Department of Computer Science | Therapy Sciences, Professorship for Physiotherapy: Exercise Science and Applied Biomechanics, Trier University of Applied Sciences, Trier, Germany.
Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt, Frankfurt am Main, Germany.
Sci Rep. 2020 Oct 9;10(1):16921. doi: 10.1038/s41598-020-73954-9.
Stabilization exercise (SE) is evident for the management of chronic non-specific low back pain (LBP). The optimal dose-response-relationship for the utmost treatment success is, thus, still unknown. The purpose is to systematically review the dose-response-relationship of stabilisation exercises on pain and disability in patients with chronic non-specific LBP. A systematic review with meta-regression was conducted (Pubmed, Web of Knowledge, Cochrane). Eligibility criteria were RCTs on patients with chronic non-specific LBP, written in English/German and adopting a longitudinal core-specific/stabilising/motor control exercise intervention with at least one outcome for pain intensity and/or disability. Meta-regressions (dependent variable = effect sizes (Cohens d) of the interventions (for pain and for disability), independent variable = training characteristics (duration, frequency, time per session)), and controlled for (low) study quality (PEDro) and (low) sample sizes (n) were conducted to reveal the optimal dose required for therapy success. From the 3,415 studies initially selected, 50 studies (n = 2,786 LBP patients) were included. N = 1,239 patients received SE. Training duration was 7.0 ± 3.3 weeks, training frequency was 3.1 ± 1.8 sessions per week with a mean training time of 44.6 ± 18.0 min per session. The meta-regressions' mean effect size was d = 1.80 (pain) and d = 1.70 (disability). Total R was 0.445 and 0.17. Moderate quality evidence (R = 0.231) revealed that a training duration of 20 to 30 min elicited the largest effect (both in pain and disability, logarithmic association). Low quality evidence (R = 0.125) revealed that training 3 to 5 times per week led to the largest effect of SE in patients with chronic non-specific LBP (inverted U-shaped association). In patients with non-specific chronic LBP, stabilization exercise with a training frequency of 3 to 5 times per week (Grade C) and a training time of 20 to 30 min per session (Grade A) elicited the largest effect on pain and disability.
稳定性练习（SE）在慢性非特异性下腰痛（LBP）的治疗中很明显。因此，最佳的剂量-反应关系对于取得最大的治疗效果仍然未知。目的是系统地回顾稳定练习对慢性非特异性 LBP 患者疼痛和残疾的剂量-反应关系。进行了系统评价和荟萃回归分析（Pubmed、Web of Knowledge、Cochrane）。纳入标准为：患者为慢性非特异性 LBP，接受 RCT 治疗，使用英文/德文发表，采用纵向核心特异性/稳定/运动控制的运动干预，至少有一个疼痛强度和/或残疾的结果。荟萃回归（因变量=干预措施的效应大小（Cohen d）（疼痛和残疾），自变量=训练特征（持续时间、频率、每次治疗时间）），并控制（低）研究质量（PEDro）和（低）样本量（n），以揭示治疗成功所需的最佳剂量。从最初选择的 3415 项研究中，有 50 项研究（n=2786 例 LBP 患者）入选。n=1239 例患者接受 SE 治疗。训练持续时间为 7.0±3.3 周，训练频率为每周 3.1±1.8 次，每次治疗时间平均为 44.6±18.0 分钟。荟萃回归的平均效应大小为 d=1.80（疼痛）和 d=1.70（残疾）。总 R 为 0.445 和 0.17。中等质量证据（R=0.231）表明，20 至 30 分钟的训练时间产生的效果最大（疼痛和残疾均呈对数关联）。低质量证据（R=0.125）表明，每周训练 3 至 5 次对慢性非特异性 LBP 患者的 SE 效果最大（倒 U 形关联）。在患有非特异性慢性 LBP 的患者中，每周进行 3 至 5 次训练（C 级）和每次训练 20 至 30 分钟（A级）的稳定运动训练对疼痛和残疾的效果最大。
