Br J Sports Med:运动疗法或可改善持续性腰痛,尤其是对无重体力劳动者

2020-12-30 MedSci原创 MedSci原创

随着生活节奏的加快,腰痛的发病率逐年上升,据Lancet杂志研究数据显示,从2006至2016年腰痛的发病率增加了18%,而且腰痛已成为全球致残主要病因之一,也是近30年来的主要致残病因。

随着生活节奏的加快,腰痛的发病率逐年上升,据Lancet杂志研究数据显示,从2006至2016年腰痛的发病率增加了18%,而且腰痛已成为全球致残主要病因之一,也是近30年来的主要致残病因。国际上腰痛按病因可分为:非特异性腰痛和特异性腰痛,而非特异性腰痛是指找不到确切的组织病理学结构改变,又不能通过客观检查明确其病因的腰痛,约占腰痛的85%。腰痛不仅影响机体健康,而且还会给社会带来沉重的医疗成本。

目前,多国指南相继发布了腰痛物理治疗或非药物治疗指南,其中运动疗法被广泛推荐用于治疗持续的非特异性腰痛。虽然越来越多的证据表明,适度运动对缓解腰痛有效,但从运动中获益的人群仍然存在不确定性。近日,发表在Br J Sports Med杂志的一项研究显示,与其他治疗相比,短期内运动疗法对疼痛、功能限制和总体康复效果更显著,尤其是在没有繁重的体力需求和使用止痛药物的情况下。

在这项研究中,研究人员收集了来自Cochrane数据库2000年到2012年的27项研究包括3514名参与者,所有参与者均为非特异性持续性(>12周)腰背痛(单独或伴有腿痛)。研究人员通过收集参与者基线特征、运动以及短期、中期和长期随访的结果,并采用多层次混合效应回归分析主要评估运动疗法对减少疼痛轻度,与背部相关功能限制的治疗效果,以及发现更有可能从运动疗法中获益的腰痛患者的特征。

研究和参与者的流程图。IPD是个体参与者数据;RCT是随机对照试验

结果发现,与没有相关治疗或常规护理相比,运动疗法平均来看可减少腰部疼痛程度,在短期随访中23%的参与者通过运动疗法改善了功能限制。同时,对于没有繁重的体力劳动和使用止痛药物的参与者来说,运动疗法对减轻腰疼的效果更好。与没有相关治疗或常规护理相比,身体质量指数较低的参与者运动疗法同样产生了很好的效果。

3个月随访中,运动疗法对疼痛和功能限制的影响

总体来说,运动疗法对持续性非特异性腰痛有改善,其中对于使用药物治疗腰痛的个体,以及没有重体力劳动的个体来说,可能会从运动中获得比其他治疗更多的益处。这项研究提供了潜在的有用信息,有助于设计出更好地匹配特定亚组的运动干预方案。

原始出处

Jill A Hayden 1, Maria N Wilson 2, Samuel Stewart.et al.Exercise treatment effect modifiers in persistent low back pain: an individual participant data meta-analysis of 3514 participants from 27 randomised controlled trials.Br J Sports Med.2020 Nov;54(21):1277-1278.

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    2021-02-15 健康达人

    #运动锻炼#确实可以改善肌肉机能,从而有利于#腰痛##肩周炎#等治疗哦,只是过去没有人认真研究,这里提供了可靠的证据支持

    0

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  4. [GetPortalCommentsPageByObjectIdResponse(id=1922612, encodeId=e2691922612a4, content=<a href='/topic/show?id=3f3156324ff' target=_blank style='color:#2F92EE;'>#持续性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56324, encryptionId=3f3156324ff, topicName=持续性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2c31495, createdName=liuyg0228, createdTime=Thu Dec 09 15:53:53 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=924708, encodeId=b074924e0878, content=<a href='/topic/show?id=5d66942366c' target=_blank style='color:#2F92EE;'>#运动锻炼#</a>确实可以改善肌肉机能,从而有利于<a href='/topic/show?id=0f71854e742' target=_blank style='color:#2F92EE;'>#腰痛#</a><a href='/topic/show?id=421b819560b' target=_blank style='color:#2F92EE;'>#肩周炎#</a>等治疗哦,只是过去没有人认真研究,这里提供了可靠的证据支持, beContent=null, objectType=article, channel=null, level=null, likeNumber=189, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94236, encryptionId=5d66942366c, topicName=运动锻炼), TopicDto(id=85477, encryptionId=0f71854e742, topicName=腰痛), TopicDto(id=81956, encryptionId=421b819560b, topicName=肩周炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=健康达人, createdTime=Mon Feb 15 11:06:45 CST 2021, time=2021-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1331873, encodeId=abde13318e365, content=<a href='/topic/show?id=a0d894194ec' target=_blank style='color:#2F92EE;'>#运动疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94194, encryptionId=a0d894194ec, topicName=运动疗法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=951d2500061, createdName=12498717m66(暂无昵称), createdTime=Fri Jan 01 07:53:53 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610839, encodeId=b99616108395b, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Fri Jan 01 07:53:53 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=912604, encodeId=611c91260483, content=该运动运动了,最近腰好痛啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=45b65448887, createdName=ms1000001275436736, createdTime=Thu Dec 31 16:06:49 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=912391, encodeId=a71091239172, content=困困的, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K7ZTjFvQibURUwGmevyQCnZbEay4uhhb3ic3icekqV0LJu9rlmO6JmbAibQT7Ld1sPVLBa7VvKUFo3uJ/0, createdBy=77971947351, createdName=凯丽菇凉, createdTime=Thu Dec 31 00:11:39 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=912317, encodeId=8c7191231ec3, content=适量运动,好处多! , beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211019/df01a4bfb64246379ddfef3370d04115/e1274c8eb5e440918f56f83bcfea9031.jpg, createdBy=3a345397082, createdName=Jessica, createdTime=Wed Dec 30 21:36:50 CST 2020, time=2020-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=912250, encodeId=4d9f912250d0, content=久坐者的必备,亲测有效.., beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220301/6252e946e5ef413b86dc0f7d1f73b6db/9a7e8c88a38e487b8da4968a67bbd261.png, createdBy=b9f692910, createdName=rayms, createdTime=Wed Dec 30 17:29:16 CST 2020, time=2020-12-30, status=1, ipAttribution=)]
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    2020-12-31 ms1000001275436736

    该运动运动了,最近腰好痛啊

    0

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    2020-12-31 凯丽菇凉

    困困的

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1922612, encodeId=e2691922612a4, content=<a href='/topic/show?id=3f3156324ff' target=_blank style='color:#2F92EE;'>#持续性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56324, encryptionId=3f3156324ff, topicName=持续性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2c31495, createdName=liuyg0228, createdTime=Thu Dec 09 15:53:53 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=924708, encodeId=b074924e0878, content=<a href='/topic/show?id=5d66942366c' target=_blank style='color:#2F92EE;'>#运动锻炼#</a>确实可以改善肌肉机能,从而有利于<a href='/topic/show?id=0f71854e742' target=_blank style='color:#2F92EE;'>#腰痛#</a><a href='/topic/show?id=421b819560b' target=_blank style='color:#2F92EE;'>#肩周炎#</a>等治疗哦,只是过去没有人认真研究,这里提供了可靠的证据支持, beContent=null, objectType=article, channel=null, level=null, likeNumber=189, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94236, encryptionId=5d66942366c, topicName=运动锻炼), TopicDto(id=85477, encryptionId=0f71854e742, topicName=腰痛), TopicDto(id=81956, encryptionId=421b819560b, topicName=肩周炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=健康达人, createdTime=Mon Feb 15 11:06:45 CST 2021, time=2021-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1331873, encodeId=abde13318e365, content=<a href='/topic/show?id=a0d894194ec' target=_blank style='color:#2F92EE;'>#运动疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94194, encryptionId=a0d894194ec, topicName=运动疗法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=951d2500061, createdName=12498717m66(暂无昵称), createdTime=Fri Jan 01 07:53:53 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610839, encodeId=b99616108395b, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Fri Jan 01 07:53:53 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=912604, encodeId=611c91260483, content=该运动运动了,最近腰好痛啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=45b65448887, createdName=ms1000001275436736, createdTime=Thu Dec 31 16:06:49 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=912391, encodeId=a71091239172, content=困困的, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K7ZTjFvQibURUwGmevyQCnZbEay4uhhb3ic3icekqV0LJu9rlmO6JmbAibQT7Ld1sPVLBa7VvKUFo3uJ/0, createdBy=77971947351, createdName=凯丽菇凉, createdTime=Thu Dec 31 00:11:39 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=912317, encodeId=8c7191231ec3, content=适量运动,好处多! , beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211019/df01a4bfb64246379ddfef3370d04115/e1274c8eb5e440918f56f83bcfea9031.jpg, createdBy=3a345397082, createdName=Jessica, createdTime=Wed Dec 30 21:36:50 CST 2020, time=2020-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=912250, encodeId=4d9f912250d0, content=久坐者的必备,亲测有效.., beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220301/6252e946e5ef413b86dc0f7d1f73b6db/9a7e8c88a38e487b8da4968a67bbd261.png, createdBy=b9f692910, createdName=rayms, createdTime=Wed Dec 30 17:29:16 CST 2020, time=2020-12-30, status=1, ipAttribution=)]
    2020-12-30 Jessica

    适量运动,好处多!

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1922612, encodeId=e2691922612a4, content=<a href='/topic/show?id=3f3156324ff' target=_blank style='color:#2F92EE;'>#持续性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56324, encryptionId=3f3156324ff, topicName=持续性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2c31495, createdName=liuyg0228, createdTime=Thu Dec 09 15:53:53 CST 2021, time=2021-12-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=924708, encodeId=b074924e0878, content=<a href='/topic/show?id=5d66942366c' target=_blank style='color:#2F92EE;'>#运动锻炼#</a>确实可以改善肌肉机能,从而有利于<a href='/topic/show?id=0f71854e742' target=_blank style='color:#2F92EE;'>#腰痛#</a><a href='/topic/show?id=421b819560b' target=_blank style='color:#2F92EE;'>#肩周炎#</a>等治疗哦,只是过去没有人认真研究,这里提供了可靠的证据支持, beContent=null, objectType=article, channel=null, level=null, likeNumber=189, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94236, encryptionId=5d66942366c, topicName=运动锻炼), TopicDto(id=85477, encryptionId=0f71854e742, topicName=腰痛), TopicDto(id=81956, encryptionId=421b819560b, topicName=肩周炎)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=健康达人, createdTime=Mon Feb 15 11:06:45 CST 2021, time=2021-02-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1331873, encodeId=abde13318e365, content=<a href='/topic/show?id=a0d894194ec' target=_blank style='color:#2F92EE;'>#运动疗法#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94194, encryptionId=a0d894194ec, topicName=运动疗法)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=951d2500061, createdName=12498717m66(暂无昵称), createdTime=Fri Jan 01 07:53:53 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1610839, encodeId=b99616108395b, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=552a19396740, createdName=ms3994565386320060, createdTime=Fri Jan 01 07:53:53 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=912604, encodeId=611c91260483, content=该运动运动了,最近腰好痛啊, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=45b65448887, createdName=ms1000001275436736, createdTime=Thu Dec 31 16:06:49 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=912391, encodeId=a71091239172, content=困困的, beContent=null, objectType=article, channel=null, level=null, likeNumber=100, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib06iaV3D9Tg5K7ZTjFvQibURUwGmevyQCnZbEay4uhhb3ic3icekqV0LJu9rlmO6JmbAibQT7Ld1sPVLBa7VvKUFo3uJ/0, createdBy=77971947351, createdName=凯丽菇凉, createdTime=Thu Dec 31 00:11:39 CST 2020, time=2020-12-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=912317, encodeId=8c7191231ec3, content=适量运动,好处多! , beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211019/df01a4bfb64246379ddfef3370d04115/e1274c8eb5e440918f56f83bcfea9031.jpg, createdBy=3a345397082, createdName=Jessica, createdTime=Wed Dec 30 21:36:50 CST 2020, time=2020-12-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=912250, encodeId=4d9f912250d0, content=久坐者的必备,亲测有效.., beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220301/6252e946e5ef413b86dc0f7d1f73b6db/9a7e8c88a38e487b8da4968a67bbd261.png, createdBy=b9f692910, createdName=rayms, createdTime=Wed Dec 30 17:29:16 CST 2020, time=2020-12-30, status=1, ipAttribution=)]
    2020-12-30 rayms

    久坐者的必备,亲测有效..

    0

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