Andrew Bastianon, Dr Lianne Wood, Mr Yannick Gilanyi, Mr Harrison Hansford, Dr Mitchell T. Gibbs, Prof Sarah Dean, Prof Nadine Foster, Dr Jill Hayden, Matthew D Jones
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Random-effects meta-analysis was performed in R for PI and FL at the closest time point post-intervention. We used predefined subgroups of exercise adherence of ‘Good’ (90-100%), ‘Moderate’ (70-89%), or ‘Poor’ (14-69%) adherence. We used the risk of bias judgements provided by Cochrane.\n \n \n \n All trials included were deemed low risk of bias. Compared to usual care, ‘Good’ adherence was associated with reduced PI by 17.83 points on a 100-point scale (95% CI -26.23 to -9.43; I2 = 81.7%) and FL by 9.69 points on a 100-point scale (95% CI -12.64 to -6.74; I2 = 18.9%). ‘Moderate’ adherence was associated with reduced PI by 6.93 points (95% CI -10.43 to -3.44; I2 = 18.3%) and FL by 3.80 points (95% CI -6.10 to -1.49; I2 = 0%). ‘Low’ adherence was associated with reduced PI by 7.50 points (95% CI -19.83 to -4.84; I2 = 89.7%) and FL by 3.35 points (95% CI -10.45 to -3.74; I2 = 82.7%).\n \n \n \n Greater adherence to exercise is associated with greater improvements in PI and FL in adults with CNSLBP. Further research is needed to understand the causal effect of adherence on patient-reported outcomes. 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However, the benefits of exercise diminish over time, as does adherence to exercise. It is unclear whether greater exercise adherence is associated with improvements in pain intensity (PI) and functional limitation (FL). We explored the relationship between exercise adherence and patient-reported outcomes in people with CNSLBP.\\n \\n \\n \\n We conducted a secondary analysis of the Cochrane systematic review, ‘Exercise therapy for chronic low back pain’, using a subset of 24 trials that measured exercise adherence compared to usual care. Random-effects meta-analysis was performed in R for PI and FL at the closest time point post-intervention. We used predefined subgroups of exercise adherence of ‘Good’ (90-100%), ‘Moderate’ (70-89%), or ‘Poor’ (14-69%) adherence. We used the risk of bias judgements provided by Cochrane.\\n \\n \\n \\n All trials included were deemed low risk of bias. 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引用次数: 0
摘要
运动被广泛认为是治疗慢性非特异性腰背痛(CNSLBP)的一线疗法。然而,随着时间的推移,运动的益处会逐渐减少,坚持运动的程度也是如此。目前尚不清楚坚持锻炼是否与疼痛强度(PI)和功能限制(FL)的改善有关。我们探讨了中枢神经系统慢性阻塞性脑病患者坚持锻炼与患者报告结果之间的关系。 我们对 Cochrane 系统综述 "慢性腰背痛的运动疗法 "进行了二次分析,使用了 24 项试验的子集,这些试验与常规护理相比,对运动依从性进行了测量。在 R 中对干预后最近时间点的 PI 和 FL 进行了随机效应荟萃分析。我们采用了预先设定的运动依从性亚组,即 "良好"(90%-100%)、"中等"(70%-89%)或 "较差"(14%-69%)依从性。我们采用了 Cochrane 提供的偏倚风险判断。 所有纳入的试验均被认为偏倚风险较低。与常规护理相比,"良好 "依从性与 PI 下降有关,按 100 分制计算,PI 下降 17.83 分(95% CI -26.23 至 -9.43;I2 = 81.7%),按 100 分制计算,FL 下降 9.69 分(95% CI -12.64 至 -6.74;I2 = 18.9%)。中度 "依从性与 PI 降低 6.93 分(95% CI -10.43 至 -3.44;I2 = 18.3%)和 FL 降低 3.80 分(95% CI -6.10 至 -1.49;I2 = 0%)有关。低 "坚持率与 PI 下降 7.50 个点(95% CI -19.83 至 -4.84;I2 = 89.7%)和 FL 下降 3.35 个点(95% CI -10.45 至 -3.74;I2 = 82.7%)有关。 对于患有 CNSLBP 的成年人来说,更坚持锻炼与 PI 和 FL 的改善幅度更大相关。要了解坚持锻炼对患者报告结果的因果效应,还需要进一步的研究。还需要在随机试验中更好地报告这一潜在的重要运动参数。
ADHERENCE TO PRESCRIBED EXERCISE AND CLINICAL OUTCOMES IN PEOPLE WITH CHRONIC NONSPECIFIC LOW BACK PAIN: A SYSTEMATIC REVIEW AND META-ANALYSIS
Exercise is widely accepted as a first-line treatment for chronic non-specific low back pain (CNSLBP). However, the benefits of exercise diminish over time, as does adherence to exercise. It is unclear whether greater exercise adherence is associated with improvements in pain intensity (PI) and functional limitation (FL). We explored the relationship between exercise adherence and patient-reported outcomes in people with CNSLBP.
We conducted a secondary analysis of the Cochrane systematic review, ‘Exercise therapy for chronic low back pain’, using a subset of 24 trials that measured exercise adherence compared to usual care. Random-effects meta-analysis was performed in R for PI and FL at the closest time point post-intervention. We used predefined subgroups of exercise adherence of ‘Good’ (90-100%), ‘Moderate’ (70-89%), or ‘Poor’ (14-69%) adherence. We used the risk of bias judgements provided by Cochrane.
All trials included were deemed low risk of bias. Compared to usual care, ‘Good’ adherence was associated with reduced PI by 17.83 points on a 100-point scale (95% CI -26.23 to -9.43; I2 = 81.7%) and FL by 9.69 points on a 100-point scale (95% CI -12.64 to -6.74; I2 = 18.9%). ‘Moderate’ adherence was associated with reduced PI by 6.93 points (95% CI -10.43 to -3.44; I2 = 18.3%) and FL by 3.80 points (95% CI -6.10 to -1.49; I2 = 0%). ‘Low’ adherence was associated with reduced PI by 7.50 points (95% CI -19.83 to -4.84; I2 = 89.7%) and FL by 3.35 points (95% CI -10.45 to -3.74; I2 = 82.7%).
Greater adherence to exercise is associated with greater improvements in PI and FL in adults with CNSLBP. Further research is needed to understand the causal effect of adherence on patient-reported outcomes. Better reporting of this potentially important exercise parameter in randomised trials is also needed.