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基于诊所和远程康复的运动控制练习对慢性下腰痛患者的影响:一项 3 个月随访的随机对照试验。

Effects of Clinic-based and Telerehabilitation-based Motor Control Exercises in Individuals with Chronic Low-back Pain: A Randomized Controlled Trial With 3-Month Follow-up.

机构信息

Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara.

Faculty of Health Science, Department of Physical Therapy and Rehabilitation, Çankiri Karatekin University, Çankiri.

出版信息

Clin J Pain. 2024 Dec 1;40(12):700-708. doi: 10.1097/AJP.0000000000001245.

Abstract

OBJECTIVE

To evaluate the effectiveness of clinic-based and telerehabilitation-based motor control exercises in individuals with chronic low-back pain 3 months posttreatment.

METHODS

Forty-two participants were randomized to either clinic-based or telerehabilitation-based groups, performing exercises 3 times weekly for 8 weeks. Assessments were conducted pre-intervention, postintervention and 1 and 3 month follow-ups. The primary outcome was pain intensity (Visual Analog Scale) for low-back pain.

RESULTS

Both exercise approaches were found to be similarly effective in improving pain disability, quality of life (except for emotional response, energy level, sleep, and social isolation), and pain catastrophizing at both follow-up time points. The Visual Analog Scale showed statistically significant reductions in pain from baseline at all time points in both groups ( P <0.001), with effect sizes ranging from moderate to strong. Nottingham Health Profile showed significant improvements in physical activity, pain, and total score, with effect sizes ranging from moderate to strong. No statistically significant changes in spatiotemporal gait parameters were observed in either group. According to the postintervention intention-to-treat analysis, lumbar flexion range of motion showed statistically significant improvements in both groups with small effect sizes ( P <0.05).

DISCUSSION

Telerehabilitation-based motor control exercises proved as effective as clinic-based methods in treating chronic low-back pain, offering a viable alternative tailored to individual needs and circumstances.

摘要

目的

评估基于诊所和远程康复的运动控制练习对慢性下腰痛患者治疗后 3 个月的疗效。

方法

42 名参与者被随机分配到基于诊所或远程康复的组中,每周进行 3 次、每次 8 周的练习。在干预前、干预后以及 1 个月和 3 个月的随访中进行评估。主要结局指标为下腰痛的疼痛强度(视觉模拟评分)。

结果

两种运动方法在改善疼痛残疾、生活质量(除情绪反应、能量水平、睡眠和社会隔离外)和疼痛灾难化方面均显示出同样的效果,在两个随访时间点均有统计学意义(P<0.001),效应大小范围从中等到强。诺丁汉健康概况显示身体活动、疼痛和总分均有显著改善,效应大小范围从中等到强。两组的时空步态参数均无统计学意义的变化。根据干预后意向治疗分析,腰椎前屈活动范围在两组均有统计学意义的改善,且效应大小较小(P<0.05)。

讨论

基于远程康复的运动控制练习在治疗慢性下腰痛方面与基于诊所的方法同样有效,为满足个人需求和情况提供了一种可行的替代方案。

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