Engel Tilman, Niederer Daniel, Arampatzis Adamantios, Banzer Winfried, Beck Heidrun, Floessel Philipp, Haag Thore, Mueller Steffen, Schiltenwolf Marcus, Schmidt Hendrik, Schneider Christian, Stengel Dirk, Stoll Josefine, Wippert Pia-Maria, Mayer Frank
University Outpatient Clinic, Sports Medicine & Sports Orthopedics, University of Potsdam, Potsdam, Germany.
Division of Preventive and Sports Medicine, Institute for Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, Frankfurt am Main, Germany.
Arch Rehabil Res Clin Transl. 2025 Jan 27;7(1):100430. doi: 10.1016/j.arrct.2025.100430. eCollection 2025 Mar.
To investigate the feasibility and effects of a sensorimotor stabilization exercise intervention with and without behavioral treatment in nonspecific low back pain.
A three-armed multicenter randomized controlled trial.
Five study sites across Germany (3 orthopedic university outpatient clinics, 1 university sports medicine department, and 1 clinical institution).
Six hundred and sixty-two volunteers (N=662) (59% females, age 39±13y) with low back pain.
Sensorimotor training (SMT), sensorimotor training with behavioral therapy (SMT+BT), and usual care group (UCG; continuation of the already ongoing individual treatment regime). Intervention groups performed a 12-week (3wk center-based, 9wk home-based) program.
Adherence, dropout rates, adverse events, and intervention effects on pain intensity, disability, and trunk torque (gain scores, repeated measures analysis of variance, α-level<0.05).
In total, 220 participants received SMT, 222 received SMT+BT, and 170 were analyzed as UCG. Dropout rates were 10% for SMT and SMT+BT at week 3, 31% and 30% at week 4, and 49% and 50% at week 12. Adherence rates above 80% were reached in both interventions; 134 adverse events occurred. Intervention effects compared to UCG were found for pain intensity (SMT, =.011, effect size d=0.41), disability (SMT+BT, =.020, d=0.41), and peak torque (SMT, =.045, d=0.38; SMT+BT, =.019, d=0.44), with overall small effect sizes.
Participants were highly adherent to the sensorimotor exercise, but showed increased dropout rates, particularly during home-based training. Both interventions proved to be feasible, and although only SMT showed an increased effect on pain intensity compared to UCG, the SMT+BT showed positive effects on disability. Both interventions led to increases in strength, indicative of a neuromuscular adaptation.
探讨有无行为治疗的感觉运动稳定训练干预对非特异性下腰痛的可行性及效果。
一项三臂多中心随机对照试验。
德国的五个研究地点（3个骨科大学门诊、1个大学运动医学科和1个临床机构）。
662名患有下腰痛的志愿者（N = 662）（59%为女性，年龄39±13岁）。
感觉运动训练（SMT）、感觉运动训练联合行为疗法（SMT+BT）和常规护理组（UCG；继续进行已有的个体化治疗方案）。干预组进行为期12周（3周中心训练，9周居家训练）的项目。
依从性、脱落率、不良事件以及干预对疼痛强度、功能障碍和躯干扭矩的影响（增益分数，重复测量方差分析，α水平<0.05）。
总共220名参与者接受了SMT，222名接受了SMT+BT，170名作为UCG进行分析。SMT和SMT+BT在第3周的脱落率为10%，第4周为31%和30%，第12周为49%和50%。两种干预的依从率均达到80%以上；发生了134起不良事件。与UCG相比，干预在疼痛强度（SMT，P = 0.011，效应大小d = 0.41）、功能障碍（SMT+BT组，P = 0.020，d = 0.41）和峰值扭矩方面（SMT，P = 0.045，d = 0.38；SMT+BT，P = 0.019，d = 0.44）有效果，总体效应大小较小。
参与者对感觉运动训练的依从性很高，但脱落率增加，尤其是在居家训练期间。两种干预均被证明是可行的，虽然只有SMT与UCG相比对疼痛强度有更大的效果，但SMT+BT对功能障碍有积极影响。两种干预均导致力量增加，表明存在神经肌肉适应性变化。
