核心稳定训练在非特异性腰背痛患者中应用效果的系统评价

目的系统性评价核心稳定训练与一般运动或手法治疗对非特异性腰背痛患者的康复疗效。方法计算机检索Medline、EMBASE、PubMed、Cochrane Central Register of Controlled Trials、PsycINFO、中国生物医学文献数据库、CNKI、中国科技期刊全文数据库和万方数据库,检索时间从建库到2018年10月20日。收集所有核心稳定训练对非特异性腰背痛患者康复效果的随机对照试验(RCT)和临床对照研究。2名研究者按照纳入和排除标准独立检索文献、筛选文献、评价纳入文献的质量,并提取资料,使用Revman 5.3软件进行Meta分析。结果共纳入14篇文献,均为RCT。Meta分析结果显示,核心稳定运动训练组与一般运动训练组疼痛改善对比结果(Z=4.67,P<0.001)[OR=1.01,95%CI(-1.43,-0.59)],证据显示有统计学意义(P<0.05);稳定运动训练和一般运动训练后患者的脊柱功能障碍评分对比(Z=5.03,P<0.01)[OR=-7.18,95%CI(-9.98,-4.38)],证据显示有统计学意义(P<0.05)。其他指标对比结果均无统计学意义(P>0.05)。结论核心运动组和手法治疗组都能有效地降低非特异腰背痛患者疼痛,并且核心稳定训练能促进非特异性腰背痛患者功能障碍的缓解,鼓励将核心稳定训练作为非特异性腰痛患者肌肉骨骼康复的一部分。

Systematic review on the effect of core stability training for the patients with non-specific low back pain

Objective To systematically evaluate the rehabilitation efficacy of core stability training versus general exercises or manual therapy in patients with non-specific low back pain.Methods The Medline,EMBASE,PubMed,Cochrane Central Register of Controlled Trials(CENTRAL),PsycINFO,China Biology Medicine(CBM),CNKI,VIP and Wanfang database were searched by computer,and the retrieval time was from the establishment of the database to 20th October,2018.All randomized controlled trials(RCT)and clinical control studies of the rehabilitation effects of core stability training on patients with non-specific low back pain were collected.According to the inclusion and exclusion criteria,2 researchers independently searched the literature,screened the literature and evaluated the quality of the included literature.And the data were extracted for Meta-analysis using Revman 5.3 software.Results A total of 14 articles were included,all of which were RCTs.The results of Meta-analysis showed that the comparison of pain improvement between core stability training group and general exercise training group was(Z=4.67,P<0.001)[OR=1.01,95%CI(-1.43,-0.59)],and the evidence showed statistical significance(P<0.05).The comparison of Oswestry Disability Index scores of patients after core stability training and general exercise training was(Z=5.03,P<0.01)[OR=-7.18,95%CI(-9.98,-4.38)],and the evidence showed statistical significance(P<0.05).The comparison results of other indicators were not statistically significant(P>0.05).Conclusions The core stability training group and manual therapy group can effectively reduce pain in patients with non-specific low back pain,and core stability training can promote the relief of dysfunction in patients with non-specific low back pain,and core stability training should be encouraged as part of musculoskeletal rehabilitation for patients with non-specific low back pain.