GSpine4, IRCCS Ospedale Galeazzi - Sant'Ambrogio, Milano, Italy.
Department of Orthopaedics, Faculty of Medicine and Psychology, University of Rome "La Sapienza", Rome, Italy.
Sci Rep. 2024 May 21;14(1):11546. doi: 10.1038/s41598-024-62276-9.
Chronic low back pain (cLBP) is a major cause of disability and healthcare expenditure worldwide. Its prevalence is increasing globally from somatic and psychosocial factors. While non-pharmacological management, and in particular physiotherapy, has been recommended as a first-line treatment for cLBP, it is not clear what type of physiotherapeutic approach is the most effective in terms of pain reduction and function improvement. This analysis is rendered more difficult by the vast number of available therapies and a lack of a widely accepted classification that can effectively highlight the differences in the outcomes of different management options. This study was conducted according to the PRISMA guidelines. In January 2024, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase. All the randomised controlled trials (RCTs) which compared the efficacy of physiotherapy programs in patients with cLBP were accessed. Studies reporting on non-specific or mechanical cLPB were included. Data concerning the Visual Analogic Scale (VAS) or numeric rating scale (NRS), Roland Morris Disability Questionnaire (RMQ) and Oswestry Disability Index (ODI). Data from 12,773 patients were collected. The mean symptom duration was 61.2 ± 51.0 months and the mean follow-up was 4.3 ± 5.9 months. The mean age was 44.5 ± 9.4 years. The mean BMI was 25.8 ± 2.9 kg/m. The Adapted Physical Exercise group evidenced the lowest pain score, followed by Multidisciplinary and Adapted Training Exercise/Complementary Medicine. The Adapted Physical Exercise group evidenced the lowest RMQ score followed by Therapeutic Exercises and Multidisciplinary. The Multidisciplinary group evidenced the lowest ODI score, followed by Adapted Physical Exercise and Physical Agent modalities. Within the considered physiotherapeutic and non-conventional approaches to manage nonspecific and/or mechanic cLBP, adapted physical exercise, physical agent modalities, and a multidisciplinary approach might represent the most effective strategy to reduce pain and disability.
慢性下背痛（cLBP）是全球残疾和医疗保健支出的主要原因。由于躯体和心理社会因素，其全球患病率正在增加。虽然非药物治疗，特别是物理治疗，已被推荐为 cLBP 的一线治疗方法，但哪种物理治疗方法在减轻疼痛和改善功能方面最有效尚不清楚。由于有大量的治疗方法可供选择，而且缺乏一种广泛接受的分类方法来有效突出不同管理方案结果的差异，因此这一分析变得更加困难。本研究根据 PRISMA 指南进行。2024 年 1 月，检索了以下数据库：PubMed、Web of Science、Google Scholar 和 Embase。检索了比较物理治疗方案对 cLBP 患者疗效的所有随机对照试验（RCT）。纳入了报告非特异性或机械性 cLPB 的研究。收集了关于视觉模拟评分（VAS）或数字评分量表（NRS）、Roland Morris 残疾问卷（RMQ）和 Oswestry 残疾指数（ODI）的数据。共纳入 12773 名患者。平均症状持续时间为 61.2±51.0 个月，平均随访时间为 4.3±5.9 个月。平均年龄为 44.5±9.4 岁。平均 BMI 为 25.8±2.9kg/m。适应性体育锻炼组疼痛评分最低，其次是多学科和适应性训练/补充医学。适应性体育锻炼组 RMQ 评分最低，其次是治疗性运动和多学科。多学科组 ODI 评分最低，其次是适应性体育锻炼和物理因子治疗。在考虑的非药物治疗和非传统方法中，适应性体育锻炼、物理因子治疗和多学科方法可能是减轻疼痛和残疾的最有效策略。
