Mbada Chidozie Emmanuel, Ayanniyi Olusola, Ogunlade Samuel Olusegun
Department of Medical Rehabilitation, College of Health Sciences, Obafemi Awolowo University, Ile-Ife, Nigeria.
African Population and Health Research Center, Nairobi, Kenya.
Arch Physiother. 2015 Sep 21;5:10. doi: 10.1186/s40945-015-0010-0. eCollection 2015.
Psychosocial factors precipitate and perpetuate the risk of developing long-term Low-Back Pain (LBP) with resultant disability. However, management of psychosocial aspects of LBP still remains a major challenge. This study investigated the effect of static or dynamic back extensors endurance exercise on psychosocial variables of Fear-Avoidance Behaviour (FAB), Pain Self-Efficacy Belief (PSEB) and Back Pain Consequences Belief (BPCB) in patients with LBP.
A randomized-controlled trial of 67 patients assigned into McKenzie Protocol (MP) group ( = 25), MP and Static Endurance Exercise Group (MPSEEG; = 22); and MP and Dynamic Endurance Exercise Group (MPDEEG; = 20) was carried out. Treatment was applied thrice weekly for eight weeks.
The groups were comparable in general and baseline psychosocial parameters ( > 0.05). The different regimens had significant effects on all outcome parameters across baseline, 4 and 8 week ( < 0.05). The regimens were comparable in mean change scores on BPCB and FAB at the 4th and 8th week respectively ( > 0.05). MPDBEEG had higher mean change in PSEB at the 4 and 8 week respectively.
McKenzie Protocol alone, or in combination with static or dynamic back extensors endurance exercise has comparable effect on FAB, PSEB and BPCB in patients with LBP. The addition of dynamic endurance exercise to the MP led to significantly higher positive effects on PSEB.
社会心理因素会引发并持续导致长期下背痛（LBP）及由此产生的残疾风险。然而，LBP社会心理方面的管理仍然是一项重大挑战。本研究调查了静态或动态背部伸展肌耐力训练对LBP患者恐惧回避行为（FAB）、疼痛自我效能信念（PSEB）和背痛后果信念（BPCB）等社会心理变量的影响。
对67例患者进行随机对照试验，将其分为麦肯齐疗法（MP）组（n = 25）、MP与静态耐力训练组（MPSEEG；n = 22）；以及MP与动态耐力训练组（MPDEEG；n = 20）。治疗每周进行三次，共八周。
各组在一般和基线社会心理参数方面具有可比性（P>0.05）。不同治疗方案在基线、第4周和第8周对所有结局参数均有显著影响（P<0.05）。各治疗方案在第4周和第8周BPCB和FAB的平均变化评分方面具有可比性（P>0.05）。MPDEEG在第4周和第8周PSEB的平均变化较高。
单独的麦肯齐疗法，或与静态或动态背部伸展肌耐力训练相结合，对LBP患者的FAB、PSEB和BPCB具有相似的效果。在MP基础上增加动态耐力训练对PSEB产生显著更高的积极影响。
