医学
随机对照试验
物理疗法
Oswestry残疾指数
物理医学与康复
再培训
腰椎
腰痛
康复
置信区间
外科
替代医学
病理
国际贸易
业务
内科学
作者
Joshua Farragher,Adrian Pranata,Gavin Williams,Doa El‐Ansary,Selina M. Parry,Ross A. Clark,Benjamin F. Mentiplay,Jessica Kasza,Samuel Crofts,Adam L. Bryant
标识
DOI:10.2519/jospt.2024.12349
摘要
OBJECTIVE: To determine if adding lumbar neuromuscular control retraining exercises to a 12-week program of strengthening exercises has greater effect for improving disability than 12 weeks of strengthening exercises alone in people with chronic low back pain (LBP). DESIGN: Single centre, participant and assessor-blinded, comparative effectiveness randomized controlled trial. METHODS: 69 participants (31 females; 29 males; mean age 46.5 years) with non-specific chronic LBP were recruited for a twelve-week program involving lumbar extension neuromuscular retraining in addition to resistance exercises (intervention) or 12 weeks of resistance exercises alone (control). The primary outcome measure was the Oswestry Disability Index. Secondary outcome measures included the Numeric Rating Scale, Tampa Scale for Kinesiophobia, Pain Self-efficacy Questionnaire, and the International Physical Activity Questionnaire. Outcomes were measured at baseline, 6 and 12 weeks. RESULTS: Forty-three participants (22 control; 21 intervention) completed all outcome measures at 6 and 12 weeks. Fourteen participants were lost to follow-up and 12 participants discontinued due to COVID-19 restrictions. Both groups demonstrated clinically important changes in disability, pain intensity and kinesiophobia. The difference between groups with respect to disability was imprecise and not clinically meaningful (mean difference, -4.4, 95% CI [-10.2, 1.4]) at 12 weeks. Differences in secondary outcomes at 6 or 12 weeks were also small with wide confidence intervals. CONCLUSIONS: Adding lumbar neuromuscular control retraining to a series of resistance exercises offered no additional benefit over resistance exercises alone over a 12-week period.
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