Arora Nitin Kumar, Donath Lars, Owen Patrick J, Miller Clint T, Kaczorowski Svenja, Saueressig Tobias, Pedder Hugo, Mundell Niamh L, Tagliaferri Scott D, Diwan Ashish, Chen Xiaolong, Zhao Xiaohui, Huessler Eva-Maria, Ehrenbrusthoff Katja, Ford Jon J, Hahne Andrew J, Hammel Ludwig, Norda Heike, Belavy Daniel L
Hochschule für Gesundheit, Department of Applied Health Sciences, Division of Physiotherapy, University of Applied Sciences, Bochum, Germany.
Department of Intervention Research in Exercise Training, German Sport University Cologne, Koln, Germany.
BMJ Open Sport Exerc Med. 2024 Aug 16;10(3):e002108. doi: 10.1136/bmjsem-2024-002108. eCollection 2024.
Chronic low back disorders are the leading cause of direct and indirect healthcare burden globally. Exercise training improves pain intensity, mental health and physical function. However, the optimal prescription variables are unknown. We aim to compare the efficacy of various exercise dosages for chronic low back disorders to identify the optimal prescription variables. Six databases (Medline, SPORTDiscus, CINAHL, PsycINFO, EMBASE and CENTRAL), trial registries (ClinicalTrials.gov and WHO International Clinical Trials Registry Platform) and reference lists of prior systematic reviews will be searched, and we will conduct forward and backward citation tracking. We will include peer-reviewed randomised controlled trials (individual, cluster or cross-over trials) published in English or German language comparing exercise training to other exercise training or non-exercise training interventions (conservative, non-surgical, non-pharmacological, non-invasive treatments, placebo, sham, usual/standard care, no-treatment control, waitlist control) in adults with chronic low back disorders. Outcomes will include pain intensity, disability, mental health, adverse events, adherence rate, dropout rate and work capacity. Version 2 of the Cochrane risk-of-bias tool will be employed. The dose will be categorised as cumulative dose (total and weekly minutes of exercise training) and individual dose prescription variables (intervention duration, session duration, frequency and intensity). Dose-response model-based network meta-analysis will be used to assess the comparative efficacy of different exercise doses to determine a dose-response relationship. The certainty of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation. Information about optimal exercise training dosage will help in enhancing treatment outcomes.
慢性腰痛症是全球直接和间接医疗负担的主要原因。运动训练可改善疼痛强度、心理健康和身体功能。然而，最佳的处方变量尚不清楚。我们旨在比较各种运动剂量对慢性腰痛症的疗效，以确定最佳的处方变量。将检索六个数据库（Medline、SPORTDiscus、CINAHL、PsycINFO、EMBASE和CENTRAL）、试验注册库（ClinicalTrials.gov和世界卫生组织国际临床试验注册平台）以及先前系统评价的参考文献列表，并且我们将进行向前和向后的引文跟踪。我们将纳入以英文或德文发表的同行评审随机对照试验（个体、整群或交叉试验），这些试验比较了慢性腰痛症成人患者的运动训练与其他运动训练或非运动训练干预措施（保守治疗、非手术治疗、非药物治疗、非侵入性治疗、安慰剂、假手术、常规/标准护理、无治疗对照、候补名单对照）。结局将包括疼痛强度、残疾、心理健康、不良事件、依从率、退出率和工作能力。将采用Cochrane偏倚风险工具第2版。剂量将分为累积剂量（运动训练的总分钟数和每周分钟数）和个体剂量处方变量（干预持续时间、每次训练持续时间、频率和强度）。基于剂量反应模型的网络荟萃分析将用于评估不同运动剂量的比较疗效，以确定剂量反应关系。证据的确定性将使用推荐分级评估、制定和评价系统进行评估。关于最佳运动训练剂量的信息将有助于提高治疗效果。
