Snook S H, Webster B S, McGorry R W, Fogleman M T, McCann K B
Liberty Mutual Research Center for Safety and Health, Hopkinton, Massachusetts, USA.
Spine (Phila Pa 1976). 1998 Dec 1;23(23):2601-7. doi: 10.1097/00007632-199812010-00015.
Eighteen-month, randomized controlled trial with partial crossover.
To test the hypothesis that the control of lumbar flexion in the early morning will significantly reduce chronic, nonspecific low back pain.
Previous studies have indicated an increased risk of low back pain with bending forward in the early morning, primarily because of increased fluid content in the intervertebral discs at that time.
After 6 months of recording baseline data, 85 subjects with persistent or recurring low back pain were randomly assigned to treatment and control groups. The treatment group received instruction in the control of early morning lumbar flexion. The control group received a sham treatment of six exercises shown to be ineffective in reducing low back pain. Six months later, the control group received the experimental treatment, Diaries were used to record daily levels of pain intensity, disability, impairment, and medication usage.
Significant reductions in pain intensity (P < 0.01) were recorded for the treatment group, but not for the control group (point estimate, 33%; 95% confidence interval, 11-55%). After receiving the experimental treatment, the control group responded with similar reductions (P < 0.05). Significant reductions also were observed in total days in pain, disability, impairment, and medication usage.
Controlling lumbar flexion in the early morning is a form of self-care with potential for reducing pain and costs associated with chronic, nonspecific low back pain.
为期18个月的部分交叉随机对照试验。
检验清晨控制腰椎前屈能显著减轻慢性非特异性下腰痛这一假设。
既往研究表明，清晨向前弯腰时下腰痛风险增加，主要是因为此时椎间盘内液体含量增加。
在记录6个月基线数据后，将85例持续性或复发性下腰痛患者随机分为治疗组和对照组。治疗组接受清晨腰椎前屈控制指导。对照组接受六种被证明对减轻下腰痛无效的模拟练习。6个月后，对照组接受实验性治疗。使用日记记录每日疼痛强度、功能障碍、身体损伤和药物使用水平。
治疗组疼痛强度显著降低（P < 0.01），而对照组未降低（点估计值为33%；95%置信区间为11 - 55%）。接受实验性治疗后，对照组也有类似程度的降低（P < 0.05）。疼痛总天数、功能障碍、身体损伤和药物使用也显著减少。
清晨控制腰椎前屈是一种自我护理方式，有可能减轻慢性非特异性下腰痛相关的疼痛和费用。
