Motor Control Exercise for Chronic Low Back Pain: A Randomized Placebo-Controlled Trial
Motor Control Exercise for Chronic Low Back Pain: A Randomized Placebo-Controlled Trial
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DOI：
10.2522/ptj.20090218
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发表时间：
2009-12-01
期刊：
影响因子：
3.2
通讯作者：
Jennings, Matthew D.
中科院分区：
文献类型：
--
作者：
Costa, Leonardo O. P.;Maher, Christopher G.;Jennings, Matthew D.
背景。运动干预对慢性腰痛治疗有效的证据来自非安慰剂对照试验。目的。本研究的目的是探讨运动控制运动对慢性腰痛患者的疗效。这是一项随机、安慰剂对照试验。这项研究是在澳大利亚的一个门诊物理治疗部门进行的。研究对象是154名持续时间超过12周的慢性腰痛患者。在8周的时间里进行了12次运动控制练习（即旨在改善腰背部特定肌肉功能和控制姿势和运动的练习）或安慰剂（即失谐超声治疗和失谐短波治疗）。主要结果是疼痛强度、活动（通过患者特异性功能量表测量）和患者在2个月时对恢复的总体印象。次要结局是疼痛；活动（通过患者特异性功能量表测量），患者在6个月和12个月时对恢复的总体印象；活动限制（通过Roland-Morris残疾问卷测量）在2、6和12个月；以及12个月后持续或复发疼痛的风险。2个月时，运动干预改善了患者的活动和总体恢复印象，但没有明显减轻疼痛。运动对活动的平均影响（由患者特异性功能量表测量）为1.1分（95%可信区间[CI]=0.3至1.8），平均影响总体印象恢复为1.5分（95% CI=0.4至2.5），平均影响疼痛为0.9分（95% CI=-0.01至1.8），均以11分制测量。次要结果也有利于运动控制练习。临床医生不能对干预措施视而不见。对于患有慢性腰痛的人来说，运动控制锻炼对恢复和活动的整体印象有短期的改善，但对疼痛没有改善。大多数在短期内观察到的效果在6个月和12个月的随访中保持不变。
Background. The evidence that exercise intervention is effective for treatment of chronic low back pain conics from trials that are not placebo-controlled.Objective. The purpose of this study Was to investigate the efficacy of motor control exercise for people with chronic low back pain.Design. This was a randomized, placebo-controlled trial.Setting. The study Was conducted in an outpatient physical therapy department in Australia.Patients. The participants were 154 patients with chronic low back pain of more than 12 weeks' duration.Intervention. Twelve sessions of motor control exercise (ie, exercises designed to improve function of specific muscles of the low back region and the control of posture and movement) or placebo (ie, detuned ultrasound therapy and detuned short-wave therapy) were conducted over 8 weeks.Measurements. Primary Outcomes were pain intensity, activity (measured by the Patient-Specific Functional Scale), and patient's global impression of recovery measured at 2 months. Secondary outcomes were pain; activity (measured by the Patient-Specific Functional Scale), patient's global impression of recovery measured at 6 and 12 months; activity limitation (measured by the Roland-Morris Disability Questionnaire) at 2, 6, and 12 months; and risk of persistent or recurrent pain at 12 months.Results. The exercise intervention improved activity and patient's global impression of recovery but did not clearly reduce pain at 2 months. The mean effect of exercise on activity (measured by the Patient-Specific Functional Scale) was 1.1 points (95% confidence interval [CI]=0.3 to 1.8), the mean effect oil global impression of recovery was 1.5 points (95% CI=0.4 to 2.5), and the mean effect on pain was 0.9 points (95% CI=-0.01 to 1.8), all measured on 11-point scales. Secondary outcomes also favored motor control exercise.Limitation. Clinicians could not be blinded to the intervention the), provided.Conclusions. Motor control exercise produced short-term improvements in global impression of recovery and activity, but not pain, for people with chronic low back pain. Most of the effects observed in the short term were maintained at the 6- and 12-month follow-ups.