一般体能训练与运动控制联合手法治疗对慢性腰痛患者抑郁症状的改善作用：一项随机可行性试验。
General strength and conditioning versus motor control with manual therapy for improving depressive symptoms in chronic low back pain: A randomised feasibility trial.
机构信息
Deakin University, Geelong, Australia, Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences.
Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia.
出版信息
PLoS One. 2019 Aug 1;14(8):e0220442. doi: 10.1371/journal.pone.0220442. eCollection 2019.
OBJECTIVES
Exercise can be used as a treatment for depressive symptoms in the general population. However, little is known as to whether exercise has mental health benefits for adults experiencing chronic low back pain (CLBP). The aim of this study was to examine the feasibility of two intervention protocols commonly used in clinical practice for treating chronic low back pain, but with differing exercise dose, on depressive symptoms.
METHODS
Forty men and women (mean age = 35) experiencing chronic persistent (>3 months), non-specific low back pain were recruited into a randomised clinical trial during 2015-2016. Participants were randomised to receive motor control (low-dose exercise) and manual therapy (n = 20), or general strength and conditioning training (moderate-dose exercise) (n = 20). Depressive symptoms were assessed fortnightly throughout a 6-month follow-up period using the Centre for Epidemiologic Studies Depression Scale (CES-D 10). Linear mixed models were used to examine within-group and between-group changes in depressive symptoms.
RESULTS
Mean CES-D 10 score at baseline was 9.17 (SD = 4.32). There was evidence of a small decrease in average depressive symptoms over time (β -0.19 per fortnight, 95% CI = -0.34, -0.02). However, there was no evidence that change over time was dependent on treatment group.
CONCLUSIONS
Reduction in depressive symptoms amongst adults with CLBP occurred with both treatment methods (motor control [low-dose exercise] and manual therapy; or general strength and conditioning [moderate-dose exercise]). Further interventions including a true control group are needed to draw conclusions as to the effectiveness of each of these treatment methods on depressive symptoms amongst adults with CLBP.
TRIAL REGISTRATION
Australian New Zealand Clinical Trials Registry, ACTRN12615001270505. Registered on 20 November 2015.
目的
运动可作为一般人群中抑郁症状的治疗方法。然而，对于经历慢性下背痛（CLBP）的成年人，运动是否对其心理健康有益知之甚少。本研究旨在探讨两种在临床实践中常用于治疗慢性下背痛的干预方案的可行性，这两种方案在运动剂量上有所不同，而其对抑郁症状的影响也不同。
方法
2015 年至 2016 年期间，招募了 40 名患有慢性持续性（>3 个月）、非特异性下背痛的男性和女性（平均年龄=35 岁）参加随机临床试验。参与者被随机分配接受运动控制（低剂量运动）和手动治疗（n=20）或一般力量和调理训练（中剂量运动）（n=20）。在 6 个月的随访期间，每两周使用流行病学研究中心抑郁量表（CES-D 10）评估抑郁症状。使用线性混合模型来检查组内和组间抑郁症状的变化。
结果
基线时 CES-D 10 的平均得分为 9.17（SD=4.32）。随着时间的推移，抑郁症状有轻度下降的趋势（每两周减少 0.19 分，95%CI=-0.34，-0.02）。然而，没有证据表明变化时间取决于治疗组。
结论
CLBP 成年人的抑郁症状随着两种治疗方法（运动控制[低剂量运动]和手动治疗；或一般力量和调理训练[中剂量运动]）的使用而减少。需要进一步的干预措施，包括真正的对照组，以确定这些治疗方法对 CLBP 成年人的抑郁症状的有效性。
试验注册
澳大利亚新西兰临床试验注册中心，ACTRN12615001270505。于 2015 年 11 月 20 日注册。
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