运动辅助治疗慢性腰痛效果的贝叶斯网状meta分析

doi:10.15942/j.jcsu.2022.04.024

成都体育学院学报 ›› 2022, Vol. 48 ›› Issue (4): 129-135.doi: 10.15942/j.jcsu.2022.04.024

运动辅助治疗慢性腰痛效果的贝叶斯网状meta分析

杨俊超, 陈君颖, 许春艳, 邱俊强

北京体育大学运动人体科学学院,北京 100084

收稿日期:2021-10-01 修回日期:2022-01-10 出版日期:2022-07-15 发布日期:2022-08-03
通讯作者: 邱俊强,博士,教授,研究方向:运动促进健康和运动营养,E-mail:qiujunqiang@bsu.edu.cn。
作者简介:杨俊超,博士,研究方向:运动促进健康,E-mail:474007589@qq.com。
基金资助:
国家重点研发计划“基于能量平衡原理的中国人运动能耗基准与健身指导方案”(2018YFC2000601)。

Effect of Adjuvant Exercise Treatment on Chronic Low Back Pain: A Bayesian Network Meta-analysis

YANG Junchao, CHEN Junying, XU Chunyan, Qiu Junqiang

School of Sport Science, Beijing Sport University, Beijing, 100084

Received:2021-10-01 Revised:2022-01-10 Online:2022-07-15 Published:2022-08-03

摘要/Abstract

摘要： 目的:运用贝叶斯网状Meta分析评价运动辅助治疗慢性腰痛(chronic low back pain,CLBP)的效果。方法:计算机检索PubMed、EMbase、The Cochrane Library、CNKI 和WanFang Data数据库,搜集运动辅助治疗慢性腰痛患者的随机对照试验(randomized controlled trials,RCTs),检索时限均从建库至2020年5月。由2位评价员独立筛选文献、提取资料,并采用RCTs偏倚风险的工具RoB2评价纳入研究的偏倚风险后,运用R软件进行贝叶斯网状Meta分析。结果:共纳入26个RCT,包括2 001名CLBP患者。网状Meta分析结果显示:在常规治疗基础上,瑜伽[MD = -2.7,95%CI:(-4.8,-0.61)]辅助治疗CLBP患者疼痛最有效,其次是核心稳定性/运动控制训练[MD = -1.1,95%CI:(-2,-0.16)]和悬吊运动[MD = -1.1,95%CI:(-1.8,-0.40)];运动辅助治疗CLBP患者功能方面,核心稳定性/运动控制训练[MD = -5.30,95%CI:(-10.00,-1.10)]最有效,其次是悬吊运动[MD = -4.30,95%CI:(-8.10,-0.51)]。结论:当前证据表明,在联合常规治疗下,瑜伽、核心稳定性/运动控制训练和悬吊运动辅助治疗慢性腰痛患者效果更好。建议未来围绕运动疗法辅助治疗慢性腰痛患者方面开展更多高质量的随机对照试验。

关键词: 运动疗法, 慢性腰痛, 疼痛, 功能, 贝叶斯网状Meta分析, 随机对照试验

Abstract: Objective: To systematically review the effect of adjuvant exercise treatment for patients with chronic low back pain (CLBP) by bayesian network meta-analysis (NMA). Methods: The PubMed, Embase, The Cochrane Library, CNKI and Wan Fang Data databases were electronically searched to collect randomized controlled trials (RCTs) on exercise for patients with CLBP from inception to May, 2020. Two reviewers respectively screened the literature, extracted data, and evaluated the risk of bias of the included studies using the RCTs RoB2, and then performed a Bayesian network meta-analysis using R software.Results: A total of 26 RCTs were included, including 2 001 CLBP patients. The effect of adjuvant exercise treatment in patients with CLBP were in the following rankings: Yoga [MD=-2.7,95%CI(-4.8,-0.61)], stabilization/motor control [MD=-1.1,95%CI(-2,-0.16)] and sling exercise [MD=-1.1,95%CI(-1.8,-0.40)]. The effect of adjuvant exercise treatment on function in patients with CLBP were in the following rankings: stabilization/motor control [MD=-5.30,95%CI(-10.00,-1.10)] and sling exercise [MD=-4.30,95%CI(-8.10,-0.51)].Conclusion: Current evidence suggests that yoga, stabilization/motor control and sling exercise, as adjuvant treatments in combination with conventional therapy, are more effective in patients with CLBP. More high-quality RCTs should be developed in the future for the adjuvant treatment of patients with CLBP.

Key words: exercise treatment, chronic low back pain, pain, function, Bayesian network meta-analysis, RCT

中图分类号:

G804.5

杨俊超, 陈君颖, 许春艳, 邱俊强. 运动辅助治疗慢性腰痛效果的贝叶斯网状meta分析[J]. 成都体育学院学报, 2022, 48(4): 129-135.

YANG Junchao, CHEN Junying, XU Chunyan, Qiu Junqiang. Effect of Adjuvant Exercise Treatment on Chronic Low Back Pain: A Bayesian Network Meta-analysis[J]. Journal of Chengdu Sport University, 2022, 48(4): 129-135.

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链接本文: https://cdtyxb.cdsu.edu.cn/CN/10.15942/j.jcsu.2022.04.024

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参考文献

[1] HARTVIGSEN J,HANCOCK MJ,KONGSTED A, et al. What low back pain is and why we need to pay attention[J]. The Lancet, 2018, 391(10137): 2356-2367.
[2] MAHER C,UNDERWOOD M,BUCHBINDER R. Non-specific low back pain[J]. The Lancet, 2017, 389(10070): 736-747.
[3] HOY D,BAIN C,LYN MARCH GW, et al. A systematic review of the global prevalence of low back pain[J]. Arthritis Rheum, 2012, 64(6): 2028–2037.
[4] VOS T,ABAJOBIR AA,ABATE KH, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016[J]. The Lancet, 2017, 390(10100): 1211-1259.
[5] STUBBS B,KOYANAGI A,THOMPSON T, et al. The epidemiology of back pain and its relationship with depression, psychosis, anxiety, sleep disturbances, and stress sensitivity: Data from 43 low- and middle-income countries[J]. Gen Hosp Psychiatry, 2016, 43(2016): 63-70.
[6] O'CONNELL NE,COOK CE,WAND BM, et al. Clinical guidelines for low back pain: A critical review of consensus and inconsistencies across three major guidelines[J]. Best Pract Res Clin Rheumatol, 2016, 30(6): 968-980.
[7] 中国康复医学会脊柱脊髓专业委员会专家组. 中国急/慢性非特异性腰背痛诊疗专家共识[J]. 中国脊柱脊髓杂志, 2016, 26(12): 1134-1138.
[8] HUANG R,NING J,CHUTER VH, et al. Exercise alone and exercise combined with education both prevent episodes of low back pain and related absenteeism: systematic review and network meta-analysis of randomised controlled trials (RCTs) aimed at preventing back pain[J]. Br J Sports Med, 2020, 54(13): 766-770.
[9] 田金徽,李伦. 网状Meta分析方法与实践 [M]. 北京: 中国医药科技出版社, 2017, 2-20.
[10] KRISMER M,VAN TULDER M,LOW BACK PAIN GROUP OF THE B, et al. Strategies for prevention and management of musculoskeletal conditions. Low back pain (non-specific)[J]. Best Pract Res Clin Rheumatol, 2007, 21(1): 77-91.
[11] 刘津池,刘畅,华成舸. 随机对照试验偏倚风险评价工具 RoB2(2019 修订版)解读[J]. 中国循证医学杂志, 2021, 21(6): 1-8.
[12] 马彬. 系统评价/Meta分析在基础医学领域的应用 [M]. 兰州市: 兰州大学出版社, 2018, 1-120.
[13] 杜东,范建中,尹瑞雪. 不同角速度下等速躯干屈伸训练对腰痛患者核心肌群的影响 [J]. 中国康复理论与实践, 2019, 25(4): 381-384.
[14] 江领群,祁俊菊. 瑜伽在慢性腰背疼痛患者中的应用研究[J]. 重庆医学 2017, 46(24): 3402-3404.
[15] 李非,李丽,陈加新, 等. 悬吊运动疗法辅助治疗脊柱关节炎性腰背痛的临床观察 [J]. 风湿病与关节炎, 2017, 6(7): 34-37.
[16] 李志辉,张任君,韦玉玲, 等. 悬吊运动疗法治疗慢性非特异性下背痛疗效分析 [J]. 中国现代医生, 2014, 52(19): 144-146.
[17] 刘丽爽,王瑾,郄淑燕. 悬吊式核心稳定训练在慢性非特异性下背痛治疗中的应用[J]. 中国医药导报, 2018, 15(34): 81-84.
[18] 刘攀. 针刺结合悬吊运动训练治疗慢性非特异性腰痛的临床疗效观察 [D]. 济南; 山东中医药大学, 2012, 1-38.
[19] 穆烁,吴建伟. 核心肌力训练对运动员慢性非特异性腰痛的治疗作用分析[J]. 蚌埠医学院学报 2019 44(12): 1649-1652.
[20] 王欣,田秀娟,王金玲, 等. 悬吊运动训练治疗慢性非特异性腰痛的效果 [J]. 中国康复理论与实践 2019, 25(4): 385-389.
[21] 王新,朱群邦,方凡夫, 等. 健身气功八段锦辅助治疗老年男性慢性腰痛患者的临床观察[J]. 中华中医药杂志 2017, 32(10): 4753-4755.
[22] 张宝娟. 温针灸结合八段锦训练对慢性腰肌劳损的临床疗效研究 [D]. 济南; 山东中医药大学, 2012, 1-45.
[23] AKHTAR M,KARIMI H,GILANI S. Effectiveness of core stabilization exercises and routine exercise therapy in management of pain in chronic nonspecific low back pain a randomized controlled clinical trial[J]. Pak J Med Sci, 2017, 33(4): 1002-1006.
[24] BHADAURIA EA,GURUDUT P. Comparative effectiveness of lumbar stabilization, dynamic strengthening, and Pilates on chronic low back pain randomized clinical trial[J]. Journal ofExercise Rehabilitation, 2017, 13(4): 477-485.
[25] CHAN C,MOK N,YEUNG E. Aerobic exercise training in addition to conventional physiotherapy for chronic low back pain a randomized controlled trial[J]. Arch Phys Med Rehabil, 2011, 92(10): 1681-1685.
[26] CRUZ-DIAZ D,MARTINEZ-AMAT A,OSUNA-PEREZ MC, et al. Short- and long-term effects of a six-week clinical Pilates program in addition to physical therapy on postmenopausal women with chronic low back pain: a randomized controlled trial[J]. Disabil Rehabil, 2015, 38(13): 1300-1308.
[27] CUESTA-VARGAS AI,ADAMS N,SALAZAR JA, et al. Deep water running and general practice in primary care for non-specific low back pain versus general practice alone: randomized controlled trial[J]. Clin Rheumatol, 2012, 31(7): 1073-1078.
[28] GUR A,KARAKOC M,CEVIK R, et al. Efficacy of low power laser therapy and exercise on pain and functions in chronic low back pain[J]. Lasers Surg Med, 2003, 32(3): 233-238.
[29] HALL AM,MAHER CG,LAM P, et al. Tai chi exercise for treatment of pain and disability in people with persistent low back pain a randomized controlled trial[J]. Arthritis Care Res (Hoboken), 2011, 63(11): 1576–1583.
[30] KIM J,KIM Y,BAE S, et al. The effect of the neurac sling exercise on postural balance adjustment and muscular response patterns in chronic low back pain patients[J]. J Phys Ther Sci, 2013, 25(8): 1015-1019.
[31] MCDONOUGH S,TULLY M,BOYD A, et al. Pedometer-driven walking for chronic low back painA feasibility randomized controlled trial[J]. Clin J Pain, 2013, 29(11): 972-981.
[32] MIYAMOTO G,COSTA L,GALVANIN T, et al. Efficacy of the addition of modified Pilates exercises to a minimal intervention in patients with chronic low back paina randomized controlled trial[J]. Phys Ther, 2012, 93(3): 310-320.
[33] NABAVI N,MOHSENI BANDPEI MA,MOSALLANEZHAD Z, et al. The effect of 2 different exercise programs on pain intensity and muscle dimensions in patients with chronic low back pain: a randomized controlled trial[J]. J Manipulative Physiol Ther, 2018, 41(2): 102-110.
[34] NIEMISTÖ L,TIINA L-S,PEKKA R, et al. A Randomized Trial of Combined Manipulation, Stabilizing Exercises, and Physician Consultation Compared to Physician Consultation Alone for Chronic Low Back Pain[J]. Spine, 2003, 29(19): 2185-2191.
[35] PARK J,LEE S,KO D. The effects of the nintendo wii exercise program on chronic work-related low back pain in industrial workers[J]. J Phys Ther Sci, 2013, 25(8): 985-988.
[36] RYAN CG,GRAY HG,NEWTON M, et al. Pain biology education and exercise classes compared to pain biology education alone for individuals with chronic low back pain: a pilot randomised controlled trial[J]. Man Ther, 2010, 15(4): 382-387.
[37] SALAVATI M,AKHBARI B,TAKAMJANI I, et al. Effect of spinal stabilization exercise on dynamic postural control and visual dependency in subjects with chronic non-specific low back pain[J]. J Bodyw Mov Ther, 2016, 20(2): 441-448.
[38] SAPER RBKJS, Diana Cullum-Dugan, Roger B Davis, Russell S Phillips, Larry Culpepper. Yoga for chronic low back pain in a predominantly minority population a pilot randomized controlled trial [J]. Altern Ther Health Med, 2009, 15(6): 18–27.
[39] 王雪强, 陈佩杰, 矫玮,等. 运动疗法治疗腰痛的专家共识 [J]. 体育科学, 2019, 39 (3): 19-29.
[40] OWEN PJ,MILLER CT,MUNDELL NL, et al. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis[J].Br J Sports Med,2019,0(0):1-12.
[41] MAHER CG,HAYDEN JA,SARAGIOTTO BT, et al. Letter in response to: ‘Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis'by Owen et al[J]. British Journal of Sports Medicine, 2020.
[42] 康玉杰,于红妍. 下背痛运动干预效果的元分析[J]. 体育科学, 2019, 39(2): 63-72.
[43] 张世洪. Meta分析应合理设置亚组分析与敏感性分析以准确解释结果[J]. 中国现代神经疾病杂志, 2016, 16(1): 1-2.

运动辅助治疗慢性腰痛效果的贝叶斯网状meta分析

Effect of Adjuvant Exercise Treatment on Chronic Low Back Pain: A Bayesian Network Meta-analysis

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