抗阻带训练或一般运动在腰痛的多学科康复中的作用:一项随机试验。

Resistance band training or general exercise in multidisciplinary rehabilitation of low back pain? A randomized trial.

机构信息

Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, NTNU, Norwegian University of Science and Technology, Trondheim, Norway.

Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.

出版信息

Scand J Med Sci Sports. 2018 Sep;28(9):2074-2083. doi: 10.1111/sms.13091. Epub 2018 Apr 24.

Abstract

Multidisciplinary biopsychosocial rehabilitation has been recommended for chronic low back pain (LBP), including physical exercise. However, which exercise modality that is most advantageous in multidisciplinary biopsychosocial rehabilitation is unclear. In this study, we investigated whether multidisciplinary biopsychosocial rehabilitation could be more effective in reducing pain-related disability when general physical exercise was replaced by strength training in the form of progressive resistance training using elastic resistance bands. In this single-blinded (researchers), randomized controlled trial, 99 consenting adults with moderate-to-severe non-specific LBP were randomized to three weeks of multidisciplinary biopsychosocial rehabilitation with either general physical exercise or progressive resistance band training and were then instructed to continue with their respective home-based programs for nine additional weeks, in which three booster sessions were offered. The primary outcome was between-group difference in change on the Oswestry Disability Index (ODI) at 12 weeks. Due to early dropouts, data from 74 participants (mean age: 45 years, 57% women, mean ODI: 30.4) were obtained at baseline, 61 participants were followed-up at 3 weeks, and 46 at 12 weeks. There was no difference in the change in ODI score between groups at 12 weeks (mean difference 1.9, 95% CI: -3.6, 7.4, P = .49). Likewise, the change in secondary outcomes did not differ between groups, except for the patient-specific functional scale (0-10), which favored general physical exercise (mean difference 1.4, 95% CI: 0.1, 2.7, P = .033). In conclusion, this study does not support that progressive resistance band training compared to general physical exercise improve outcomes in multidisciplinary biopsychosocial rehabilitation for patients with non-specific LBP.

摘要

多学科生物心理社会康复已被推荐用于慢性下腰痛(LBP),包括体育锻炼。然而,在多学科生物心理社会康复中,哪种运动方式最有利尚不清楚。在这项研究中,我们研究了当一般体育锻炼被渐进式抗阻训练(使用弹性阻力带)取代时,多学科生物心理社会康复是否可以更有效地减少疼痛相关残疾。在这项单盲(研究人员)、随机对照试验中,99 名同意的中重度非特异性 LBP 成年人被随机分配到为期三周的多学科生物心理社会康复治疗,其中包括一般体育锻炼或渐进式阻力带训练,然后被指示继续进行各自的家庭计划,为期九周,其中提供三次强化课程。主要结局是在 12 周时 Oswestry 残疾指数(ODI)的组间差异变化。由于早期退出,74 名参与者(平均年龄:45 岁,57%为女性,平均 ODI:30.4)在基线时获得了数据,61 名参与者在 3 周时进行了随访,46 名参与者在 12 周时进行了随访。在 12 周时,两组之间 ODI 评分的变化没有差异(平均差异 1.9,95%CI:-3.6,7.4,P=0.49)。同样,除了患者特定的功能量表(0-10)外,各组之间的次要结局变化也没有差异,后者倾向于一般体育锻炼(平均差异 1.4,95%CI:0.1,2.7,P=0.033)。总之,这项研究不支持渐进式抗阻带训练与一般体育锻炼相比,能改善非特异性 LBP 患者多学科生物心理社会康复的结局。

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