急性,亚急性和持续性腰部疼痛的临床过程:系统性审查和元分析
Sarah B Wallwork1, Felicity A Braithwaite2, Mary O'Keeffe2
1IIMPACT in Health (Wallwork, Braithwaite, Moseley), University of South Australia, Kaurna Country, Adelaide, Australia; Persistent Pain Research Group, Hopwood Centre for Neurobiology (Braithwaite), South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia; Institute for Musculoskeletal Health (O'Keeffe), School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia; School of Health Sciences and Physiotherapy (Travers), University of Notre Dame Australia, Fremantle, Australia; School of Biomedical Science (Summers), Queensland University of Technology, Queensland, Australia; Caring Futures Institute (Lange), College of Nursing and Health Sciences, Flinders University, Adelaide, Australia; Institute for Health Research (Hince), Faculty of Medicine, Nursing, Midwifery and Health Sciences, University of Notre Dame, Fremantle, Australia; Masters and Doctoral Programs in Physical Therapy (Costa, Menezes Costa), Universidade Cidade de São Paulo, São Paulo, Brazil; UniSA STEM (Chiera), University of South Australia, Kaurna Country, Adelaide, Australia sarah.wallwork@unisa.edu.au.
急性和亚急性腰痛在6周内显著改善. 持续的腰部疼痛表现出最小的改善,突出显示在亚急性病例中需要早期干预,以防止慢性化.
科学领域:
- 临床流行病学临床流行病学
- 肌肉骨系统疾病 肌肉骨系统疾病
背景情况:
- 了解腰部疼痛 (LBP) 的临床过程对于有效治疗和患者分层至关重要.
- 之前的系统性审查和元分析提供了洞察力,需要更新以纳入最近的研究.
研究的目的:
- 更新2012年关于急性,亚急性和持续性非特异性腰部疼痛的临床过程的系统综述和元分析.
- 为了更好地了解52周的疼痛和残疾轨迹.
主要方法:
- 搜索了Embase,MEDLINE和CINAHL数据库 (2011-2023) 对于潜在的初始队列研究.
- 包括报告参与者患有急性 (<6 周),亚急性 (6-<12 周) 或持续性 (12-<52 周) LBP 的研究.
- 使用混合模型计算疼痛和残疾的综合估计,纠正疼痛发病时间.
主要成果:
- 包括95项研究 (17,974名参与者进行审查,9,224人进行元分析).
- 急性LBP显示显著减少疼痛:56 (基线) 到21 (52周) (中等确定性).
- 亚急性LBP也有所改善:63 (基线) 到31 (52 wk) (中度确定性). 持续的LBP表现出最小的改善:56 (基线) 到40 (52 wk) (非常低的确定性).
- 残疾的结果略有有利于疼痛的结果.
结论:
- 急性和亚急性LBP在6周内表现出明显的改善.
- 持久性LBP的特点是高疼痛和残疾,随着时间的推移几乎没有变化.
- 针对缓慢恢复的亚急性LBP患者的干预措施对于防止过渡到慢性疼痛至关重要.


