School of Physical Therapy and Graduate Institute of Rehabilitation Science, College of Medicine, Chang Gung University, Linkou, Taoyuan, Taiwan.
Department of Physical Medicine and Rehabilitation, Lo-Hsu Medical Foundation Inc., Lotung Poh-Ai Hospital, Yilan, Taiwan.
Spine (Phila Pa 1976). 2024 Nov 1;49(21):1512-1520. doi: 10.1097/BRS.0000000000004989. Epub 2024 Mar 20.
Systematic review and meta-analysis.
This study aims to assess the effectiveness of lumbar segmental stabilization exercise (LSSE) in managing spondylolysis and spondylolisthesis.
Spondylolysis and spondylolisthesis are spinal disorders associated with lumbar segmental instability. LSSE has shown positive effects in treating these conditions; however, systematic reviews and meta-analyses are lacking.
A systematic search adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, including studies from the inception of the databases used up to January 2024, was conducted. Disability improvement and pain intensity change were the primary and secondary outcomes, respectively, standardized using Hedges g . Eligible articles underwent independent scrutiny by two authors, who also performed data extraction and quality assessment. Data pooling was accomplished using a random-effects model.
In total, five randomized controlled trials comprising 198 participants were included, revealing a trend effect toward disability improvement in the LSSE group (Hedges g =-0.598, 95% CI: -1.211 to 0.016, P =0.056, I2 =75.447%). When the LSSE was administered as a single treatment, disability improvement became significant (Hedge g =-1.325, 95% CI: -2.598 to -0.053, P =0.041, I2 =80.020%). No significant effect of LSSE on pain reduction was observed (Hedges g =-0.496, 95% CI: -1.082 to 0.090, P =0.097, I2 =73.935%).
In summary, our meta-analysis suggests that LSSE can potentially improve disability, especially when used as a single treatment. LSSE appears more beneficial in reducing disability than alleviating pain. Future research on different patient groups is needed to understand comprehensively LSSE's effects on other musculoskeletal disorders.
系统评价和荟萃分析。
本研究旨在评估腰椎节段稳定运动（LSSE）在治疗峡部裂和脊椎滑脱中的有效性。
峡部裂和脊椎滑脱是与腰椎节段不稳定相关的脊柱疾病。LSSE 已被证明对这些疾病有积极的影响，但缺乏系统评价和荟萃分析。
我们进行了一项系统搜索，遵循系统评价和荟萃分析的首选报告项目指南，包括从使用的数据库开始到 2024 年 1 月的研究。主要结果是残疾改善，次要结果是疼痛强度变化，分别使用 Hedges g 进行标准化。合格的文章由两位作者进行独立审查，他们还进行了数据提取和质量评估。使用随机效应模型进行数据汇总。
共有 5 项随机对照试验，包括 198 名参与者，结果显示 LSSE 组的残疾改善趋势（Hedges g =-0.598，95%置信区间：-1.211 至 0.016，P =0.056，I2 =75.447%）。当 LSSE 作为单一治疗时，残疾改善变得显著（Hedge g =-1.325，95%置信区间：-2.598 至 -0.053，P =0.041，I2 =80.020%）。LSSE 对疼痛减轻没有显著影响（Hedges g =-0.496，95%置信区间：-1.082 至 0.090，P =0.097，I2 =73.935%）。
总之，我们的荟萃分析表明，LSSE 可能有助于改善残疾，特别是作为单一治疗时。LSSE 在减轻残疾方面似乎比缓解疼痛更有效。需要对不同患者群体进行进一步研究，以全面了解 LSSE 对其他肌肉骨骼疾病的影响。
