Treboul Functional Rehabilitation Center, ORPEA/CLINEA, Douarnenez, France.
Research and ÉPIC Center, Montreal Heart Institute, Montréal, QC, Canada.
Eur J Phys Rehabil Med. 2023 Oct;59(5):576-585. doi: 10.23736/S1973-9087.23.07998-4. Epub 2023 Sep 22.
Non-specific chronic low back pain (NSCLBP) refers to a complex condition that involves structural, biomechanical, cognitive, psychological, social, and lifestyle issues. First-line therapies include physical therapy and exercise, as well as psychological follow-up and pain medication.
The aim of this study was to assess the impact of a 6-week center-based program using a multi-axis motorized platform (HUBER) connected with force sensors, that allows the patients to execute isometric exercises on the spine flexion-to-extension ratio at 60 and 120°/s, pain, trunk flexibility, and disability.
The design of the study was prospective, active control, parallel-group, assessor-blinded, randomized controlled trial.
The setting was outpatients physical therapy clinic.
The population analyzed presented NSCLBP.
Seventy individuals with NSCLBP were randomized into 2 intervention arms (1:1 ratio): 1/standard rehabilitation group (STAND) with physiotherapy, balneotherapy and cycloergometer exercises and 2/HUBER rehabilitation group (HUB) with physiotherapy, balneotherapy and HUBER exercises. Both programs lasted 6 weeks, with 4 sessions of 2 hours each per week.
Each group reported statistically significant improvements on the isokinetic spine strength, flexibility of the trunk, lumbar joint mobility, muscular endurance of the trunk and of the lower limbs, pain score and disability (P<0.05). The spine flexion/extension ratio at 60˚/s improved similarly between groups (-22.23 for HUB, and -13.04 for STAND; P=0.178) with a greater effect size in HUB. Only HUB reported a significant improvement in the spine flexion-to-extension ratio at 120˚/s (from 87.3 to 78.6, P=0.012). HUB reported a greater decrease in the Oswestry Disability Index (-16.83) compared to STAND (-12.11), with a statistically significant effect between groups (P=0.036).
Exercises performed on the HUBER platform added to physiotherapy and balneotherapy are as effective as a standard rehabilitation program with physiotherapy, balneotherapy and cycloergometer exercises to improve isokinetic spine strength, lumbar joint mobility, flexibility and muscular endurance of the trunk and the lower limbs. In addition, exercising with the HUBER platform result in a greater reduction in disability compared to a standard rehabilitation program (clinicalTrials.gov: NCT05437016).
A variety of intervention techniques, including supervised exercise and manual therapy are now used to manage persistent NSCLBP. The added value of the HUBER device on disability suggests that the platform could be beneficial.
非特异性慢性下腰痛（NSCLBP）是一种复杂的病症，涉及结构、生物力学、认知、心理、社会和生活方式等多个方面。一线治疗包括物理治疗和锻炼，以及心理随访和止痛药物。
本研究旨在评估使用连接力传感器的多轴电动平台（HUBER）进行为期 6 周的中心基础计划对脊柱屈伸比为 60°/s 和 120°/s 的等速脊柱力量、躯干灵活性、腰痛、躯干和下肢肌肉耐力和残疾的影响。
研究设计为前瞻性、主动对照、平行组、评估者盲法、随机对照试验。
门诊物理治疗诊所。
分析人群表现为非特异性慢性下腰痛。
70 名非特异性慢性下腰痛患者随机分为 2 个干预组（1:1 比例）：1/标准康复组（STAND），包括物理治疗、水疗和自行车运动，2/HUBER 康复组（HUB），包括物理治疗、水疗和 HUBER 运动。两个方案均持续 6 周，每周进行 4 次、每次 2 小时的治疗。
两组在等速脊柱力量、躯干柔韧性、腰椎关节活动度、躯干和下肢肌肉耐力、腰痛和残疾评分方面均有统计学意义的改善（P<0.05）。两组脊柱屈伸比在 60˚/s 时的改善相似（HUB 为-22.23，STAND 为-13.04；P=0.178），HUB 的效果更大。只有 HUB 报告在 120˚/s 时脊柱屈伸比有显著改善（从 87.3 降至 78.6，P=0.012）。与 STAND 相比，HUB 的 Oswestry 残疾指数（-16.83）下降更大，两组间有统计学意义（P=0.036）。
在 HUBER 平台上进行的运动与物理治疗和水疗相结合，与包括物理治疗、水疗和自行车运动的标准康复方案一样有效，可以改善等速脊柱力量、腰椎关节活动度、躯干和下肢的柔韧性和肌肉耐力。此外，与标准康复方案相比，在 HUBER 平台上进行运动可使残疾程度降低更大（clinicalTrials.gov：NCT05437016）。
目前，包括监督锻炼和手法治疗在内的各种干预技术都被用于管理持续性非特异性慢性下腰痛。HUBER 设备在残疾方面的附加价值表明该平台可能有益。
