腰痛与久坐行为关联性的研究进展

Relationship between the Low Back Pain and Sedentary Behaivor:A Systematic Review

目的:近年来,腰痛(low back pain,LBP)成为威胁大众健康的公共卫生热点问题,本文系统综述将久坐行为作为腰痛危险因素的流行病学研究,旨在为公共卫生政策制定和预防腰痛提供理论依据。方法:在PubMed、Web of Science、Elsevier和CNKI电子文献数据库中搜索2009-2019年有关久坐行为与腰痛关联性的文献,根据研究样本的代表性、久坐行为和腰痛的定义和统计分析方法等,确定每篇文献的质量。结果:确定了13项研究,其中7项横断面研究和6项前瞻性研究,7项涉及久坐行为的职业,7项涉及久坐行为的剂量。除了其中3项研究外,其他研究均未发现久坐行为和腰痛之间的正相关关系,仅有1项研究报道久坐行为与职业有关,2项研究报道坐位时间与腰痛呈正相关。结论:1)最近广泛的流行病学文献不再支持"久坐行为是腰痛的风险因素"这一观点;2)不良坐姿和缺少日常身体活动可能才是久坐引起腰痛的强预测因子;3)建议养成腰椎前凸的坐姿习惯,增加坐姿调整频率以及每天进行不少于60 min中等至剧烈强度的身体活动来预防腰痛,采取有针对性的运动干预措施。

Purpose: In recent years, low back pain(LBP) has become a hot public health issue that threatens public health. This thesis systematically reviews the research on epidemiological investigation that regards sedentary behavior as a risk factor for LBP, aiming to provide theoretical basis for public health policy formulation and prevention of LBP. Methods: Articles on the correlation between sedentary behavior and LBP from 2009 to 2019 were searched in PubMed,Web of Science, Elsevier and CNKI Electronic Literature Database. The quality of each article was determined according to the representativeness of research samples, sedentary behavior,definition of LBP and statistical analysis methods. Results: 13 studies were identified, including7 cross-sectional studies and 6 prospective studies, 7 occupations involving sedentary behaviors and 7 doses involving sedentary behaviors. It was found that, except for 3 studies, no positive correlation between sedentary behavior and LBP could be found in other studies. Only one study reported that sedentary behavior was related to occupation and 2 studies reported that sitting time was positively related to LBP. Conclusions: 1) recent extensive epidemiological literature no longer supports the view that sedentary behavior is a risk factor for LBP;2) poor sitting posture and lack of daily physical activities may be strong predictors of LBP caused by sitting;3) it is recommended to develop a back-up posture habit, and increase the sitting adjustment frequency, and daily physical activity no less than 60 min to moderate intensity to prevent LBP,and take targeted exercise intervention to relieve or treat LBP under the guidance of professionals.