运动依从性与慢性非特异性下腰痛成人的疼痛强度改善和功能受限相关：一项Cochrane综述的二次分析。
Exercise adherence is associated with improvements in pain intensity and functional limitations in adults with chronic non-specific low back pain: a secondary analysis of a Cochrane review.
作者信息
Jones Matthew D, Hansford Harrison J, Bastianon Andrew, Gibbs Mitchell T, Gilanyi Yannick L, Foster Nadine E, Dean Sarah G, Ogilvie Rachel, Hayden Jill A, Wood Lianne
机构信息
School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Australia.
School of Health Sciences, Faculty of Medicine and Health, UNSW Sydney, Australia.
出版信息
J Physiother. 2025 Apr;71(2):91-99. doi: 10.1016/j.jphys.2025.03.004. Epub 2025 Apr 1.
QUESTION
What is the association between exercise adherence and the effects of exercise on pain intensity and functional limitations in adults with chronic non-specific low back pain (CNSLBP)?
DESIGN
Systematic review with meta-analysis.
PARTICIPANTS
Adults with CNSLBP.
INTERVENTION
Randomised controlled trials of exercise compared with no exercise (eg, usual care, placebo/sham or another conservative treatment). Adherence to exercise must have been reported.
OUTCOME MEASURES
Pain intensity and functional limitations.
RESULTS
This study included 46 trials with 56 exercise groups. High exercise adherence (80 to 100%) was associated with reduced pain intensity (0 to 100 scale) (MD -14.32, 95% CI -18.61 to -10.03, low certainty) and functional limitations (0 to 100 scale) (MD -8.08, 95% CI -10.68 to -5.49, low certainty). Moderate exercise adherence (60 to 79%) was not associated with reduced pain intensity (MD -4.53, 95% CI -9.39 to 0.34, very low certainty) or functional limitations (MD -2.75, 95% CI -6.00 to 0.51, very low certainty). Low exercise adherence (< 59%) was associated with reduced pain intensity (MD -5.33, 95% CI -10.00 to -0.66, low certainty) and functional limitations (MD -4.43, 95% CI -7.14 to -1.72, moderate certainty). Compared with low adherence, additional differences in outcomes for moderate and high adherence were mostly negligible.
CONCLUSION
Higher exercise adherence is associated with larger improvements in clinical outcomes in adults with CNSLBP, although overall differences are small compared with lower adherence. Other factors besides adherence between the trials and exercise programs could explain these results. Further research is needed to determine the causal effect of exercise adherence on outcomes in adults with CNSLBP.
REGISTRATION
PROSPERO CRD42023447355 and Open Science Framework https://osf.io/7p6dw/.
问题
在患有慢性非特异性下腰痛（CNSLBP）的成年人中，运动依从性与运动对疼痛强度和功能受限的影响之间有何关联？
设计
系统评价与荟萃分析。
参与者
患有CNSLBP的成年人。
干预措施
将运动的随机对照试验与不运动（如常规护理、安慰剂/假治疗或另一种保守治疗）进行比较。必须报告运动依从性。
结局指标
疼痛强度和功能受限。
结果
本研究纳入了46项试验，其中有56个运动组。高运动依从性（80%至100%）与疼痛强度降低（0至100量表）（平均差-14.32，95%置信区间-18.61至-10.03，低确定性）和功能受限（0至100量表）（平均差-8.08，95%置信区间-10.68至-5.49，低确定性）相关。中等运动依从性（60%至79%）与疼痛强度降低（平均差-4.53，95%置信区间-9.39至0.34，极低确定性）或功能受限（平均差-2.75，95%置信区间-6.00至0.51，极低确定性）无关。低运动依从性（<59%）与疼痛强度降低（平均差-5.33，95%置信区间-10.00至-0.66，低确定性）和功能受限（平均差-4.43，95%置信区间-7.14至-1.72，中等确定性）相关。与低依从性相比，中等和高依从性在结局方面的额外差异大多可忽略不计。
结论
在患有CNSLBP的成年人中，较高的运动依从性与临床结局的更大改善相关，尽管与较低依从性相比总体差异较小。试验和运动项目之间除依从性之外的其他因素可能解释了这些结果。需要进一步研究以确定运动依从性对患有CNSLBP的成年人结局的因果效应。
注册信息
PROSPERO CRD42023447355以及开放科学框架https://osf.io/7p6dw/ 。
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