等速躯干训练对非特异性下腰痛患者疼痛、残疾和力量的影响：系统评价和荟萃分析。

Isokinetic trunk training on pain, disability, and strength in non-specific low back pain patients: A systematic review and meta-analysis.

机构信息

Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.

Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago, Chile.

出版信息

J Back Musculoskelet Rehabil. 2023;36(6):1237-1250. doi: 10.3233/BMR-220301.

DOI:10.3233/BMR-220301

PMID:37458013

Abstract

BACKGROUND

Low back pain is one of the leading causes of disability globally, with a high economic and social burden. A decrease or imbalance in trunk strength has been associated with the occurrence of low back pain and its severity. Trunk strength training is helpful in the treatment of Non-specific low back pain (NSLBP) patients. However, we do not know the effects of trunk isokinetic training (IKT) on pain intensity, disability, and trunk strength.

OBJECTIVE

This systematic review aimed to determine the effects of trunk IKT in NSLBP patients on pain intensity, disability, and trunk flexor and extensor isokinetic strength.

METHODS

We searched PubMed, Web of Science, Scopus, CENTRAL, and PEDro, from January 2001 until March 2021 and updated to November 2022. Randomized controlled trials (RCTs) that investigated the effect of IKT in adult participants with NSLBP on pain intensity, disability, or isokinetic trunk strength were included. Mean difference (MD) and 95% confidence intervals (95% CI) were calculated for pain. Bias was assessed using the Cochrane risk of bias (RoB) tool and evidence certainty via Grading of Recommendations Assessment, Development and Evaluation (GRADE).

RESULTS

Among 1750 retrieved articles, eight were included in this review. Meta-analysis comparing IKT (trunk isokinetic training, n= 134) with control groups (conventional exercises, n= 133) revealed that IKT decreases pain intensity (MD -1.50 (95% CI: -2.60; -0.39)) immediately post-intervention, and one month (MD -1.97 (95% CI: -2.92; -1.03)) and at six months follow-up (MD -2.48 (95% CI: -2.77; -2.19)), although with a very low to low quality according to the GRADE rating. Besides, IKT decreases disability and increases isokinetic trunk strength, but with scant evidence.

CONCLUSIONS

Trunk IKT could be a novel clinical tool for pain management in patients with NSLBP, although evidence is scarce. In addition, few RCTs exist for IKT on disability or trunk isokinetic strength in patients with NSLBP. Therefore, further research on this topic is needed.

摘要

背景

腰痛是全球导致残疾的主要原因之一，具有较高的经济和社会负担。躯干力量的下降或不平衡与腰痛的发生及其严重程度有关。躯干力量训练有助于治疗非特异性腰痛（NSLBP）患者。然而，我们不知道躯干等速训练（IKT）对疼痛强度、残疾和躯干屈伸肌等速力量的影响。

目的

本系统评价旨在确定 NSLBP 患者躯干 IKT 对疼痛强度、残疾和躯干屈伸肌等速力量的影响。

方法

我们检索了 PubMed、Web of Science、Scopus、CENTRAL 和 PEDro 数据库，检索时间为 2001 年 1 月至 2021 年 3 月，并更新至 2022 年 11 月。纳入了调查成人 NSLBP 患者 IKT 对疼痛强度、残疾或躯干等速力量影响的随机对照试验（RCT）。计算了疼痛的均数差（MD）和 95%置信区间（95%CI）。使用 Cochrane 偏倚风险（RoB）工具评估偏倚，并使用推荐评估、制定与评价（GRADE）分级评估证据确定性。

结果

在检索到的 1750 篇文章中，有 8 篇纳入本综述。与对照组（常规运动，n=133）相比，比较 IKT（躯干等速训练，n=134）的荟萃分析显示，IKT 可即刻降低疼痛强度（MD-1.50，95%CI：-2.60；-0.39），并在一个月（MD-1.97，95%CI：-2.92；-1.03）和 6 个月随访（MD-2.48，95%CI：-2.77；-2.19）时降低疼痛强度，尽管根据 GRADE 评级，证据质量为极低至低。此外，IKT 可降低残疾程度并增加躯干等速力量，但证据不足。