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基于腹部横肌预激活的运动干预对初级保健慢性非特异性下腰痛患者的疗效:一项随机对照试验。

Effectiveness of an exercise intervention based on preactivation of the abdominal transverse muscle in patients with chronic nonspecific low back pain in primary care: a randomized control trial.

机构信息

Faculty of Nursing and Physiotherapy, Universidad de Lleida, Roig 2, 25198, Lleida, Montserrat, España.

Group of Studies on Society, Health, Education and Culture (GESEC), Universidad de Lleida, Pl. de Víctor Siurana 1, 25003, Lleida, España.

出版信息

BMC Prim Care. 2023 Sep 6;24(1):180. doi: 10.1186/s12875-023-02140-3.

Abstract

BACKGROUND

Low back pain is one of the most common disabling pathologies in humanity worldwide. Physical exercises have been used in recent decades to reduce the pain, improve the functionality of the lumbar spine and avoid relapses. The purpose of the study is to analyze the effect of a program based on re-education exercises involving preactivation of the abdominal transverse muscle compared to conventional treatment in adults with chronic nonspecific low back pain.

METHODS

A two-arm, single-blind randomized control trial with 35 primary care patients with chronic nonspecific low back pain. Both groups received a 4-week intervention. Data were collected at baseline and at the end of the intervention. Sixteen patients participated in the intervention group, and 19 patients in the control group.

RESULTS

For the experimental group, the outcomes of disability and activation of the abdominal transverse muscle decreased significantly (MD -2.9; CI 95% -5.6 to -0.35; η2 = 0.14; p = 0.028) and (MD 2.3; CI 95% 0.91 to 3.67; η2 = 0.25; p = 0.002) respectively, with a large effect size, compared to the control group. There were no differences between the groups in pain intensity, thickness, and resistance of the transverse abdominal muscle.

CONCLUSION

A 4-week specific program based on re-education exercises of the preactivation of the abdominal transverse muscle is more effective than conventional treatment for reducing disability and increasing the activation of the abdominal transverse muscle measured by VAS scale and PBU.

TRIAL REGISTRATION

Clinicaltrials.gov identifier: NCT03097497. Date of registration: 31/03/2017.

摘要

背景

下腰痛是全世界最常见的使人丧失能力的疾病之一。在最近几十年中,人们一直使用身体锻炼来减轻疼痛,改善腰椎功能并避免复发。本研究的目的是分析基于腹部横向肌预激活的再教育运动方案与常规治疗对慢性非特异性下腰痛成人的影响。

方法

一项在初级保健中有 35 名慢性非特异性下腰痛患者参与的双臂、单盲、随机对照试验。两组均接受 4 周的干预。在基线和干预结束时收集数据。实验组有 16 名患者参加,对照组有 19 名患者。

结果

对于实验组,残疾和腹部横向肌激活的结果明显下降(MD -2.9;CI 95% -5.6 至 -0.35;η2 = 0.14;p = 0.028)和(MD 2.3;CI 95% 0.91 至 3.67;η2 = 0.25;p = 0.002),具有较大的效应量,与对照组相比。两组之间疼痛强度、腹部横向肌厚度和阻力无差异。

结论

与常规治疗相比,为期 4 周的基于腹部横向肌预激活的再教育运动方案更能有效减少残疾和增加 VAS 量表和 PBU 测量的腹部横向肌激活。

试验注册

Clinicaltrials.gov 标识符:NCT03097497。注册日期:2017 年 3 月 31 日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb74/10483714/fbde845cb989/12875_2023_2140_Fig1_HTML.jpg

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