Department of Medical Surgical-Therapy, Faculty of Medicine and Health Sciences, Research Group PhysioH, University of Extremadura, Badajoz, Spain.
Department of Medical Surgical-Therapy, Faculty of Medicine and Health Sciences, Research Group PhysioH, University of Extremadura, Badajoz, Spain -
Eur J Phys Rehabil Med. 2023 Apr;59(2):201-211. doi: 10.23736/S1973-9087.23.07430-0. Epub 2023 Feb 6.
Among the most effective therapeutic interventions in non-specific chronic low back pain, clinical practice guidelines highlight exercise therapy and patient education. However, the variability in the type of exercise and its dosage means that there is no clear evidence regarding the most optimal form of therapeutic exercise.
The main objective of this study was to ascertain the effects produced by two different exercise interventions (supervised exercise therapy and laser-guided exercise therapy) and pain neuroscience education on postural control measured by the displacement center of pressure (CoP) and energy spectral density (ESD) in subjects with non-specific chronic low back pain.
This is a single-blinded randomized clinical comparative controlled trial.
The study was carried out in different private physiotherapy care centers.
We enrolled 60 subjects with non-specific chronic low back pain of at least 3-month duration, aged 18-45 years.
Both groups performed a total of 16 therapeutic exercise sessions and 8 pain neuroscience education sessions, with the laser-guided exercise therapy group performing laser-guided exercises. The main outcome measures evaluated were ESD and displacement of CoP measured at 3 different times (baseline, post-treatment, and 3 month follow-up).
The most important differences for ESD and displacement of CoP variables were obtained for eyes open, unstable surface anteroposterior axis (F(2,92)=7.36, P=0.001, d=0.71) and eyes closed, stable surface mediolateral axis (F(2,92)=3.24, P<0.001, d=0.76). Further, time × group interactions showed significant statistical differences in both cases as well as significant differences between baseline and 3 month's follow-up.
Both exercise modalities (supervised exercise therapy and laser-guided exercise therapy) showed changes in variables related to postural control (displacement of CoP and ESD). However, the laser-guided exercise therapy program showed greater improvements in ESD.
Analysis of a new approach for the quantification of data obtained from postural control assessment relying on widely used devices (accelerometers and pressure platforms).
在非特异性慢性下腰痛最有效的治疗干预措施中，临床实践指南强调运动疗法和患者教育。然而，运动类型和剂量的可变性意味着，关于最有效的治疗性运动形式，尚无明确证据。
本研究的主要目的是确定两种不同的运动干预措施（监督运动疗法和激光引导运动疗法）和疼痛神经科学教育对非特异性慢性下腰痛患者的姿势控制（通过压力中心位移（CoP）和能量谱密度（ESD）测量）的影响。
这是一项单盲随机临床对照试验。
研究在不同的私人物理治疗护理中心进行。
我们招募了 60 名患有非特异性慢性下腰痛且至少持续 3 个月的患者，年龄在 18-45 岁之间。
两组均进行了总共 16 次治疗性运动治疗和 8 次疼痛神经科学教育，激光引导运动疗法组进行了激光引导运动。主要评估指标为 ESD 和 CoP 位移，在 3 个不同时间（基线、治疗后和 3 个月随访）进行测量。
在睁眼、不稳定表面前-后轴（F(2,92)=7.36，P=0.001，d=0.71）和闭眼、稳定表面中-侧轴（F(2,92)=3.24，P<0.001，d=0.76）时，ESD 和 CoP 变量的最重要差异是获得的。此外，时间×组之间的相互作用在这两种情况下均显示出显著的统计学差异，以及与 3 个月随访相比的显著差异。
两种运动方式（监督运动疗法和激光引导运动疗法）均显示与姿势控制（CoP 位移和 ESD）相关的变量发生了变化。然而，激光引导运动疗法方案在 ESD 方面显示出更大的改善。
分析一种新的方法，用于量化基于广泛使用的设备（加速度计和压力平台）获得的姿势控制评估数据。
