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慢性非特异性下腰痛的家庭体育锻炼干预:系统评价与多变量Meta分析

Home Physical Exercise Interventions in Chronic Non-Specific Low Back Pain: Systematic Review and Multivariate Meta-Analysis.

作者信息

Lapuente-Hernández Diego, Gil-Calvo Marina, Cuenca-Zaldívar Juan Nicolás, Carcasona-Otal Alberto, Herrero Pablo, Matute-Llorente Ángel

机构信息

Department of Physiatry and Nursing, Faculty of Health Sciences, University of Zaragoza, 50009 Zaragoza, Spain.

iHealthy Research Group, Instituto de Investigación Sanitaria (IIS) Aragon, HCU Lozano Blesa, 50009 Zaragoza, Spain.

出版信息

Healthcare (Basel). 2025 Aug 22;13(17):2094. doi: 10.3390/healthcare13172094.

Abstract

: Low back pain is considered one of the leading causes of disability. Up to 90% of cases are classified as non-specific, which, if prolonged for at least 12 weeks, is considered non-specific chronic low back pain (NSCLBP). Physical exercise is one of the selected treatments for NSCLBP. Interest in the use of remote interventions has recently emerged. The main objective was to analyze the effect of home exercise interventions to reduce pain intensity and functional disability in individuals with NSCLBP. : A systematic review was conducted in April 2024. Both multivariate and univariate meta-analysis was performed with the difference before and after treatment, adjusting both models with a meta-regression that included the covariates age and body mass index (BMI). Heterogeneity was analyzed with Cochran's Q test as well as with the I estimator, and effect size was calculated with Hedges'G. : A total of six studies, with moderate-high methodological quality and a heterogeneous risk of bias, were included. There was a statistically significant pre-/post-treatment effect on functional disability (moderate effect: Hedge's g = 0.69, = 0.018) and pain intensity (large effect: Hedge's g = 1.11, = 0.007) in both univariate and multivariate (moderate effect: Hedge's g = 0.77) meta-analyses when comparing unsupervised home exercise with supervised in-person exercise, in favor of the latter. This effect was significantly moderated by BMI ( = 0.003 for both outcomes) negatively. : Unsupervised home exercise appears to be less effective than supervised in-person exercise in effectively reducing pain intensity and functional disability in the short term in individuals with NSCLBP.

摘要

腰痛被认为是导致残疾的主要原因之一。高达90%的病例被归类为非特异性的,如果持续至少12周,则被视为非特异性慢性腰痛(NSCLBP)。体育锻炼是NSCLBP的选定治疗方法之一。最近出现了对使用远程干预措施的兴趣。主要目的是分析家庭锻炼干预措施对减轻NSCLBP患者疼痛强度和功能障碍的效果。:2024年4月进行了一项系统评价。采用治疗前后差异进行多变量和单变量荟萃分析,并用包括协变量年龄和体重指数(BMI)的荟萃回归对两个模型进行调整。用Cochran's Q检验以及I估计量分析异质性,并用Hedges'G计算效应量。:总共纳入了六项研究,方法学质量为中高,偏倚风险异质性较大。在比较无监督家庭锻炼与有监督的面对面锻炼时,单变量和多变量荟萃分析(中等效应:Hedge's g = 0.77)对功能障碍(中等效应:Hedge's g = 0.69,P = 0.018)和疼痛强度(大效应:Hedge's g = 1.11,P = 0.007)均有统计学显著的治疗前/后效应,支持后者。BMI对这种效应有显著的负向调节作用(两个结局的P均为0.003)。:在短期内,无监督家庭锻炼在有效减轻NSCLBP患者疼痛强度和功能障碍方面似乎不如有监督的面对面锻炼有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4a69/12428419/a7d3fcdc612e/healthcare-13-02094-g003.jpg

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