Thermal therapy is frequently used as an adjunct to treatment in patients suffering from chronic low back pain. It is also an inherent part of patients’ self-administered pain treatment. This review aims to update th...Thermal therapy is frequently used as an adjunct to treatment in patients suffering from chronic low back pain. It is also an inherent part of patients’ self-administered pain treatment. This review aims to update the evidence for thermal therapy treatments in non-specific chronic low back pain patients and to rate the methodological quality of the corresponding clinical trials. Previous studies have reported contradictory evidence for the effectiveness of thermal therapy. An electronic search on MEDLINE (PubMed), PEDro, CENTRAL and CINHAL databases was conducted between May 2016 and February 2018. Clinical trials comparing local thermal therapy to conservative or no treatment were assessed for eligibility. Pain, physical function and global health were defined as outcome parameters. A total of n = 9 studies met the inclusion criteria. All of them applied an electrophysical agent as the thermal treatment: continuous ultrasound (n = 6), short-wave diathermy (n = 2), microwave diathermy (n = 1). Out of the n = 6 studies on ultrasound treatment, n = 2 reported significant within and between-group results for pain reduction after 4 to 6 weeks of treatment. Both short-wave diathermy studies demonstrated significant between-group results for pain reduction after 3 weeks of treatment. Contradictory results for all other observed outcome parameters were reported regardless of the intervention. Moreover, significant within-group results for the control groups questioned the effectiveness of the intervention treatments. Therefore, the effect of thermal therapy, (electrophysical agents), is not superior to any control treatment except for ultrasound treatment on short-term pain reduction.展开更多
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 ...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。展开更多
非特异性下腰痛(non-specific low back pain,NLBP)是指找不到确切的组织病理学结构改变,又不能通过客观检查明确其病因的腰痛,具有高患病率及高复发率的特点。麦肯基疗法是治疗NLBP的一种常用物理治疗方法,在2019年我国运动疗法治疗腰...非特异性下腰痛(non-specific low back pain,NLBP)是指找不到确切的组织病理学结构改变,又不能通过客观检查明确其病因的腰痛,具有高患病率及高复发率的特点。麦肯基疗法是治疗NLBP的一种常用物理治疗方法,在2019年我国运动疗法治疗腰痛的体育科学、康复科学和骨科领域等专家组专家共识中被推荐用于NLBP的治疗,证据等级为Ⅰ级。本文就麦肯基疗法在NLBP中的临床应用进行总结,并从缓解腰椎疼痛、改善腰椎活动度、增强躯干肌肉力量,提高功能性活动等方面对其作用机制进行综述。展开更多
文摘Thermal therapy is frequently used as an adjunct to treatment in patients suffering from chronic low back pain. It is also an inherent part of patients’ self-administered pain treatment. This review aims to update the evidence for thermal therapy treatments in non-specific chronic low back pain patients and to rate the methodological quality of the corresponding clinical trials. Previous studies have reported contradictory evidence for the effectiveness of thermal therapy. An electronic search on MEDLINE (PubMed), PEDro, CENTRAL and CINHAL databases was conducted between May 2016 and February 2018. Clinical trials comparing local thermal therapy to conservative or no treatment were assessed for eligibility. Pain, physical function and global health were defined as outcome parameters. A total of n = 9 studies met the inclusion criteria. All of them applied an electrophysical agent as the thermal treatment: continuous ultrasound (n = 6), short-wave diathermy (n = 2), microwave diathermy (n = 1). Out of the n = 6 studies on ultrasound treatment, n = 2 reported significant within and between-group results for pain reduction after 4 to 6 weeks of treatment. Both short-wave diathermy studies demonstrated significant between-group results for pain reduction after 3 weeks of treatment. Contradictory results for all other observed outcome parameters were reported regardless of the intervention. Moreover, significant within-group results for the control groups questioned the effectiveness of the intervention treatments. Therefore, the effect of thermal therapy, (electrophysical agents), is not superior to any control treatment except for ultrasound treatment on short-term pain reduction.
文摘目的:比较不同姿势颈部抗阻训练对慢性非特异性颈痛(chronic non-specific neck pain,CNSNP)的干预效果,为CNSNP探寻一种更高效的运动疗法。方法:51例CNSNP患者(年龄41.0±5.0岁)随机分为3组:俯卧姿颈部抗阻训练组(A组,n=17)、坐姿颈部抗阻训练组(B组,n=17)和俯卧姿对照组(C组,n=17)。测试指标包括视觉模拟评分(visual analog score,VAS)、颈椎功能障碍指数(neck disability index,NDI)、颅颈角(craniocervical angle,CVA)、颈椎活动度(range of motion,ROM)和均方根振幅(root mean square,RMS)。所有指标均在干预前和干预4周后进行测量。结果:A组的干预效果优于B组和C组。A组的颈部疼痛评分(VAS)、颈椎功能障碍指数(NDI)、颅颈角(CVA)、颈椎屈曲活动度(ROM)、颈椎伸展活动度(ROM)、RMS(斜方肌上束,屈曲;胸锁乳突肌,静息;胸锁乳突肌,伸展)较B组和C组均存在显著性差异(P<0.05)。A组的RMS(斜方肌上束,静息)较B组无显著性差异(P>0.05)、较C组存在显著性差异(P<0.05)。结论:俯卧姿颈部抗阻训练能更有效地降低颈部肌肉的VAS和RMS,增加颈部ROM和CVA。
文摘目的: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。
文摘非特异性下腰痛(non-specific low back pain,NLBP)是指找不到确切的组织病理学结构改变,又不能通过客观检查明确其病因的腰痛,具有高患病率及高复发率的特点。麦肯基疗法是治疗NLBP的一种常用物理治疗方法,在2019年我国运动疗法治疗腰痛的体育科学、康复科学和骨科领域等专家组专家共识中被推荐用于NLBP的治疗,证据等级为Ⅰ级。本文就麦肯基疗法在NLBP中的临床应用进行总结,并从缓解腰椎疼痛、改善腰椎活动度、增强躯干肌肉力量,提高功能性活动等方面对其作用机制进行综述。
