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运动疗法对腰痛患者治疗结局的影响:系统评价的伞状综述

Impact of Exercise Therapy on Outcomes in Patients with Low Back Pain: An Umbrella Review of Systematic Reviews.

作者信息

Viderman Dmitriy, Kalikanov Sultan, Myrkhiyeva Zhuldyz, Alisherov Shakhrizat, Dossov Mukhit, Seitenov Serik, Abdildin Yerkin

机构信息

Department of Surgery, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan.

Department of Anesthesiology, Intensive Care, and Pain Medicine, National Research Oncology Center, Astana 010000, Kazakhstan.

出版信息

J Clin Med. 2025 Aug 22;14(17):5942. doi: 10.3390/jcm14175942.

Abstract

: This umbrella review aims to analyze the effectiveness of exercise therapy for low back pain through an analysis of systematic reviews that evaluate pain reduction, quality of life improvement, and functional outcomes. : This review adhered to PRISMA guidelines and systematic review of review recommendations by searching across PubMed, Scopus, and the Cochrane Library. This study searched for systematic reviews alongside meta-analyses that evaluated exercise interventions in treating low back pain (LBP). This study included reviews that examined exercise therapy for LBP patients and presented data regarding their pain intensity, disability, and quality-of-life outcomes. Data extraction and quality assessment were performed independently by several reviewers. The methodological quality of the included systematic reviews was assessed using the AMSTAR 2 tool. : This research yielded 88 systematic reviews from 997 evaluated records. Reduction of pain emerged as the primary measured outcome in systematic reviews (81.8%, n = 72), and these studies showed significant improvement rates of 83.0%. The proportion of studies that concluded no change was 9.1%. The most frequently studied exercises were strengthening, aerobic, and mind-body exercises. The reviews reported quality of life improvements in 27.3% (n = 24), but most reviews (68.2%) did not assess this outcome. No studies indicated worsening outcomes. Exercise interventions demonstrated various forms that effectively contribute to LBP management, according to the study results. : This umbrella review of 88 systematic reviews highlights that exercise therapy is a safe, effective, and commonly used strategy for managing low back pain. However, key limitations include the low methodological quality of several included reviews, risk of bias, imprecision, limited reporting of adverse effects, and confounding from multicomponent interventions. While there is limited certainty that any one type of exercise is more effective than others, individualized approaches and patient adherence appear to be critical factors in optimizing outcomes.

摘要

本伞状综述旨在通过对评估疼痛减轻、生活质量改善和功能结局的系统评价进行分析,来分析运动疗法对腰痛的有效性。本综述遵循PRISMA指南以及系统评价的综述建议,通过检索PubMed、Scopus和Cochrane图书馆进行。本研究检索了评估运动干预治疗腰痛(LBP)的系统评价以及荟萃分析。本研究纳入了检查LBP患者运动疗法并呈现其疼痛强度、残疾和生活质量结局数据的综述。数据提取和质量评估由几位评审员独立进行。使用AMSTAR 2工具评估纳入的系统评价的方法学质量。本研究从997条评估记录中得出88篇系统评价。疼痛减轻成为系统评价中的主要测量结局(81.8%,n = 72),这些研究显示显著改善率为83.0%。得出无变化结论的研究比例为9.1%。最常研究的运动是强化运动、有氧运动和身心运动。综述报告生活质量改善的比例为27.3%(n = 24),但大多数综述(68.2%)未评估这一结局。没有研究表明结局恶化。根据研究结果,运动干预表现出多种有效有助于LBP管理的形式。本对88篇系统评价的伞状综述强调,运动疗法是管理腰痛的一种安全、有效且常用的策略。然而,关键局限性包括一些纳入综述的方法学质量低、偏倚风险、不精确性、不良反应报告有限以及多成分干预的混杂因素。虽然对于任何一种运动比其他运动更有效的确定性有限,但个体化方法和患者依从性似乎是优化结局的关键因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2fdf/12429691/e5497141048c/jcm-14-05942-g001.jpg

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