Yildirim Pelin, Gultekin Alper
Department of Physical Medicine and Rehabilitation, Kocaeli DerinceTrainingand Research Hospital, Kocaeli, Turkey.
Department of Orthopedics and Traumatology, University of Health Sciences, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.
Spine (Phila Pa 1976). 2022 May 15;47(10):711-719. doi: 10.1097/BRS.0000000000004316. Epub 2022 Jan 11.
Randomized controlled trial.
To investigate the effect of a stretch and strengthbased yoga exercise program on neuropathic pain due to LDH.
LDH with neuropathic pain influences treatment outcomes negatively. Most yoga poses include the parameters of spinal training and help reduce pain and disability in patients with low back injuries. We hypothesized that yoga positively affects both LDH and neuropathic pain by increasing mobilization, core muscle strength, and spinal and hamstring flexibility.
In total, 48 patients with neuropathic pain due to LDH were randomly assigned to a control group and a yoga group. All patients underwent a patient education program. In addition, the selected yoga exercise was taught and performed to the yoga group for one hour twice weekly for 12 weeks. Neuropathic pain (Douleur Neuropathique 4 for diagnosis; Leeds Assessment of Neuropathic Symptoms and Signs for severity), low back pain (the short-form of McGill Pain Questionnaire), disability (Oswestry Disability Index), and function (modified Schober and passive knee extension test) were measured blind before and at the one-, three-, and six-month follow-ups. The patient global assessment was applied at the six-month followup. The intention-to-treat analysis was performed in this study.
The intention-to-treat analysis showed a statistically significant difference in neuropathic pain, patient global assess ment, low back pain, disability, and function in favor of the yoga group at post-treatment. The between-group effect sizes were moderate at six-months follow-up.
It was determined that the selected stretch and strength-based yoga exercise could be a promising treatment option for neuropathic pain due to LDH.
随机对照试验。
探讨基于伸展和力量训练的瑜伽锻炼计划对腰椎间盘突出症所致神经性疼痛的影响。
伴有神经性疼痛的腰椎间盘突出症对治疗结果有负面影响。大多数瑜伽姿势都包含脊柱训练参数，有助于减轻腰痛患者的疼痛和残疾程度。我们假设瑜伽通过增加活动度、核心肌肉力量以及脊柱和腘绳肌柔韧性，对腰椎间盘突出症和神经性疼痛均有积极影响。
总共48例因腰椎间盘突出症导致神经性疼痛的患者被随机分为对照组和瑜伽组。所有患者均接受患者教育计划。此外，为瑜伽组教授并指导其进行选定的瑜伽练习，每周两次，每次1小时，共12周。在基线以及1个月、3个月和6个月随访时，采用盲法测量神经性疼痛（采用Douleur Neuropathique 4进行诊断；采用利兹神经病理性症状和体征评估量表评估严重程度）、腰痛（采用麦吉尔疼痛问卷简表）、残疾程度（采用Oswestry残疾指数）和功能（改良Schober试验和被动膝关节伸展试验）。在6个月随访时进行患者整体评估。本研究采用意向性分析。
意向性分析显示，治疗后瑜伽组在神经性疼痛、患者整体评估、腰痛、残疾程度和功能方面有统计学意义上的显著差异。随访6个月时组间效应量为中等。
确定所选的基于伸展和力量训练的瑜伽练习可能是治疗腰椎间盘突出症所致神经性疼痛的一种有前景的治疗选择。
2级。
