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瑜伽、物理疗法和家庭运动对慢性下腰痛的影响:一项随机试验中的疼痛感知、功能、应激和生活质量。

Yoga, Physical Therapy and Home Exercise Effects on Chronic Low Back Pain: Pain Perception, Function, Stress, and Quality of Life in a Randomized Trial.

机构信息

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

出版信息

Percept Mot Skills. 2024 Dec;131(6):2216-2243. doi: 10.1177/00315125241292235. Epub 2024 Oct 15.

Abstract

Low back pain is a common health problem. In this study, we investigated the effects of yoga, physical therapy (PT), and home exercise (HE) on pain perception, function, stress, and quality of life in chronic low back pain (cLBP). We randomly assigned 54 participants to three distinct treatment groups: (a) a physical therapy group (PT) who received spinal stabilization exercises (SSE) combined with local heat and transcutaneous electrical stimulation; (b) a home exercise group (HE) who received SSE as part of the home program; and (c) a yoga group who received yoga exercises. The primary outcome measures were a Visual Analog Scale (VAS) for measuring pain, and the Oswestry Disability Index (ODI) to measure function. Secondary outcome measures were the Tampa Kinesiophobia Scale (TKS), Central Sensitization Inventory (CSI), pain sensitivity (L3 and deltoid R/L PPTs), Spielberger State-Trait Anxiety Inventory (STAI), plasma cortisol and DHEA-S levels, Transversus Abdominis (TrA) muscle activation, and the Nottingham Health Profile (NHP). Assessments were conducted before and after a six-week intervention period. All three groups demonstrated improvements in pain on the VAS, function on the ODI, pain sensitivity on the L3 and deltoid R/L PPTs, CSI, anxiety on the STAI, TrA muscle activation, and quality of life on the NHP ( < .05). The PT group exhibited a more pronounced improvement on the ODI score ( < .05) than the other groups. Cortisol levels only decreased in the PT group ( < .05). The exercises did not impact DHEA-S and NHP-S parameters. Thus, all interventions resulted in decreased stress, pain intensity, pain sensitivity, central sensitization, and improved function and quality of life; there was no singularly superior approach between interventions. These findings will aid in tailoring treatment programs for managing cLBP according to individual needs.

摘要

腰痛是一种常见的健康问题。在这项研究中,我们调查了瑜伽、物理治疗(PT)和家庭运动(HE)对慢性腰痛(cLBP)患者疼痛感知、功能、压力和生活质量的影响。我们将 54 名参与者随机分配到三个不同的治疗组:(a)物理治疗组(PT),接受脊柱稳定运动(SSE)结合局部热疗和经皮电刺激;(b)家庭运动组(HE),接受 SSE 作为家庭方案的一部分;(c)瑜伽组,接受瑜伽运动。主要结局指标为视觉模拟评分(VAS)测量疼痛,Oswestry 功能障碍指数(ODI)测量功能。次要结局指标为坦帕运动恐惧调查问卷(TKS)、中枢敏化问卷(CSI)、疼痛敏感性(L3 和三角肌 R/L PPTs)、状态-特质焦虑量表(STAI)、血浆皮质醇和 DHEA-S 水平、腹横肌(TrA)肌肉激活和诺丁汉健康调查问卷(NHP)。评估在 6 周干预期前后进行。所有三组在 VAS 上的疼痛、ODI 上的功能、L3 和三角肌 R/L PPTs 上的疼痛敏感性、CSI、STAI 上的焦虑、TrA 肌肉激活和 NHP 上的生活质量均有改善( <.05)。PT 组在 ODI 评分上的改善更为显著( <.05)。皮质醇水平仅在 PT 组下降( <.05)。运动对 DHEA-S 和 NHP-S 参数没有影响。因此,所有干预措施均降低了压力、疼痛强度、疼痛敏感性、中枢敏化,改善了功能和生活质量;干预之间没有单一的优势方法。这些发现将有助于根据个体需求制定治疗慢性腰痛的方案。

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