Manniche C, Asmussen K, Lauritsen B, Vinterberg H, Karbo H, Abildstrup S, Fischer-Nielsen K, Krebs R, Ibsen K
Department of Rheumatology, Central Hospital Hillerød, Denmark.
Spine (Phila Pa 1976). 1993 Apr;18(5):560-7. doi: 10.1097/00007632-199304000-00007.
Sixty-two patients with chronic low back pain occurring 14-60 months after undergoing discectomy for the first time were randomized to two physical treatment groups: 24 sessions of intensive dynamic back exercises with hyperextension or 24 sessions of intensive dynamic back exercises without hyperextension. At the conclusion of therapy and at one-year follow-up, no difference was seen between the randomized groups, with regard to the combined assessments of pain, disability and objective measurements. A difference for back exercises without hyperextension to be superior to the other treatment regimen was statistically significant at the three-month follow-up. In the patient's qualitative assessment of treatment outcome there were seen no significant differences between back exercises with or without hyperextension. There was a similar and significant improvement of the isometric endurance of back muscles in both groups, but the flexibility of the spine was significantly improved only in the group using hyperextension exercises. The overall response rate of an earlier published investigation was reproduced. It is concluded that chronic back patients after first time discectomy may benefit from an intensive rehabilitation protocol including intensive exercises. The added use of hyperextension exercises does not confer any independent benefit. Furthermore, the training had to continue for more than 2-3 months before a statistical significant decrease in back pain was reported in the patient pain diary.
62例首次接受椎间盘切除术后14 - 60个月出现慢性下腰痛的患者被随机分为两个物理治疗组：24节强化动态背部过伸锻炼课程或24节无过伸的强化动态背部锻炼课程。在治疗结束时及一年随访时，随机分组的两组在疼痛、功能障碍及客观测量的综合评估方面未见差异。在三个月随访时，无过伸的背部锻炼优于其他治疗方案的差异具有统计学意义。在患者对治疗结果的定性评估中，有过伸和无过伸的背部锻炼之间未见显著差异。两组的背部肌肉等长耐力均有类似且显著的改善，但仅在使用过伸锻炼的组中脊柱灵活性得到显著改善。重复了一项早期发表研究的总体反应率。得出的结论是，首次椎间盘切除术后的慢性背痛患者可能受益于包括强化锻炼在内的强化康复方案。额外使用过伸锻炼并未带来任何独立的益处。此外，在患者疼痛日记中报告背痛有统计学显著下降之前，训练必须持续超过2 - 3个月。
