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教育对下背痛患者接受物理治疗的影响:一项I级系统评价和荟萃分析。

Impact of education in patients undergoing physiotherapy for lower back pain: a level I systematic review and meta-analysis.

作者信息

Migliorini Filippo, Maffulli Nicola, Schäfer Luise, Manocchio Nicola, Bossa Michela, Foti Calogero, Betsch Marcel, Kubach Joshua

机构信息

Department of Life Sciences, Health, and Health Professions, Link Campus University, Via del Casale Di San Pio V, 00165, Rome, Italy.

Department of Orthopedics and Trauma Surgery, Academic Hospital of Bolzano (SABES-ASDAA), 39100, Bolzano, Italy.

出版信息

Eur J Trauma Emerg Surg. 2025 Feb 19;51(1):113. doi: 10.1007/s00068-025-02788-9.

Abstract

INTRODUCTION

Lower back pain (LBP) is one of the most common musculoskeletal disorders in modern society, with a lifetime incidence of up to 90%. According to most national and international guidelines, educational interventions play a central role in the multimodal treatment of LBP. This systematic review and meta-analysis investigated the impact of educational interventions on pain and disability in patients with LBP undergoing physiotherapy compared to patients without educational interventions undergoing physiotherapy.

METHODS

In October 2024, a comprehensive computer-aided search was performed to assess the online databases PubMed, Web of Science, Google Scholar, and Embase. The search followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria with an established PICOTD algorithm. Two authors independently performed the data extraction and risk of bias evaluation. The primary outcome measures extracted were a pain score (VAS or NRS) and the Roland Morris Disability Questionnaire (RMQ).

RESULTS

Data from 8152 patients were retrieved. The mean length of follow-up was 6.2 ± 3.9 months, the mean length of symptom duration was 66.7 ± 51.6 months, and the mean age of the patients was 46.7 ± 9.2 years. Compared to physiotherapy alone, additional education did not reduce pain (P = 0.4) or disability according to the RMQ (P = 0.9).

CONCLUSION

The addition of education did not impact pain and disability in patients undergoing physiotherapy for chronic non-specific LPB.

LEVEL OF EVIDENCE

Level I, systematic review and meta-analysis of RCTs.

摘要

引言

下背痛(LBP)是现代社会中最常见的肌肉骨骼疾病之一,终生发病率高达90%。根据大多数国家和国际指南,教育干预在LBP的多模式治疗中起着核心作用。本系统评价和荟萃分析调查了与未接受教育干预而接受物理治疗的患者相比,教育干预对接受物理治疗的LBP患者疼痛和残疾的影响。

方法

2024年10月,进行了全面的计算机辅助检索,以评估在线数据库PubMed、科学网、谷歌学术和Embase。检索遵循系统评价和荟萃分析的首选报告项目(PRISMA)标准以及既定的PICOTD算法。两位作者独立进行数据提取和偏倚风险评估。提取的主要结局指标为疼痛评分(视觉模拟评分法或数字评定量表)和罗兰·莫里斯残疾问卷(RMQ)。

结果

检索到8152例患者的数据。平均随访时间为6.2±3.9个月,平均症状持续时间为66.7±51.6个月,患者平均年龄为46.7±9.2岁。与单纯物理治疗相比,额外的教育并没有减轻疼痛(P=0.4),根据RMQ也没有减轻残疾程度(P=0.9)。

结论

对于慢性非特异性下背痛接受物理治疗的患者,增加教育对疼痛和残疾没有影响。

证据级别

I级,随机对照试验的系统评价和荟萃分析。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1177/11839871/07d17779ad61/68_2025_2788_Fig1_HTML.jpg

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