Sub-classification based specific movement control exercises are superior to general exercise in sub-acute low back pain when both are combined with manual therapy: A randomized controlled trial.
Sub-classification based specific movement control exercises are superior to general exercise in sub-acute low back pain when both are combined with manual therapy: A randomized controlled trial.
复制标题
当两者与手动疗法结合使用时，基于亚分类的特定运动控制练习优于亚急性下腰痛的一般运动：一项随机对照试验。
DOI：
10.1186/s12891-016-0986-y
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发表时间：
2016-03-22
影响因子：
2.3
通讯作者：
Airaksinen O
中科院分区：
文献类型：
--
作者：
Lehtola V;Luomajoki H;Leinonen V;Gibbons S;Airaksinen O
临床指南建议对腰痛（LBP）患者的亚组进行研究，但迄今为止，只有少数研究发表。LBP的一个亚组是运动控制障碍（MCI），并且已经开发了识别该亚组的临床测试。此外，运动似乎有利于慢性LBP（CLBP）的管理，但对亚急性LBP的管理知之甚少。进行了一项随机对照试验（RCT），比较一般运动与特定运动控制运动（SMCE）对复发性亚急性LBP组MCI患者残疾和功能的影响。患有MCI的参与者参加了五次特定或一般运动的治疗。在两组中，均应用了短期的手法治疗。主要结局为残疾，采用Roland-Morris残疾问卷（RMDQ）进行评估。这些测量是在基线、三个月干预后立即进行的，以及12个月的随访。70例患者符合入选标准，有资格参加试验。在12个月时完成了61例患者（SMCE n = 30，一般运动n = 31）的测量。（辍学率12.9%）。两组患者在12个月随访时报告的残疾（RMDQ）显著减少。然而，基线和12个月测量值之间RMDQ的平均变化显示SMCE组的改善具有统计学显著性上级优势-1.9分（-3.9至-0.5）95%（CI）。结果未达到具有临床意义的三点差异。用奥斯韦斯特里残疾指数（ODI）测量的组间无统计学差异。对于患有非特异性复发性亚急性LBP和MCI的受试者，由SMCE和手动治疗联合组成的干预可能上级一般运动联合手动治疗。研究方案注册号为ISRCTN 48684087。2012年1月18日进行了回顾性注册。本文的在线版本（doi：10.1186/s12891-016-0986-y）包含补充材料，可供授权用户使用。
Clinical guidelines recommend research on sub-groups of patients with low back pain (LBP) but, to date, only few studies have been published. One sub-group of LBP is movement control impairment (MCI) and clinical tests to identify this sub-group have been developed. Also, exercises appear to be beneficial for the management of chronic LBP (CLBP), but very little is known about the management of sub-acute LBP. A randomized controlled trial (RCT) was conducted to compare the effects of general exercise versus specific movement control exercise (SMCE) on disability and function in patients with MCI within the recurrent sub-acute LBP group. Participants having a MCI attended five treatment sessions of either specific or general exercises. In both groups a short application of manual therapy was applied. The primary outcome was disability, assessed by the Roland-Morris Disability Questionnaire (RMDQ). The measurements were taken at baseline, immediately after the three months intervention and at twelve-month follow-up. Seventy patients met the inclusion criteria and were eligible for the trial. Measurements of 61 patients (SMCE n = 30 and general exercise n = 31) were completed at twelve months. (Drop-out rate 12.9 %). Patients in both groups reported significantly less disability (RMDQ) at twelve months follow-up. However, the mean change on the RMDQ between baseline and the twelve-month measurement showed statistically significantly superior improvement for the SMCE group -1.9 points (-3.9 to -0.5) 95 % (CI). The result did not reach the clinically significant three point difference. There was no statistical difference between the groups measured with Oswestry Disability Index (ODI). For subjects with non-specific recurrent sub-acute LBP and MCI an intervention consisting of SMCE and manual therapy combined may be superior to general exercise combined with manual therapy. The study protocol registration number is ISRCTN48684087. It was registered retrospectively 18th Jan 2012. The online version of this article (doi:10.1186/s12891-016-0986-y) contains supplementary material, which is available to authorized users.