不同核心肌训练对慢性非特异性下腰痛患者疼痛和功能治疗效果的荟萃分析

摘要(中文译文)

比较特定核心肌群训练方式——核心稳定性训练、悬吊运动疗法（SET）、普拉提和呼吸训练——与非核心训练对照对慢性非特异性下背痛（CNLBP）患者疼痛和功能的影响。系统检索了来自PubMed、Web of Science和Cochrane Library的随机对照试验（RCT）。采用RevMan中的随机效应荟萃分析对33项RCT（涉及1，757例患者）进行分析，并按训练类型、模式和时长进行亚组分析。核心稳定性训练显著减轻疼痛（SMD = -0.95，95% CI：-1.35至-0.55）并改善功能（SMD = -1.09，95% CI：-1.63至-0.55），尽管异质性较高（ = 93%-95%）。在缓解疼痛方面，SET（SMD = -1.43）和普拉提（SMD = -1.48）效果最强，其次是呼吸训练（SMD = -0.75）；传统核心稳定性训练效果较差（SMD = -0.36）。在功能改善方面，SET（SMD = -2.60）和联合干预（SMD = -1.07）优于单一训练。短期（<8周）SET产生了显著获益，而长期（≥8周）呼吸训练维持了效果。核心肌群训练可减轻CNLBP患者的疼痛并增强功能。SET和普拉提具有显著的短期镇痛效果，而联合干预更有效地改善功能。临床方案应个体化，未来研究必须标准化参数并检验多模式协同效应。：标识符：CRD420251031252。

Abstract

To compare the effects of specific core muscle training modalities-core stability training, sling exercise therapy (SET), Pilates, and breathing training-vs. non-core-training controls on pain and function in patients with chronic nonspecific low back pain (CNLBP). Randomized controlled trials (RCTs) from PubMed, Web of Science, and Cochrane Library were systematically searched. Thirty-three RCTs involving 1,757 patients were analyzed using random-effects meta-analysis in RevMan, with subgroup analyses by training type, mode, and duration. Core stability training significantly reduced pain (SMD = -0.95, 95% CI: -1.35 to -0.55) and improved function (SMD = -1.09, 95% CI: -1.63 to -0.55), despite high heterogeneity ( = 93%-95%).For pain relief, SET (SMD = -1.43) and Pilates (SMD = -1.48) showed the strongest effects, followed by breathing training (SMD = -0.75); conventional core stability training was less effective (SMD = -0.36). For functional improvement, SET (SMD = -2.60) and combined interventions (SMD = -1.07) outperformed single training. Short-term (<8 weeks) SET yielded prominent benefits, while long-term (≥8 weeks) breathing training sustained effects. Core muscle training alleviates pain and enhances function in CNLBP. SET and Pilates offer notable short-term analgesia, whereas combined interventions improve function more effectively. Clinical protocols should be individualized, and future studies must standardize parameters and examine multimodal synergies. : identifier: CRD420251031252.

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