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一项随机对照试验,比较慢性非特异性下腰痛患者长期使用两种不同压力的软性腰骶矫形器的效果。

A randomized controlled trial comparing the long-term use of soft lumbosacral orthoses at two different pressures in patients with chronic nonspecific low back pain.

作者信息

Samani Mahbobeh, Shirazi Zahra Rojhani, Hadadi Mohammad, Sobhani Sobhan

机构信息

Student Research Committee, Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.

Department of Physical Therapy, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran.

出版信息

Clin Biomech (Bristol). 2019 Oct;69:87-95. doi: 10.1016/j.clinbiomech.2019.07.003. Epub 2019 Jul 5.

Abstract

BACKGROUND

There is concern that wearing soft lumbosacral orthoses for prolonged periods may impair motor function. Moreover, the pressure applied by lumbosacral orthoses on the abdominal wall is usually ignored when these orthoses are prescribed.

METHOD

In this randomized controlled trial study, 48 patients with chronic nonspecific low back pain were randomly divided into high pressure, normal pressure and control groups. All groups received medication for 4 weeks. The normal pressure and high pressure groups, in addition to medication, used soft lumbosacral orthoses at normal pressure and 50% increased pressure, respectively. Motor function outcome measures were strength, endurance, proprioception and electromyographic activity of the trunk muscles. Clinical outcome measures were pain and disability, which were evaluated in two sessions before and after a 4-week interval.

FINDINGS

Isometric strength, endurance and most of the electromyographic parameters were generally unaffected by wearing the lumbosacral orthosis. Pain improved in all groups, and disability and proprioception improved in the high pressure and normal pressure groups. Between-group differences in these three measures indicated better results in the lumbosacral orthoses groups than in the control group. The improvements in pain and proprioception were significantly greater in the high pressure group than the normal pressure group.

INTERPRETATION

Long-term use of lumbosacral orthoses had no significant adverse effects on motor function or clinical factors in patients with chronic low back pain. Increasing lumbosacral orthosis tightness may improve motor functioning and the clinical efficacy of the orthosis.

CLINICAL TRIAL REGISTRATION NUMBER

Code: IRCT201708192391N38.

摘要

背景

人们担心长时间佩戴柔软的腰骶矫形器可能会损害运动功能。此外,在开具腰骶矫形器处方时,通常会忽略其对腹壁施加的压力。

方法

在这项随机对照试验研究中,48例慢性非特异性下腰痛患者被随机分为高压组、常压组和对照组。所有组均接受4周的药物治疗。常压组和高压组除药物治疗外,分别使用常压和压力增加50%的柔软腰骶矫形器。运动功能结果测量指标为躯干肌肉的力量、耐力、本体感觉和肌电活动。临床结果测量指标为疼痛和功能障碍,在4周间隔前后的两个阶段进行评估。

结果

等长力量、耐力和大多数肌电参数通常不受佩戴腰骶矫形器的影响。所有组的疼痛均有所改善,高压组和常压组的功能障碍和本体感觉有所改善。这三项测量指标的组间差异表明,腰骶矫形器组的结果优于对照组。高压组疼痛和本体感觉的改善明显大于常压组。

解读

长期使用腰骶矫形器对慢性下腰痛患者的运动功能或临床因素没有显著不良影响。增加腰骶矫形器的紧密度可能会改善运动功能和矫形器的临床疗效。

临床试验注册号

代码:IRCT201708192391N38。

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