慢性非特异性腰背痛患者康复运动的最佳证据总结  

Evidence summary of rehabilitation exercise interventions for patients with chronic nonspecific low back pain

作　　者：周欣可 吴明珑[1] 胡凯利 胡嘉欣 赖婷 Zhou Xinke;Wu Minglong;Hu Kaili;Hu Jiaxin;Lai Ting(Nursing Department,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院护理部,湖北武汉430030 [2]华中科技大学同济医学院护理学院

出　　处：《护理学杂志》2024年第22期10-15,共6页Journal of Nursing Science

基　　金：湖北省卫生健康委2023-2024年度科研项目(WJ2023F002)。

摘　　要：目的总结慢性非特异性腰背痛患者康复运动的最佳证据,为临床选择适宜的康复运动方案提供依据。方法计算机检索BMJ Best Practice,UpToDate,PubMed,Cochrane Library,Web of Science,Embase,JBI循证卫生保健中心数据库、中国生物医学文献数据库、中国知网、万方数据知识服务平台、维普网、医脉通、英国国家卫生与临床优化研究所网站、新西兰临床实践指南研究组、国际指南网中关于慢性非特异性腰背痛患者运动的证据,检索的文献类型包括临床决策、指南、证据总结、系统评价、专家共识等,检索时限为2013年1月至2024年5月。由2名经过循证知识培训的研究者对纳入的文献进行质量评价后,对符合质量要求的文献进行证据的提取、汇总。结果共纳入15篇文献。其中指南2篇,专家共识1篇,临床决策2篇,系统评价9篇,随机对照试验1篇;从运动获益及安全、运动方案制订、运动方案实施、运动类型、运动时间、运动监测6个方面进行整合,共汇总27条证据。结论康复运动疗法可有效缓解慢性非特异性腰背痛患者的疼痛,锻炼肌肉,增强脊柱稳定性,提升患者生活质量。医护人员应根据实际情况对证据进行选择,为患者制订安全、科学、个体化的运动计划,以促进患者康复。Objective To summarize the best evidence of rehabilitative exercise for patients with chronic nonspecific low back pain,and to provide a basis for clinical selection of appropriate rehabilitative exercise programs.Methods A computerized search was performed on Best Practice(BMJ),UpToDate,PubMed,Cochrane Library,Web of Science,Embase,Joanna Briggs Institute Evidence-Based Health Care Database,SinoMed,China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP Database,Medlive,the National Institute for Health and Care Excellence(NICE),New Zealand Guidelines Group(NZGG),Guidelines International Network(GIN)for evidence on exercise in patients with chronic nonspecific low back pain.The types of literature searched included clinical decision-making,guidelines,evidence summaries,systematic reviews,and expert consensus,and the time frame for the search was from January 2013 to May 2024.Two researchers trained in evidence-based knowledge evaluated the quality of the included literature,and then extracted and summarized the evidence from those literature that met the quality requirements.Results A total of 15 publications(2 guidelines,1 expert consensus statement,2 clinical decisions reports,1 randomized controlled trial and 9 systematic reviews)were included.A total of 27 pieces of evidence were summarized and 6 aspects integrated,namely,benefits and safety of exercise,development of exercise program,implementation of exercise program,type of exercise,duration of exercise,and exercise monitoring.Conclusion Rehabilitative exercise therapy can effectively relieve pain,exercise muscles,enhance spinal stability,and improve the quality of life in patients with chronic nonspecific low back pain.Medical staff should select the evidence according to the actual situation and develop a safe,scientific and individualized exercise plan for patients to promote their recovery.

关 键 词：慢性非特异性腰背痛 下腰痛 康复运动 有氧运动 抗阻运动 多组分运动 证据总结 循证护理 

分 类 号：R473.6[医药卫生—护理学]