腰痛患者抗阻训练的剂量-反应关系的Meta分析

Dose-response relationships of resistance training in low back pain patients:a systematic review and Meta-Analysis

目的:探讨抗阻训练(RT)治疗慢性非特异性腰痛(CNSLBP)的临床疗效,通过分析提供RT的剂量与腰部功能改善的关系,以及影响结果最显著的剂量区间。方法:计算机检索2022年12月前CNKI、维普数据库、万方数据库、PubMed、MEDLINE、Embase、Web of Science、Cochrane对照试验注册中心发表的RT治疗CNLBP的随机对照试验。对纳入文献进行筛选,资料提取,质量评价后,采用Stata 14软件进行Meta分析,Meta回归分析以及亚组分析。结果:共纳入13篇RCT,19项结果。RT对腰部功能改善有显著影响[SMD=-1.01,95%CI(-1.42,-0.60),P<0.01]。每组次数(P=0.026)对腰部功能改善影响显著。训练次数10~12个/组(SMD=-2.38),训练周期为9~12周(SMD=-1.68),训练频率1~2次/周(SMD=-1.08),训练组数为1组(SMD=-1.96),训练时长30~39min(SMD=-0.89),训练强度大于70%1RM(SMD=-2.12),组间休息0~30s(SMD=-0.92)对腰部功能改善更有效。结论:RT可以显著改善患者腰部功能受限。未来的研究应特别关注训练变量的详细描述,以便深入分析CNSLBP在RT后的剂量-反应关系。

Objective:To explore the clinical efficacy of resistance training in the treatment of chronic non-specific low back pain(CNLBP),to provide dose-response relationships of(resistance training,RT)variables and lumbar function improvement through analysis,and to find the parameter range that most significantly affects the results.Methods:Randomized controlled trials about RT for CNLBP were electronically searched in CKNI,VIP,Wanfang,pubMed,MEDLINE,Embase,Web of Science and Cochrane Central Register of Controlled Trials before Jan.2022.After literature screening,data extraction,quality evaluation,the results of Meta-analysis,Meta-regression and subgroup analysis were conducted by Stata 14 software.Results:A total of 13 RCTs with 19 outcomes were included.RT had a significant effect on the improvement of lumbar function[SMD=-1.01,95%CI(-1.42,-0.60),P<0.01].The number of times per group(P=0.026)had significant effects on functional improvement.The effect sizes were the most effective when the training number was 10-12 per group(SMD=-2.38),the training duration was 9-12 weeks(SMD=-1.68),the training frequency was 1-2 times/week(SMD=-1.08),the training group was 1 group(SMD=-1.96),the training time was 30~39 min(SMD=-0.89),the training intensity was more than 70%1RM(SMD=-2.12),and the rest between groups was 0-30 s(SMD=-0.92).Conclusion:RT could relieve functional limitations significantly in patients with CNLBP.Future studies should pay special attention to the detailed description of training variables for further analysis of the dose-response relationship of CNSLBP after RT.