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神经康复训练计划对腰痛及奥斯维斯特里功能障碍指数评分的影响:一项回顾性等待列表对照研究

Effects of the NeuroHAB Program on Low Back Pain and Oswestry Disability Index Scores: A Retrospective Wait-List Control Study.

作者信息

Williams Brogan, Johnson David

机构信息

The Back Pain and Functional Movement Training Centre, Brisbane, QLD 4102, Australia.

出版信息

J Funct Morphol Kinesiol. 2024 Jul 3;9(3):118. doi: 10.3390/jfmk9030118.

Abstract

Movement theory and the study of movement dysfunction mark a paradigm shift in the treatment of low back pain symptoms, the majority of which are mechanical in origin at the outset. Treating movement dysfunction centers around unified and consistent rehabilitation that defines proficient movement for the lumbopelvic spine. The purpose of this study is to document the improvement in pain and disability of 290 patients who underwent NeuroHAB Functional Movement Therapy to reverse their lumbopelvic movement dysfunction attributed to causing their back pain symptoms between 2019 and 2023. Oswestry Disability Index (ODI) scores were collected from each participant on three occasions: the first consultation, after a waiting period/pre-intervention, and after the eight-week intervention. A single-factor ANOVA of all three ODI data sets was conducted, along with supporting descriptive statistics. A post-hoc -test pairwise comparison was conducted for accuracy. The average ODI 1 score (taken at the first consultation) was 15.26 ± 6.1% (CI: 14.3-16.2); ODI 2 (after a waiting period, before NeuroHAB) was 14.71 ± 6.0% (CI: 13.82-15.59); and ODI 3 (post-intervention) was 9.09 ± 8.6% (CI: 8.305-9.875). There was no significant change from ODI 1 to ODI 2 (between the consultation and waitlist control periods). However, a significant reduction between ODI 2 and ODI 3 was observed (pre- and post-intervention) (mean difference: 5.62, ≤ 0.001), and a 40.41% reduction was observed between ODI 1 (the ODI score taken at the first consultation) and ODI 3 (the ODI score taken after NeuroHAB, post-intervention) (mean difference: 6.17, ≤ 0.001). A 50% ODI reduction was reported in the "Crippled" category (mean difference 16.15, ≤ 0.001). The inclusion of functional movement proficiency and stability in future guidelines is a necessary step towards meaningful improvement in epidemic levels of back pain-related clinical and economic morbidity.

摘要

运动理论和运动功能障碍研究标志着腰痛症状治疗的范式转变,其中大多数症状最初源于机械性因素。治疗运动功能障碍围绕统一且一致的康复展开,这种康复为腰骶椎定义了熟练的运动。本研究的目的是记录290例接受神经康复功能运动疗法以逆转其归因于导致背痛症状的腰骶部运动功能障碍的患者在疼痛和残疾方面的改善情况。在三个时间点收集每位参与者的奥斯威斯利残疾指数(ODI)评分:首次咨询时、等待期/干预前以及八周干预后。对所有三个ODI数据集进行单因素方差分析,并辅以描述性统计。进行事后检验的成对比较以确保准确性。ODI 1评分(首次咨询时)的平均值为15.26±6.1%(置信区间:14.3 - 16.2);ODI 2评分(等待期后,神经康复治疗前)为14.71±6.0%(置信区间:13.82 - 15.59);ODI 3评分(干预后)为9.09±8.6%(置信区间:8.305 - 9.875)。从ODI 1到ODI 2(咨询期和等待名单对照期之间)没有显著变化。然而,观察到ODI 2和ODI 3之间有显著降低(干预前和干预后)(平均差异:5.62,p≤0.001),并且在ODI 1(首次咨询时的ODI评分)和ODI 3(神经康复治疗后、干预后的ODI评分)之间观察到降低了40.41%(平均差异:6.17,p≤0.001)。在“残疾”类别中报告ODI降低了50%(平均差异16.15,p≤0.001)。在未来指南中纳入功能性运动熟练程度和稳定性是朝着有意义地改善与背痛相关的临床和经济发病率的流行水平迈出的必要一步。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57f6/11270219/7de48e96124d/jfmk-09-00118-g001.jpg

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