The Effect of M-Health-Based Core Stability Exercise Combined with Self-Compassion Training for Patients with Nonspecific Chronic Low Back Pain: A Randomized Controlled Pilot Study.
The Effect of M-Health-Based Core Stability Exercise Combined with Self-Compassion Training for Patients with Nonspecific Chronic Low Back Pain: A Randomized Controlled Pilot Study.
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DOI：
10.1007/s40122-022-00358-0
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发表时间：
2022-06
期刊：
影响因子：
4
通讯作者：
Wang, Chuhuai
中科院分区：
文献类型：
--
作者：
Zheng, Fuming;Zheng, Yiyi;Liu, Shufeng;Yang, Jiajia;Xiao, Weihui;Xiao, Wenwu;Chen, Lichang;Yang, Wanting;Zhang, Shanshan;Yu, Qiuhua;Hao, Zengming;Wang, Yuyin;Wang, Chuhuai
非特异性慢性腰痛 (NCLBP) 是全球疾病负担的主要原因，NCLBP 的治疗一直是一个问题。本研究旨在探讨基于移动健康的核心稳定性运动（CSE）结合自我慈悲训练（SCT）的可行性和有效性，并与单独基于移动健康的CSE治疗NCLBP进行比较。本研究是一项试点、患者盲法随机对照试验。 NCLBP 参与者被随机分为干预组和对照组。所有参与者都接受了基于移动健康的 CSE，但干预组的参与者在 CSE 之前还接受了 SCT。干预每周在周六或周日进行，总共持续 4 周。患者在研究开始后 4 周和 16 周填写电子问卷来自我评估其结果。这些问卷的主要结果指标是背痛残疾（基于罗兰-莫里斯残疾问卷，RMDQ）和疼痛强度（数字评定量表，NRS；当前疼痛，最严重疼痛，平均疼痛）。次要结果指标是焦虑（GAD-7,7 项广泛性焦虑症量表）、抑郁症状（PHQ-9，患者健康问卷-9）、疼痛灾难化（PCS，疼痛灾难化量表）和自我效率（PSEQ，疼痛自我效率问卷）。共有 37 名患者完成了研究，其中包括 28 名女性（75.7%），其中干预组 19 名患者，对照组 18 名患者。患者平均年龄 (SD) 为 35.2 (11.1) 岁。对于所有主要结局，尽管各组之间没有显着差异，但我们发现干预组的参与者更早地改善了功能和疼痛。对照组的 RMDQ 评分从基线到 4 周变化了 − 1.771 分（95% CI − 3.768 至 0.227），干预组则变化了 − 4.822 分（95% CI − 6.752 至 − 2.892）（组间差异为 − 3.052 [95%] CI − 5.836 至 − 0.267]）。此外，对照组的 RMDQ 评分从基线到 16 周变化了 - 3.328 分（95% CI - 5.252 至 - 1.403），干预组则变化了 - 5.124 分（95% CI - 7.014 至 - 3.233）（组间差异 - 1.796） [95% CI − 4.501 至 0.909]）。 NRS 分数中也发现了类似的模式。对于次要结局，干预组在 GAD-7 方面优于对照组（第 16 周干预组与 CSE 的差异为 − 2.156 [95% CI − 4.434 至 − 0.122；群体效应 P 值为 0.030]）。治疗结束时，干预组 PCS 改善显着（第 4 周 PCS 评分差异， − 6.718 [95% CI − 11.872 至 − 1.564]）。我们还发现在 16 周随访中对照组 PCS 发生显着变化（− 6.326 [95% CI， − 11.250 至 − 1.401]）。至于 PSEQ，两组之间没有明显差异。没有出现影响参与研究的不良事件。该试点研究是可行的，我们的结果表明，基于移动健康的 CSE 结合 SCT 组的参与者可能比单独基于移动健康的 CSE 组的参与者更快地缓解疼痛强度和背部残疾。 ChiCTR2100042810。慢性腰痛对人们生活质量和社会经济的影响逐年加大。通过生物-心理-社会模式帮助患者自我管理腰痛似乎是一种有效的管理方法，但学科之间缺乏联系限制了多学科合作的发展。正念相关疗法（自我慈悲训练）已被证明对慢性疼痛有效，运动疗法广泛应用于康复医学。在这项研究中，这两个项目被结合起来。我们在研究中还使用了移动健康技术，这为研究带来了很多便利。研究结果显示联合组的疗效似乎更为明显，值得进一步研究。
Nonspecific chronic low back pain (NCLBP) is a leading contributor to disease burden worldwide, and the management of NCLBP has always been a problem. This study is designed to explore the feasibility and efficacy of m-health-based core stability exercise (CSE) combined with self-compassion training (SCT) and compare it with m-health-based CSE alone for the management of NCLBP. This study is a pilot, patient-blinded randomized controlled trial. Participants with NCLBP were randomized into an intervention group and a control group. All the participants received m-health-based CSE, but those in the intervention group also received SCT before CSE. The intervention took place weekly on Saturday or Sunday for 4 weeks in total. Patients self-assessed their outcomes by filling out electronic questionnaires at 4 and 16 weeks after the start of the study. The primary outcome metrics for these questionnaires were back pain disability (based on the Roland–Morris Disability Questionnaire, RMDQ) and Pain intensity (Numeric Rating Scale, NRS; current pain, worst pain, average pain). The secondary outcome metrics were anxiety (GAD-7,7-item Generalized Anxiety Disorder scale), Depression Symptoms (PHQ-9,Patient Health Questionnaire-9), pain catastrophizing (PCS, Pain Catastrophizing Scale) and Self-efficiency (PSEQ, Pain Self-Efficiency Questionnaire). A total of 37 patients comprising 28 (75.7%) females completed the study, with 19 patients in the intervention group and 18 in the control group. The mean (SD) patient age was 35.2 (11.1) years. For all primary outcomes, although there were no significant differences between groups, we found that participants in the intervention group improved function and pain earlier. The RMDQ score changed by − 1.771 points (95% CI − 3.768 to 0.227) from baseline to 4 weeks in the control group and by − 4.822 points (95% CI − 6.752 to − 2.892) in the intervention group (difference between groups, − 3.052 [95% CI − 5.836 to − 0.267]). Also, the RMDQ score changed by − 3.328 points (95% CI − 5.252 to − 1.403) from baseline to 16 weeks in the control group and by − 5.124 points (95% CI − 7.014 to − 3.233) in the intervention group (difference between groups − 1.796 [95% CI − 4.501 to 0.909]). A similar pattern was found in the NRS scores. For secondary outcomes, the intervention group was superior to the control group in for GAD-7 (intervention difference from CSE along at week 16, − 2.156 [95% CI − 4.434 to − 0.122; P value for group effect was 0.030]). At the end of treatment, the improvement in PCS in the intervention group was significant (difference in PCS score at week 4, − 6.718 [95% CI − 11.872 to − 1.564]). We also found significant changes in PCS in the control group (− 6.326 [95% CI, − 11.250 to − 1.401]) at the 16-week follow-up. As for PSEQ, there were no apparent differences between the two groups. There were no adverse events relented to study participation. The pilot study is feasible to deliver, and our results indicate that participants in the group of m-health-based CSE combined with SCT may experience faster relief from pain intensity and back disability than those in the group of m-health-based CSE alone. ChiCTR2100042810. The impact of chronic low back pain on people’s life quality and social economy is increasing year by year. Helping patients self-manage low back pain through a biological-psycho-social model seems to be an effective management approach, but the lack of connectivity between disciplines limits the development of multidisciplinary collaboration. Mindfulness-related therapy (self-compassion training) has been proven to be effective in chronic pain, and exercise therapy is widely used in rehabilitation medicine. In this study, these two programs were combined. We also used mobile health technology in the study, which brings a lot of convenience for research. The results of the study showed that the efficacy of the combined group seemed to be more obvious and worthy of further study.
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DOI：
10.1142/s1013702520500080
发表时间：
2020-12
期刊：
Hong Kong physiotherapy journal : official publication of the Hong Kong Physiotherapy Association Limited = Wu li chih liao
影响因子：
--
作者：
Chan EWM;Hamid MSA;Nadzalan AM;Hafiz E
通讯作者：
Hafiz E
影响因子：
--
作者：
Kim KH;Cho SH;Goo BO;Baek IH
通讯作者：
Baek IH
DOI：
10.1001/jama.2016.2323
发表时间：
2016-03-22
期刊：
JAMA
影响因子：
--
作者：
Cherkin DC;Sherman KJ;Balderson BH;Cook AJ;Anderson ML;Hawkes RJ;Hansen KE;Turner JA
通讯作者：
Turner JA
影响因子：
2.8
作者：
Chhabra, H. S.;Sharma, Sunil;Verma, Shalini
通讯作者：
Verma, Shalini
影响因子：
--
作者：
Asadzadeh A;Kalankesh LR
通讯作者：
Kalankesh LR