Rehabilitation Research Center, Iran University of Medical Sciences, Tehran, Iran; Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
Rehabilitation Research Center, Department of Physiotherapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
J Manipulative Physiol Ther. 2022 Mar-Apr;45(3):202-215. doi: 10.1016/j.jmpt.2022.06.003. Epub 2022 Jul 22.
The aim of this systematic review and meta-analysis was to study the effects of motor control training (MCT) on trunk muscle morphometry measured by ultrasound imaging and pain and disability in individuals with chronic low back pain.
PubMed, Web of Science, Scopus, and Cochrane Library databases were searched from study inception until January 2021. Randomized control trials evaluating both muscle morphometry and pain or disability in individuals with chronic low back pain were included. Study selection, data extraction, and quality assessment were performed by 2 reviewers independently. Modified Downs and Black tool and the Grading of Recommendations Assessment, Development and Evaluation approach were used to assess the risk of bias and quality of evidence, respectively. A meta-analysis was performed using a random effects model with mean difference or standardized mean difference (SMD).
Of 3459 studies initially identified, 15 studies were included, and 13 studies were selected for meta-analysis. The results revealed no differences in the resting thickness of the transversus abdominis, internal and external oblique, and lumbar multifidus muscles in studies that compared MCT with other interventions. The transversus abdominis muscles contraction ratio was greater (SMD = 0.93; 95% confidence interval [CI], -0.0 to 1.85) and lower pain (weighted mean difference: -1.07 cm; 95% CI, -1.91 to -0.22 cm; P = .01) and disability (SMD = -0.86; 95% CI, -1.42 to -0. 29; P < .01) scores were found in the groups who underwent MCT compared with other interventions.
This systematic review and meta-analysis found that motor control exercise training increased the transverse abdominis contraction ratio (muscle activation) and improved the level of pain and disability compared to other interventions in people with chronic low back pain. However, motor control exercise training was not superior to other interventions in increasing the resting thickness of deep abdominal and lumbar multifidus muscles in intervention times less than 12 weeks.
本系统评价和荟萃分析的目的是研究运动控制训练（MCT）对慢性下腰痛患者超声成像测量的躯干肌肉形态学以及疼痛和残疾的影响。
从研究开始到 2021 年 1 月，检索了 PubMed、Web of Science、Scopus 和 Cochrane Library 数据库。纳入了评估慢性下腰痛患者肌肉形态学以及疼痛或残疾的随机对照试验。由 2 位评审员独立进行研究选择、数据提取和质量评估。使用改良的 Downs 和 Black 工具和推荐评估、制定和评估方法（Grading of Recommendations Assessment, Development and Evaluation approach）分别评估偏倚风险和证据质量。使用随机效应模型进行荟萃分析，使用均数差值或标准化均数差值（SMD）。
在最初确定的 3459 项研究中，有 15 项研究被纳入，其中 13 项研究被纳入荟萃分析。结果显示，在与其他干预措施比较的研究中，MCT 并未改变横突腹直肌、内、外斜肌和腰椎多裂肌的静息厚度。横突腹直肌收缩比更大（SMD=0.93；95%置信区间[CI]，-0.0 至 1.85），疼痛（加权均数差值：-1.07cm；95%CI，-1.91 至 -0.22cm；P=0.01）和残疾（SMD=-0.86；95%CI，-1.42 至 -0.29；P<0.01）评分更低，这些评分在接受 MCT 的组中比在接受其他干预的组中更低。
本系统评价和荟萃分析发现，与其他干预措施相比，运动控制训练可增加横突腹直肌收缩比（肌肉激活），并降低慢性下腰痛患者的疼痛和残疾程度。然而，在干预时间少于 12 周时，运动控制训练在增加深层腹部和腰椎多裂肌的静息厚度方面并不优于其他干预措施。
