J Pain:慢性非特异性腰痛的个体化运动治疗

2022-07-30 MedSci原创 MedSci原创

个体化运动可以治疗慢性非特异性腰痛的疼痛和残疾。短期效果具有临床意义(相对于主动干预的相对差异为38%,相对于被动干预的相对差异为77%)。

近日,麻醉疼痛领域权威杂志The journal of Pain上发表了一篇研究文章,这项系统评价、荟萃分析和荟萃回归旨在调查基于单独运动或结合心理治疗的个体化干预对慢性非特异性腰痛患者疼痛强度和残疾的影响。

研究人员检索了数据库,确定了与任何对照相比,有或没有心理治疗的个体化/分层运动干预的各自随机对照试验,检索时间截至2022年1月31日。该分析共纳入了58项研究(n=10084)。

在短期随访(12周)中,相比于被动锻炼对照者,疼痛强度的低质量证据(SMD-0.28[95%CI-0.42至-0.14])和残疾的极低质量证据(-0.17[-0.31至-0.02])显示个体化与主动锻炼的疗效,,但对于残疾则不然(-0.18;[-0.22到0.01])。在长期随访(1年)中,疼痛强度(-0.14[-0.22至-0.07])和残疾(-0.20[-0.30至-0.10])的中等质量证据表明效果优于被动锻炼对照者。

敏感性分析表明对疼痛具有效应,而对残疾没有影响(短期和积极治疗相比)。个体化运动治疗与心理干预(特别是行为认知疗法)相结合导致疼痛减轻(-0.28[-0.42至-0.14],低确定性)具有临床意义。

由此可见,个体化运动可以治疗慢性非特异性腰痛的疼痛和残疾。短期效果具有临床意义(相对于主动干预的相对差异为38%,相对于被动干预的相对差异为77%)。亚组分析表明个性化锻炼(尤其是基于运动控制的治疗)与行为治疗干预相结合,以减轻疼痛的效果会增强。

原始出处:

Johannes Fleckenstein.et al.Individualized exercise in chronic non-specific low back pain: a systematic review with meta-analysis on the effects of exercise alone or in combination with psychological interventions on pain and disability.The journal of Pain.2022.https://www.jpain.org/article/S1526-5900(22)00364-9/fulltext

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