本体感受神经肌肉促进疗法改善慢性下腰痛工作年龄患者的疼痛相关和平衡结果：一项随机对照试验。
Proprioceptive neuromuscular facilitation training improves pain-related and balance outcomes in working-age patients with chronic low back pain: a randomized controlled trial.
机构信息
Department of Physical Therapy, School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand.
Department of Physical Therapy, School of Health Science, Mae Fah Luang University, Chiang Rai, Thailand.
出版信息
Braz J Phys Ther. 2019 Sep-Oct;23(5):428-436. doi: 10.1016/j.bjpt.2018.10.005. Epub 2018 Oct 17.
BACKGROUND
Proprioceptive neuromuscular facilitation training and general trunk exercises have been applied to treat chronic low back pain patients. However, there is currently little study to support the use of one treated intervention over the other to improve clinical outcomes and balance ability.
OBJECTIVE
To examine the effects of proprioceptive neuromuscular facilitation training on pain intensity, disability and static balance ability in working-age patients with chronic low back pain.
METHODS
Forty-four chronic low back pain participants aged 18-50 years were randomized either to a three-week proprioceptive neuromuscular facilitation training or to a control group receiving general trunk exercises. Pain intensity, disability and static balance ability were measured before and after the three-week intervention.
RESULTS
The proprioceptive neuromuscular facilitation training intervention showed a statistically significantly greater reduction in pain intensity and improved functional disability than the controls at three weeks (between-group difference: pain intensity 1.22 score, 95% CI: 0.58 to 1.88, p<0.001; disability 2.23 score, 95% CI: 1.22 to 3.24, p<0.001. The proprioceptive neuromuscular facilitation training intervention also had statistically better parameters of static balance ability than the control group (between-group difference: ellipse sway area during eye opened and closed conditions 129.09mm, 95% CI: 64.93 to 175.25, p<0.01 and 336.27mm, 95% CI: 109.67 to 562.87, p<0.05, respectively; the centre of pressure velocity during eye opened and eye closed conditions 6.68mm/s, 95% CI: 4.41 to 8.95, p<0.01 and 6.77mm/s, 95% CI: 4.01 to 9.54, p<0.01, respectively).
CONCLUSION
The three-week proprioceptive neuromuscular facilitation training provides better pain intensity, disability and static balance ability than general trunk exercises for working-age individuals with chronic low back pain but the effects do not reach the clinical meaningful level. The therapists should consider carefully when making recommendations regarding these interventions, taking into account effectiveness and costs.
背景
本体感觉神经肌肉促进训练和一般躯干运动已被应用于治疗慢性下腰痛患者。然而，目前几乎没有研究支持使用一种治疗干预措施而不是另一种治疗干预措施来改善临床结果和平衡能力。
目的
检查本体感觉神经肌肉促进训练对工作年龄慢性下腰痛患者疼痛强度、残疾和静态平衡能力的影响。
方法
44 名年龄在 18-50 岁的慢性下腰痛患者被随机分为三组，分别接受为期 3 周的本体感觉神经肌肉促进训练、一般躯干运动或对照组。在 3 周干预前后测量疼痛强度、残疾和静态平衡能力。
结果
本体感觉神经肌肉促进训练组在 3 周时疼痛强度和功能障碍的改善明显大于对照组（组间差异：疼痛强度 1.22 分，95%置信区间：0.58 至 1.88，p<0.001；残疾 2.23 分，95%置信区间：1.22 至 3.24，p<0.001）。本体感觉神经肌肉促进训练组的静态平衡能力参数也明显优于对照组（睁眼和闭眼条件下椭圆摆动面积分别为 129.09mm，95%置信区间：64.93 至 175.25，p<0.01 和 336.27mm，95%置信区间：109.67 至 562.87，p<0.05；睁眼和闭眼条件下的压力中心速度分别为 6.68mm/s，95%置信区间：4.41 至 8.95，p<0.01 和 6.77mm/s，95%置信区间：4.01 至 9.54，p<0.01）。
结论
为期 3 周的本体感觉神经肌肉促进训练为慢性下腰痛的工作年龄患者提供了更好的疼痛强度、残疾和静态平衡能力，优于一般躯干运动，但效果并未达到临床意义水平。治疗师在推荐这些干预措施时应仔细考虑，同时考虑有效性和成本。
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