Du Shaojie, Cui Zeyu, Peng Shurui, Wu Jieyu, Xu Jinhai, Mo Wen, Ye Jie
Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Department of Orthopedics and Traumatology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Front Med (Lausanne). 2025 Mar 28;12:1531637. doi: 10.3389/fmed.2025.1531637. eCollection 2025.
Lumbar disc herniation (LDH) is mainly characterized by pain and neurological dysfunction resulting from rupture of the fibrous ring of the lumbar disc. The incidence of LDH is increasing year by year, mainly owing to long-term sitting and immobility, improper posture, and reduced physical activity during study and work. The incidence of LDH in young people aged 18-35 years has shown a significant upward trend. LDH is one of the most common causes of back pain, affecting approximately 1-3% of the global population, and it is mainly concentrated in people aged 30-50 years. Exercise therapy, as an economically effective treatment method, can enhance the strength of core muscle groups and effectively alleviate the symptoms of LDH. However, strong evidence that proves the effectiveness of exercise therapy for LDH is still lacking. We conducted a meta-analysis of relevant clinical studies and used statistical methods to scientifically explore the effectiveness of exercise therapy for LDH.
Four databases were searched, including PubMed, Embase, Web of Science, and Ovid. The search period ended on August 24, 2024. Comparisons were made between the group that used exercise therapy (treatment group) and the group that did not (control group). If heterogeneity among the studies was strong, sensitivity analysis was performed.
Of the 580 articles initially identified, eight (encompassing 611 patients with LDH) were included in the analysis. The results of the meta-analysis demonstrated that the treatment group exhibited superior outcomes in terms of Visual Analog Scale score, Oswestry Disability Index, range of motion, McSensory score, McTotal score, and Short Form-36 score compared with the control group.
Exercise therapy is an economical, effective, and simple adjuvant therapy for patients with LDH. Exercise therapy enhances core muscle strength and lumbar stability, relieves lower back and leg pain, and improves patients' quality of life. However, no consensus on the use of exercise therapy for LDH currently exists, and there are no specific recommendations for exercise intensity, frequency, and activity that are suitable for patients with LDH. More high-quality clinical studies are needed to validate the application of exercise therapy as a treatment for LDH.
The protocol was registered on PROSPERO (CRD42024586775).
腰椎间盘突出症（LDH）的主要特征是腰椎间盘纤维环破裂导致的疼痛和神经功能障碍。LDH的发病率逐年上升，主要原因是长期久坐不动、姿势不当以及学习和工作期间体力活动减少。18至35岁年轻人中LDH的发病率呈显著上升趋势。LDH是背痛最常见的原因之一，影响全球约1%至3%的人口，且主要集中在30至50岁的人群中。运动疗法作为一种经济有效的治疗方法，可以增强核心肌群的力量，并有效缓解LDH的症状。然而，仍缺乏有力证据证明运动疗法对LDH的有效性。我们对相关临床研究进行了荟萃分析，并使用统计方法科学地探究运动疗法对LDH的有效性。
检索了四个数据库，包括PubMed、Embase、Web of Science和Ovid。检索期截至2024年8月24日。对使用运动疗法的组（治疗组）和未使用运动疗法的组（对照组）进行比较。如果研究之间的异质性很强，则进行敏感性分析。
在最初识别的580篇文章中，有8篇（涵盖611例LDH患者）纳入分析。荟萃分析结果表明，与对照组相比，治疗组在视觉模拟评分、Oswestry功能障碍指数、活动范围、McGill疼痛问卷感觉评分、McGill疼痛问卷总分和简明健康调查量表评分方面表现出更好的结果。
运动疗法是一种经济、有效且简单的LDH患者辅助治疗方法。运动疗法可增强核心肌群力量和腰椎稳定性，缓解腰腿痛，提高患者生活质量。然而，目前对于LDH使用运动疗法尚无共识，也没有针对适合LDH患者的运动强度、频率和活动的具体建议。需要更多高质量的临床研究来验证运动疗法作为LDH治疗方法的应用。
该方案已在PROSPERO（CRD42024586775）上注册。
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