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非手术治疗联合监督下运动治疗腰椎管狭窄症的疗效:系统评价和荟萃分析。

Effectiveness of non-surgical treatment combined with supervised exercise for lumbar spinal stenosis: A systematic review and meta-analysis.

机构信息

Department of Rehabilitation, International University of Health and Welfare Mita Hospital, Tokyo, Japan.

Department of Physical Therapy, School of Health Science, International University of Health and Welfare, Tochigi, Japan.

出版信息

J Back Musculoskelet Rehabil. 2023;36(4):799-813. doi: 10.3233/BMR-220220.

Abstract

BACKGROUND

The benefits of combining supervised exercise in the non-surgical treatment of lumbar spinal stenosis (LSS) is unclear.

OBJECTIVE

To compare the effectiveness of non-surgical treatments with and without supervised exercise for pain intensity, symptom severity, functional impairment/disability, walking distance, and quality of life (QOL) in LSS patients.

METHODS

Randomized controlled trials (RCTs) evaluating combinations of supervised exercises were searched using four electronic databases up to August 13, 2020. Meta-analysis was conducted for immediate and long-term results.

RESULTS

Three studies were identified, including 244 participants. Immediate-term results showed that leg pain intensity (mean distance [MD]: -0.94, 95% confidence intervals [95% CI]: -1.60 to -0.29, p< 0.01) and symptom severity (MD: -0.29, 95% CI: -0.50 to -0.08, p< 0.01) were lower in the study group than in the control group, and walking distance (MD: 415.83, 95% CI: 298.15 to 533.50, p< 0.001) and QOL were higher in the study group. Long-term results showed that functional disability/impairment (MD: -0.27, 95% CI: -0.49 to -0.04, p< 0.05) was lower in the study group than in the control group, and walking distance and QOL were higher in the study group.

CONCLUSION

The number of studies on this topic was small and limited. Combinations of non-surgical treatment and supervised exercise may not provide significant benefits.

摘要

背景

在腰椎管狭窄症(LSS)的非手术治疗中联合监督锻炼的益处尚不清楚。

目的

比较非手术治疗与非手术治疗联合监督锻炼治疗腰椎管狭窄症患者疼痛强度、症状严重程度、功能障碍/残疾、步行距离和生活质量(QOL)的效果。

方法

使用四个电子数据库检索至 2020 年 8 月 13 日评估监督锻炼联合治疗的随机对照试验(RCT)。对即时和长期结果进行荟萃分析。

结果

确定了三项研究,共纳入 244 名参与者。即时结果显示,研究组的腿部疼痛强度(平均距离 [MD]:-0.94,95%置信区间 [95%CI]:-1.60 至 -0.29,p<0.01)和症状严重程度(MD:-0.29,95%CI:-0.50 至 -0.08,p<0.01)低于对照组,且研究组的步行距离(MD:415.83,95%CI:298.15 至 533.50,p<0.001)和 QOL 更高。长期结果显示,研究组的功能障碍/残疾(MD:-0.27,95%CI:-0.49 至 -0.04,p<0.05)低于对照组,且研究组的步行距离和 QOL 更高。

结论

关于这个主题的研究数量较少且有限。非手术治疗联合监督锻炼的组合可能不会带来显著的益处。

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