Department of Rehabilitation Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Eur J Phys Rehabil Med. 2021 Oct;57(5):793-806. doi: 10.23736/S1973-9087.21.06555-2. Epub 2021 May 7.
Chronic low back pain (CLBP) has been recognized as the leading cause of disability. Up to 90% of patients with CLBP are classified as having non-specific CLBP (NSCLBP). Motor control exercise (MCE) is one of the most popular and widespread treatment options, and has many advantages in alleviating pain and disability. This meta-analysis is aimed to investigate the effectiveness of MCE on NSCLBP, disability, and core muscles reported in randomized controlled trials (RCTs).
PubMed, Web of Science, and EMBASE were searched from inception to August 2020. Articles were eligible if they were RCTs that evaluated MCE against sham or other treatments in isolation and measured outcomes including pain intensity and disability or core muscles morphologic characteristics.
Two authors independently extracted the data. Eighteen studies of 894 studies with a total of 1333 individuals with NSCLBP were retained for the meta-analysis. Compared with other conservative treatments, MCE was better in reducing pain and disability posttreatment and was better in reducing pain at the 6-month follow-up period. However, it had comparable effects on pain reduction at 12-month and 24-month follow-up period, and on disability at the 6-month, 12-month and 24-month follow-up period. MCE resulted in comparable effects to other treatments in improving the core muscle thickness posttreatment.
Low to very low quality of evidence supported that MCE resulted in a greater reduction of pain and disability posttreatment, and a greater reduction of pain at the 6-month follow-up than other treatments for NSCBLP. The findings in this review further support that MCE may be more effective than other treatments at short-term follow-ups, and at least has equivalent long-term effects to other forms of treatments in NSCLBP.
慢性下腰痛（CLBP）已被认为是导致残疾的主要原因。高达 90%的 CLBP 患者被归类为非特异性 CLBP（NSCLBP）。运动控制训练（MCE）是最流行和广泛应用的治疗方法之一，在缓解疼痛和残疾方面具有许多优势。本荟萃分析旨在研究随机对照试验（RCT）中 MCE 对 NSCLBP、残疾和核心肌群的疗效。
从建库到 2020 年 8 月，检索了 PubMed、Web of Science 和 EMBASE。如果 RCT 评估了 MCE 与假对照或其他单独治疗的效果，并测量了包括疼痛强度和残疾或核心肌群形态特征在内的结局，则符合纳入标准。
两位作者独立提取数据。保留了 894 项研究中的 18 项研究，共纳入 1333 名 NSCLBP 患者进行荟萃分析。与其他保守治疗相比，MCE 在治疗后减轻疼痛和残疾方面效果更好，在 6 个月随访时减轻疼痛方面效果更好。然而，在 12 个月和 24 个月随访时，在减轻疼痛方面以及在 6 个月、12 个月和 24 个月随访时，在减轻残疾方面，MCE 的效果与其他治疗相当。MCE 在改善治疗后核心肌群厚度方面与其他治疗效果相当。
低至极低质量证据支持 MCE 治疗 NSCLBP 后可更有效地减轻疼痛和残疾，且在 6 个月随访时可更有效地减轻疼痛。本综述的结果进一步支持 MCE 在短期随访时可能比其他治疗更有效，并且在长期随访中至少与其他形式的治疗等效。
