定量有氧运动早期干预对非特异性下腰痛的康复作用

摘要

背景:非特异性下腰痛的临床治疗方法较多,但多为被动对症治疗,有关主动运动早期干预治疗的报道较少.目的:研究定量有氧运动早期干预加功能重建对非特异性下腰痛的治疗效果.设计:临床随机对照试验设计.地点和对象:资料收集于阿曼首都马斯喀特亚洲医学中心1996-01/1998-12门诊收治非特异性下腰痛(nonspecific low back pain,NLBP)患者189例,其中男112例,女77例(均为阿拉伯人和欧洲人).干预:189例非特异性下腰痛患者按就诊顺序随机分成两组:A组(137例)主动运动早期干预加推拿治疗,B组(52例)推拿治疗;用视觉模拟量表(VAS)和腰痛问卷调查量表(OSW),对两组患者进行治疗前后分析评估.主要观察指标:治疗前后VAS和OSW评分指数变化.结果:两组VAS和OSW指数都有下降,A组指数下降明显大于B组[A组VAS治疗前后的值分别为(59.64±1.19),(28.98±0.95),B组为(63.33±1.91),(36.86±1.47),t=36.644,19.785,P＜0.01;A组OSW治疗前后的值分别为(26.781±0.492),(11.649±0.357),B组为(27.098±0.756),(15.625±0.570)(t=42.216,18.202,P＜0.01).6个月～2年随访表明A组复发率(15.08%,19/126)低于B组(35.42%,17/48).结论:运动疗法早期介入治疗非特异性下腰痛,可缓解疼痛,改善和重建腰部功能,预防机体功能下降,提高日常生活活动能力.%BACKGROUND: There are quite a number of treatment methods for non-specific low back pain(NLBP), of which most are passive expectant treatments. There are few reports on early exercise interventions to it.OBJECTIVE: To explore the therapeutic effects of early aerobic intervention and functional reconstruction on non-specific low back pain.DESIGN: A clinical randomized case control study was conducted.SETTING and PARTICIPANTS: Totally 189 cases of NLBP treated in outpatient service during January 1996 to December 1998 were collected from Asia Medical Complex Muscat Sultanate of Oman. There were 112 males and 77 females who all were Arabs and Europeans.INTERVENTIONS: The 189 cases were divided randomly into two groups by their visiting order. There were 137 cases in Group A receiving early exercises and massage treatment. Fifty-two cases of Group B only took massage treatment. Visual analogue scale(VAS) and Oswestry low back pain index (OSW) were used to assess the therapeutic effects of two groups before and after treatment.MAIN OUTCOME MEASURES: Changes of VAS and OSW score index before and after treatment.RESULTS: The index of VAS and OSW in both groups all decreased. The decrease of index of Group A was more prominent than that of Group B. The VAS value of Group A and Group B before and after treatment were (59.64±1.19), (28.98±0.95) and (63.33±1.91), (36.86±1.47)respectively( t =36. 644, 19. 785, P ＜ 0. 01). The value of OSW in Group A was (26. 781 ±0. 492), (11. 649 -0. 357) respectively before and after treatment, while in Group B it was (27. 098 ±0. 756), (15. 625 ±0. 570)respectively( t =42. 216, 18. 202, P ＜ 0.01). The recurrence rate in Group A (15.08%, 19/126) was lower than that of Group B (35.42%, 17/48)after 6-month to 2-year follow-up.CONCLUSION: Early intervention of exercise therapy for NLBP can relieve pain, improve and reconstruct waist functions, prevent body from functional decline and improve daily mobility.