Department of Orthopedic Rehabilitation, Instituto Nacional de Rehabilitation "Luis Guillermo Ibarra", México City, Mexico.
Departamento de Rehabilitación, Hospital Naval de Tapachula, Tapachula, Chiapas, México.
Phys Ther. 2021 Aug 1;101(8). doi: 10.1093/ptj/pzab108.
Exercise is the mainstay of treatment in individuals with low back pain and the first-line option in degenerative spondylolisthesis (DS); however, there is still no consensus surrounding the superiority of any specific exercise program. Thus, the primary aim of this study was to compare the effectiveness of lumbar stabilization exercises and flexion exercises for pain control and improvements of disability in individuals with chronic low back pain (CLBP) and DS.
A randomized controlled trial was conducted in a tertiary public hospital and included 92 individuals over the age of 50 years who were randomly allocated to lumbar stabilization exercises or flexion exercises. Participants received 6 sessions of physical therapy (monthly appointments) and were instructed to execute exercises daily at home during the 6 months of the study. The primary outcome (measured at baseline, 1 month, 3 months, and 6 months) was pain intensity (visual analog scale, 0-100 mm) and disability (Oswestry Disability Index, from 0% to 100%). Secondary outcomes were disability (Roland-Morris Disability Questionnaire, from 0 to 24 points), changes in body mass index, and flexibility (fingertip to floor, in centimeters) at baseline and 6 months, and also the total of days of analgesic use at 6-month follow-up.
Mean differences between groups were not significant (for lumbar pain: 0.56 [95% CI = -11.48 to 12.61]; for radicular pain: -1.23 [95% CI = -14.11 to 11.64]; for Oswestry Disability Index: -0.61 [95% CI = -6.92 to 5.69]; for Roland-Morris Disability Questionnaire: 0.53 [95% CI = -1.69 to 2.76]).
The findings from the present study reveal that flexion exercises are not inferior to and offer a similar response to stabilization exercises for the control of pain and improvements of disability in individuals with CLBP and DS.
Exercise is the mainstay of treatment in individuals with CLBP and DS; however, there is still no consensus surrounding the superiority of any specific exercise program. This study finds that flexion exercises are not inferior to and offer a similar response to stabilization exercises.
Exercise is the mainstay of treatment in individuals with CLBP and DS, but there is no consensus on the superiority of any specific exercise program. If you have DS, flexion exercises may provide similar effects to stabilization exercises.
运动是治疗腰痛患者和退行性脊椎滑脱症（DS）的主要方法，也是首选方法；然而，目前仍没有任何特定运动方案具有优势的共识。因此，本研究的主要目的是比较腰椎稳定运动和弯曲运动对慢性腰痛（CLBP）和 DS 患者疼痛控制和残疾改善的效果。
在一家三级公立医院进行了一项随机对照试验，纳入了 92 名年龄在 50 岁以上的患者，他们被随机分配到腰椎稳定运动或弯曲运动组。参与者接受了 6 次物理治疗（每月预约），并被指示在研究的 6 个月内每天在家中进行锻炼。主要结局（在基线、1 个月、3 个月和 6 个月测量）是疼痛强度（视觉模拟量表，0-100mm）和残疾（Oswestry 残疾指数，0%至 100%）。次要结局是残疾（Roland-Morris 残疾问卷，0-24 分）、体重指数变化、灵活性（指尖到地面，厘米）在基线和 6 个月时，以及在 6 个月随访时使用镇痛药的总天数。
组间的平均差异不显著（对于腰椎疼痛：0.56[95%CI=-11.48 至 12.61]；对于神经根性疼痛：-1.23[95%CI=-14.11 至 11.64]；对于 Oswestry 残疾指数：-0.61[95%CI=-6.92 至 5.69]；对于 Roland-Morris 残疾问卷：0.53[95%CI=-1.69 至 2.76]）。
本研究结果表明，弯曲运动在控制疼痛和改善慢性腰痛和 DS 患者的残疾方面与稳定运动的效果相似，并不逊于稳定运动。
运动是治疗慢性腰痛和 DS 患者的主要方法，但目前还没有任何特定运动方案具有优势的共识。本研究发现，弯曲运动在控制疼痛和改善残疾方面与稳定运动的效果相似。
如果您患有 DS，弯曲运动可能会提供与稳定运动类似的效果。
