 N·m·kg per time point (P < 0.001) in the LL group, which was higher than the LE (B = -0.220, P < 0.001) and LS groups (B = -0.206, P < 0.001). The LL group also showed a greater increase in running step length (2.464 cm per time point, P = 0.001) compared with LS group (B = -2.213, P = 0.013). All three groups improved similarly in back muscle function.
LL exercise therapy could be a new option for cLPB management given its superior effects in improving running capability, knee extension strength, and running gait.
本单盲随机试验旨在比较下肢（LL）锻炼与传统腰椎伸展（LE）及腰椎稳定（LS）锻炼对患有慢性下腰痛（cLBP）的业余跑步者的治疗效果，因为目前尚无针对cLBP跑步者的特定管理方案。
84名患有cLBP的业余跑步者被分配到三个锻炼组（LL、LE、LS）进行为期8周的干预。结果指标包括自我评定的疼痛和跑步能力、LL力量、背部肌肉功能以及跑步步态。在干预前、干预中期和干预结束时对参与者进行评估；选定的结果在3个月和6个月时也进行随访。采用广义估计方程来检验组间时间交互作用。
LL组在患者特异性功能量表中每个时间点改善0.949分（P < 0.001），高于LE组（B = -0.198，P = 0.001）和LS组（B = -0.263，P < 0.001）。在跑步诱发疼痛的数字疼痛评分量表中，所有三组平均每个时间点改善0.746分（P < 0.001）。LL组膝关节伸展力量每个时间点增加0.260 N·m·kg（P < 0.001），高于LE组（B = -0.220，P < 0.001）和LS组（B = -0.206，P < 0.001）。与LS组相比，LL组的跑步步长增加也更大（每个时间点2.464 cm，P = 0.001）（B = -2.213，P = 0.013）。所有三组在背部肌肉功能方面的改善相似。
鉴于LL运动疗法在改善跑步能力、膝关节伸展力量和跑步步态方面具有卓越效果，它可能是cLBP管理的一种新选择。
