运动疗法在慢性非特异性腰痛中的治疗进展

腰痛是常见的一种健康和社会问题，是所有年龄段都会出现的症状，在中老年阶段发病率最高。根据持续时间可分为急性腰痛、亚急性腰痛和慢性腰痛，临床上绝大部分腰痛是慢性非特异性的。慢性非特异性腰痛持续时间在12周以上，没有明确的病理解剖学原因，也没有具体的方法推荐给临床医生治愈慢性非特异性腰痛。因其致病因素不明确、持续时间长、预后易反复等特点严重影响患者的生活质量，造成巨大的经济负担。慢性非特异性腰痛的治疗方法纷繁多样，目前尚无高质量证据的研究表明哪种治疗方法疗效最好。其中，运动疗法具有危害小、成本低、便于实施等特点，成为临床上改善慢性非特异性腰痛主流的治疗方法。虽然运动疗法在中国急/慢性非特异性腰背痛专家共识、美国医师学会临床实践指南中被推荐用于慢性腰痛的治疗，但哪种特定的运动方式治疗慢性非特异性腰痛的疗效更好，目前证据还不够充分。运动疗法主要有核心稳定性训练、抗阻训练、有氧运动、伸展运动、普拉提、瑜伽、太极、麦肯基疗法等，随着研究的深入，运动治疗慢性非特异性腰痛的研究有所增多，本文通过查阅相关文献，将近年来国内外学者研究运动疗法治疗慢性非特异性腰痛的进展进行系统综述。 

Progress in the treatment of chronic nonspecific low back pain with exercise therapy

Low back pain is a common health and social problem that occurs at all ages, with the highest incidence in the middle and old ages. According to the duration, low back pain can be divided into acute, subacute, and chronic low back pain. Most of them are chronic nonspecific clinically. Chronic nonspecific low back pain lasts for more than 12 weeks without a clear pathoanatomical cause. No specific evidence-based methods are recommended for clinicians to cure chronic nonspecific low back pain. Given of its unclear pathogenic factors, long duration, and prognostic recurrence, the quality of life of patients is seriously affected, resulting in a huge economic burden. The treatment of chronic nonspecific low back pain is numerous and varied, and no high-quality evidence study has shown which treatment is the best. Amongst them, exercise therapy has the characteristics of low harm, low cost, and easy implementation and has thus become the mainstream clinical treatment for improving chronic nonspecific low back pain. Exercise therapy is recommended for the treatment of chronic low back pain in the Chinese expert consensus on acute/chronic nonspecific low back pain and the American College of Physicians' clinical practice guidelines. However, the evidence is insufficient to determine which specific exercise method is more effective in treating chronic nonspecific low back pain at present. Exercise therapy primarily includes core-stability training, resistance training, aerobic exercise, stretching, Pilates, yoga, Tai Chi, and McKenzie therapy. With further research, the study on the exercise treatment of chronic nonspecific low back pain has increased. Using related literature, this paper systematically reviews the progress of domestic and foreign scholars on the treatment of chronic nonspecific low back pain with exercise therapy in recent years.