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系统评价评估运动控制练习在非特异性下腰痛患者中的有效性,但不考虑其原则 - 综述。

Systematic reviews evaluating the effectiveness of motor control exercises in patients with non-specific low back pain do not consider its principles - A review.

机构信息

Composite Regional Centre for Skill Development, Rehabilitation and Empowerment of Persons with Disabilities, Lucknow, Uttar Pradesh, India.

AktivHealth, New Delhi, India.

出版信息

J Bodyw Mov Ther. 2021 Apr;26:374-393. doi: 10.1016/j.jbmt.2020.08.010. Epub 2020 Sep 6.

Abstract

BACKGROUND

Motor control exercise (MCEs), spinal stabilization or core stability exercises were developed with the aim of restoring the coordination, control, and capacity of the trunk muscles and systematic reviews (SR) evaluating their effectiveness has shown conflicting results. This we hypothesized was due to the non-consideration of principles of neuroplasticity. The objective of this review was to review the operating definitions used in these reviews for these exercises and evaluate if these reviews have considered and satisfied the principles of these exercises in persons with NSLBP, both acute and chronic.

METHODS

The available evidence to address the research question was sought in the reviews published in English between January 2006 and April 2019 using the population, intervention, comparison, and outcome format. Data were extracted against the following factors: satisfy the principles of specific inclusion criteria; interventions; experience-dependent plasticity; and measure any one of the concepts of motor control. The quality of the evidence obtained was graded using the National Institute for Health and Care Excellence protocol and the quality of SRs evaluated using the R-AMSTAR.

RESULTS

Eleven reviews on core stability/spinal stabilization exercises and four reviews on MCE were considered in this review. The results showed that most of the studies considered by the reviews did not adhere to the principles of these exercises.

CONCLUSION

There is wide heterogeneity in the understanding, administration, and progression of exercises. The exercises were implemented without considering the potential for neuroplasticity of the nervous system and the principles of motor learning.

摘要

背景

运动控制训练(MCE)、脊柱稳定或核心稳定性训练的目的是恢复躯干肌肉的协调性、控制力和能力,对其进行评估的系统评价(SR)结果存在矛盾。我们假设这是由于没有考虑神经可塑性原则。本综述的目的是回顾这些综述中用于这些运动的操作定义,并评估这些综述是否考虑并满足了急性和慢性非特异性下腰痛(NSLBP)患者的这些运动的原则。

方法

在 2006 年 1 月至 2019 年 4 月期间,以人群、干预、比较和结果的格式,在英文文献中搜索了针对该研究问题的现有证据。根据以下因素提取数据:满足特定纳入标准的原则;干预措施;经验依赖性可塑性;以及测量运动控制的任何一个概念。使用国家卫生与保健卓越研究所协议评估获得证据的质量,并使用 R-AMSTAR 评估 SR 的质量。

结果

本综述考虑了 11 篇关于核心稳定性/脊柱稳定性训练的综述和 4 篇关于 MCE 的综述。结果表明,大多数综述中考虑的研究没有遵循这些训练的原则。

结论

对运动的理解、实施和进展存在广泛的异质性。这些运动是在没有考虑神经系统的神经可塑性和运动学习原则的情况下进行的。

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