Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis
Evaluation of specific stabilizing exercise in the treatment of chronic low back pain with radiologic diagnosis of spondylolysis or spondylolisthesis
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DOI：
10.1097/00007632-199712150-00020
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发表时间：
1997-12-15
期刊：
影响因子：
3
通讯作者：
Allison, GT
中科院分区：
文献类型：
--
作者：
O'Sullivan, PB;Twomey, LT;Allison, GT
研究设计。一项随机对照试验、重测设计，并进行 3、6 和 30 个月的邮寄问卷随访。目的。确定特定运动干预治疗慢性腰痛和脊椎峡部裂或脊椎滑脱放射学诊断患者的疗效。背景数据摘要。最近背痛患者物理治疗管理的焦点是脊柱周围肌肉（深层腹部肌肉和腰椎多裂肌）的特定训练，被认为可以为腰椎提供动态稳定性和精细控制。在没有研究中，研究人员评估了这种干预措施对脊柱解剖稳定性受损的慢性腰痛人群的疗效。方法。 44 名患有这种疾病的患者被随机分配到两个治疗组。第一组接受为期 10 周的特定运动治疗计划，其中包括对腹部深层肌肉的特定训练，同时共同激活靠近帕尔缺损的腰椎多裂肌。这些肌肉的激活被纳入先前加重的静态姿势和功能性任务中。对照组按照治疗医生的指示接受治疗。结果。干预后，特定运动组的疼痛强度和功能障碍水平在统计上显着降低，并且在 30 个月的随访中仍保持这一水平。对照组在干预后或随访时这些参数没有显着变化。总结。对于患有慢性症状性脊椎峡部裂或脊椎滑脱的患者，“特定运动”治疗方法似乎比其他常用的保守治疗方案更有效。
Study Design. A randomized, controlled trial, test-retest design, with a 3-, 6-, and 30-month postal questionnaire follow-up.Objective. To determine the efficacy of a specific exercise intervention in the treatment of patients with chronic low back pain and a radiologic diagnosis of spondylolysis or spondylolisthesis.Summary of Background Data. A recent focus in the physiotherapy management of patients with back pain has been the specific training of muscles surrounding the spine (deep abdominal muscles and lumbar multifidus), considered to provide dynamic stability and fine control to the lumbar spine. In no study have researchers evaluated the efficacy of this intervention in a population with chronic low back pain where the anatomic stability of the spine was compromised.Methods. Forty-four patients with this condition were assigned randomly to two treatment groups. The first group underwent a 10-week specific exercise treatment program involving the specific training of the deep abdominal muscles, with co-activation of the lumbar multifidus proximal to the pars defects. The activation of these muscles was incorporated into previously aggravating static postures and functional tasks. The control group underwent treatment as directed by their treating practitioner.Results. After intervention, the specific exercise group showed a statistically significant reduction in pain intensity and functional disability levels, which was maintained at a 30-month follow-up. The control group showed no significant change in these parameters after intervention or at follow-up.Summary. A "specific exercise" treatment approach appears more effective than other commonly prescribed conservative treatment programs in patients with chronically symptomatic spondylolysis or spondylolisthesis.