运动/身体活动对脊柱相关疼痛患者运动恐惧的影响：一项系统综述。
Effects of exercise/physical activity on fear of movement in people with spine-related pain: a systematic review.
作者信息
Jadhakhan Ferozkhan, Sobeih Raghip, Falla Deborah
机构信息
Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.
出版信息
Front Psychol. 2023 Jul 27;14:1213199. doi: 10.3389/fpsyg.2023.1213199. eCollection 2023.
BACKGROUND
Kinesiophobia (i.e., fear of movement) can be an important contributor for ongoing pain and disability in people with spine-related pain. It remains unclear whether physical activity interventions/exercise influence kinesiophobia in this population. A systematic review was therefore conducted to synthesize the available evidence on whether physical activity interventions/exercise influence kinesiophobia in people with chronic non-specific spine-related pain.
METHODS
The study protocol was registered prospectively with PROSPERO (CRD42021295755). The following databases were systematically searched from inception to 31 January 2022 and updated on 22 June 2023: PubMed, MEDLINE, Embase, CINAHL, Web of Science, PsycINFO, ZETOC, PROSPERO and Google Scholar. Inclusion criteria were randomized or non-randomized controlled studies investigating adults aged ≥18 years, reporting the effect of exercise or physical activity on kinesiophobia in individuals with chronic non-specific spine-related pain. Two reviewers independently extracted data and assessed the quality of the included studies. Bias was assessed using the Cochrane ROB2 tool and evidence certainty via Grading of Recommendations Assessment, Development and Evaluation (GRADE).
RESULTS
Seventeen studies from seven countries involving a total of 1,354 individuals were selected for inclusion. The majority of studies ( = 13) involved participants with chronic low back pain (LBP), and Pilates was the most common form of exercise evaluated. Most of the studies reported a positive direction of effect in favor of exercise reducing kinesiophobia when compared to a control group. There was moderate to high risk of bias among the studies and the overall certainty of the evidence was very low.
CONCLUSION
This review supports the use of exercise for reducing kinesiophobia in people with chronic LBP albeit with very low certainty of evidence; Pilates (especially equipment-based) was shown to be effective as were strengthening training programmes. There was limited evidence available on the effects of exercise on kinesiophobia for people with chronic neck or thoracic pain and further research is required.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=295755.
背景
运动恐惧（即对运动的恐惧）可能是导致脊柱相关疼痛患者持续疼痛和残疾的重要因素。目前尚不清楚体育活动干预/锻炼是否会影响该人群的运动恐惧。因此，进行了一项系统评价，以综合现有证据，探讨体育活动干预/锻炼是否会影响慢性非特异性脊柱相关疼痛患者的运动恐惧。
方法
该研究方案已在国际前瞻性系统评价注册库（PROSPERO，注册号：CRD42021295755）进行前瞻性注册。从数据库创建至2022年1月31日对以下数据库进行了系统检索，并于2023年6月22日更新：PubMed、MEDLINE、Embase、护理学与健康领域数据库（CINAHL）、科学引文索引（Web of Science）、心理学文摘数据库（PsycINFO）、英国国家学术会议录数据库（ZETOC）、PROSPERO和谷歌学术。纳入标准为针对≥18岁成年人的随机或非随机对照研究，报告运动或体育活动对慢性非特异性脊柱相关疼痛个体运动恐惧的影响。两名评审员独立提取数据并评估纳入研究的质量。使用Cochrane偏倚风险评估工具（ROB2）评估偏倚，并通过推荐分级的评估、制定与评价（GRADE）方法评估证据的确定性。
结果
共纳入来自7个国家的17项研究，涉及1354名个体。大多数研究（n = 13）的参与者患有慢性腰痛（LBP），普拉提是评估的最常见运动形式。与对照组相比，大多数研究报告了运动在减轻运动恐惧方面的积极效果。这些研究存在中度至高偏倚风险，证据的总体确定性非常低。
结论
本综述支持使用运动来减轻慢性腰痛患者的运动恐惧，尽管证据的确定性很低；普拉提（尤其是器械辅助的）和强化训练计划被证明是有效的。关于运动对慢性颈部或胸部疼痛患者运动恐惧影响的证据有限，需要进一步研究。
系统评价注册信息
https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=295755 。
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