Papi Enrica, Bull Anthony M J, McGregor Alison H
Department of Surgery and Cancer, Imperial College London, London, UK; Department of Bioengineering, Imperial College London, London, UK.
Department of Bioengineering, Imperial College London, London, UK.
Clin Biomech (Bristol). 2018 Jun;55:53-64. doi: 10.1016/j.clinbiomech.2018.04.006. Epub 2018 Apr 11.
Currently, there is a widespread reliance on self-reported questionnaires to assess low back pain patients. However, it has been suggested that objective measures of low back pain patients' functional status should be used to aid clinical assessment. The aim of this study is to systematically review which kinematic /kinetic parameters have been used to assess low back pain patients against healthy controls and to propose clinical kinematic/kinetic measures.
PubMed, Embase and Scopus databases were searched for relevant studies. Reference lists of selected studies and hand searches were performed. Studies had to compare people with and without non-specific low back pain while performing functional tasks and report body segment/joint kinematic and/or kinetic data. Two reviewers independently identified relevant papers.
Sixty-two studies were included. Common biases identified were lack of assessor blinding and sample size calculation, use of samples of convenience, and poor experimental protocol standardization. Studies had small sample sizes. Range of motion maneuvers were the main task performed (33/62). Kinematic/kinetic data of different individual or combination of body segments/joints were reported among the studies, commonest was to assess the hip joint and lumbar segment motion (13/62). Only one study described full body movement. The most commonly reported outcome was range of motion. Statistically significant differences between controls and low back pain groups were reported for different outcomes among the studies. Moreover, when the same outcome was reported disagreements were noted.
The literature to date offers limited and inconsistent evidence of kinematic/kinetic measures in low back pain patients that could be used clinically.
目前,广泛依赖自我报告问卷来评估腰痛患者。然而,有人建议应使用腰痛患者功能状态的客观测量方法来辅助临床评估。本研究的目的是系统回顾哪些运动学/动力学参数已被用于评估腰痛患者并与健康对照进行比较,并提出临床运动学/动力学测量方法。
检索PubMed、Embase和Scopus数据库以查找相关研究。对所选研究的参考文献列表进行了检索,并进行了手工检索。研究必须比较在执行功能任务时有无非特异性腰痛的人群,并报告身体节段/关节的运动学和/或动力学数据。两名评审员独立识别相关论文。
纳入了62项研究。确定的常见偏倚包括缺乏评估者盲法和样本量计算、使用便利样本以及实验方案标准化差。研究的样本量较小。运动范围操作是主要执行的任务(33/62)。各项研究报告了不同个体或身体节段/关节组合的运动学/动力学数据,最常见的是评估髋关节和腰椎节段的运动(13/62)。只有一项研究描述了全身运动。最常报告的结果是运动范围。各项研究报告了对照组和腰痛组之间在不同结果上的统计学显著差异。此外,当报告相同结果时也存在分歧。
迄今为止的文献提供了有限且不一致的证据,证明腰痛患者的运动学/动力学测量方法可用于临床。