Barbari Valerio, Carbone Maria M, Storari Lorenzo, Testa Marco, Maselli Filippo
Department of Human Neurosciences, Sapienza University of Rome, Rome, ITA.
Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Savona, ITA.
Cureus. 2024 Mar 30;16(3):e57278. doi: 10.7759/cureus.57278. eCollection 2024 Mar.
A subgroup of patients with low back pain (LBP) suffers from low back-related leg pain (LBLP), which can be classified as radicular pain, or somatic referred pain without nerve root involvement. LBLP is considered an obstacle to recovery and a strong negative prognostic factor for medium- and long-term disability. In this review, we aimed to investigate the effectiveness and optimal dose of resistance training (RT) in patients with subacute or persistent LBLP to provide clinical recommendations for practice. This systematic review was conducted by adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and the recommendations of the Cochrane Collaboration. We conducted a literature search on PubMed, PEDro, Cochrane Library, Scopus, and Web of Science databases. Only randomized controlled trials (RCTs) involving patients ≥18 years of age were included. The risk of bias in the included studies was assessed using "the Cochrane Collaboration's tool for assessing risk of bias" (RoB) and the inter-rater agreement for full-text selection was evaluated using Cohen's Kappa (K). The search elicited a total of 4.537 records, and two RCTs involving a total of 196 participants were identified through a selection process based on title, abstract, and full-text assessment. Both studies had a low to moderate risk of bias. The inter-examiner concordance index for the selection of full text was excellent (K=1). RT seems to be an effective and safe intervention for patients with LBLP, but its long-term effectiveness, superiority over other types of exercise-based therapies, and optimal dosage still constitute a gray area in the literature.
一部分腰痛(LBP)患者会遭受与腰相关的腿痛(LBLP),后者可分为神经根性疼痛或无神经根受累的躯体牵涉痛。LBLP被认为是康复的障碍以及中长期残疾的一个强有力的负面预后因素。在本综述中,我们旨在研究抗阻训练(RT)对亚急性或持续性LBLP患者的有效性和最佳剂量,以便为临床实践提供建议。本系统综述遵循系统评价和Meta分析的首选报告项目(PRISMA)指南以及Cochrane协作网的建议进行。我们在PubMed、PEDro、Cochrane图书馆、Scopus和科学网数据库中进行了文献检索。仅纳入涉及年龄≥18岁患者的随机对照试验(RCT)。使用“Cochrane协作网偏倚风险评估工具”(RoB)评估纳入研究的偏倚风险,并使用Cohen's Kappa(K)评估全文选择的评分者间一致性。检索共获得4537条记录,通过基于标题、摘要和全文评估的筛选过程,确定了两项共涉及196名参与者的RCT。两项研究的偏倚风险均为低到中度。全文选择的检查者间一致性指数极佳(K=1)。RT似乎是一种对LBLP患者有效且安全的干预措施,但其长期有效性、相对于其他类型运动疗法的优越性以及最佳剂量在文献中仍是一个灰色地带。