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Non-spesifik kronik bel ağrılı hastalarda aerobik egzersiz programının etkisi

Year 2020, Volume: 45 Issue: 4, 1372 - 1383, 27.12.2020
https://doi.org/10.17826/cumj.731853

Abstract

Amaç: Egzersiz tedavisi, kronik non-spesifik bel ağrısı (NSKBA) tanısı alan hastalarda en yaygın önerilen tedavi şeklidir. Ancak bir egzersiz yönteminin başka bir egzersiz yöntemine üstün olup olmadığı tartışmalıdır.
Gereç ve Yöntem: Bu çalışmada NSKBA olan hastalar deney grubu (gözetimli aerobik egzersiz + ev egzersizi) ve kontrol grubu (sadece ev egzersizi) olmak üzere iki gruba randomize edildi. Hastalar tedavi öncesi, tedavi bitimi ve tedavi bitiminden üç ay sonra ağrı şiddeti, spinal mobilite, lomber ektansör kas dayanıklılığı, depresif semptom varlığı ve şiddeti, özürlülük ve yaşam kalitesi bakımından değerlendirildi.
Bulgular: Deney grubunda tüm değerlendirmelerde anlamlı düzelme saptanırken kontrol grubunda, ağrı, spinal mobilite ve yaşam kalitesinin fiziksel komponentinde anlamlı düzelme saptandı. Kontrol grubuna göre, deney grubunda değerlendirme parametrelerinde zamanla meydana gelen olumlu değişim anlamlı olarak daha yüksekti.
Sonuç: Aerobik egzersiz, NSKBA olan hastaların yetersizliklerinin düzeltmesine, aktivite düzeylerinin ve katılım düzeylerinin arttırılmasına katkı sağlayabilir. Ancak hangi aerobik egzersiz tipinin (sıklığının, süresinin ve yoğunluğunun) daha etkili olduğuna yönelik çalışmalara ihtiyaç vardır.

References

  • 1. vanTulder MW, Assendelft WJ, Koes BW, Bouter LM. Spinal radiographic findings and non specific low back pain. A systematic review of observational studies. Spine (PhilaPa 1976). 1997;22:427–34. 2. Main CJ, Waddell G. Behavioral responses to examination: a reappraisal of the interpretation of non organic signs. Spine. 1998; 23:2367-71. 3. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet 2017;389:736-47. 4. van Middelkoop M, Rubinstein SM, Verhagen AP, Ostelo RW, Koes BW, van Tulder MW. Exercise therapy for chronic non specific low back pain. Best Pract Res Clin Rheumatol. 2010;24:193-204. 5. Verbunt JA, Seelen HA, Vlaeyen JW, van de Heijden GJ, Heuts PH, Pons K, Knottnerus JA. Disuse and deconditioning in chronic low back pain: concepts and hypotheses on contributing mechanisms. Eur J Pain. 2003;7:9-21. 6. Stoppler MC, Shiel W. Endorphins: natural pain and stress fighters: Diperoleh Tanggal. 2014. 7. Wertli MM, Rasmussen-Barr E, Held U, Weiser S, Bachmann LM, Brunner F. Fear-avoidance beliefs-a moderator of treatment efficacy in patients with low back pain: a systematic review. Spine J. 2014; 14:2658-78. 8. Hayden JA, vanTulder MW, Malmivaara A, Koes BW. Exercise therapy for treatment of non-specific low back pain. Cochrane Database SystRev. 2005; (3):CD000335. 9. Meng XG, Yue SW. Efficacy of aerobic exercise for treatment of chronic low back pain: a meta-analysis. Am J Phys Med Rehabil. 2015;94:358-65. 10. Melzack R. Theshort-form McGill Pain Questionnaire. Pain. 1987;30:191-7. 11. Yakut Y, Yakut E, Bayar K, Uygur F. Reliability and validity of the Turkish version short-form McGill pain questionnaire in patients with rheumatoid arthritis. Clin Rheumatol. 2007;26:1083-7. 12. Macrael IF, Wright V. Measurement of back movement. Ann Rheum Dis. 1969; 28:584-9. 13. Demoulin C, Vanderthommen M, Duysens C, Crielaard JM. Spinal muscle evaluation using the Sorensen test: a critical appraisal of the literature. Joint Bone Spine. 2006;73:43-50. 14. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Archives of General Psychiatry. 1961;4:561-71. 15. Hisli N. Beck depresyon envanterinin üniversite öğrencileri için geçerliği, güvenirliği. Psikoloji Dergisi 1989; 7: 3-13. 16. Roland M, Morris R. A study of the natural history of back pain. Spine. 1983;8:141-4. 17. Kucukdeveci AA, Tennant A, Elhan AH, Niyazoglu H. Validation of the Turkish version of the Roland Morris Disability Questionnaire for use in low back pain. Spine. 2001; 26:2738–43. 18. Ware JE, Jr. SF-36 health survey update. Spine (PhilaPa 1976). 2000;25:3130-9. 19. Kocyigit H, Aydemir O, Fisek G, Olmez N, Memis A. Validity and reliability of Turkish version of Short form 36: A study of a patients with romatoid disorder. Journal of Drug andTherapy (in Turkish). 1999;12:102-6. 20. Owen PJ, Miller CT, Mundell NL, Verswijveren SJ, Tagliaferri SD, Brisby H, Bowe SJ, Belavy DL. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. Br J Sports Med. 2019 Oct 30. pii: bjsports-2019-100886. doi: 10.1136/bjsports-2019-100886. 21. Wewege MA, Booth J, Parmenter BJ. Aerobic vs. resistance exercise for chronic non-specific low back pain: A systematicreviewand meta-analysis. J Back Musculoskelet Rehabil. 2018;31:889-99. 22. Sitthipornvorakul E, Klinsophon T, Sihawong R, Janwantanaku P. The effects of walking intervention in patients with chronic low back pain: A metaanalysis of randomized controlled trials. Musculoskelet SciPract. 2018;34:38-46. 23. Kim H, Min TJ, Kang SH, Kim DK, Seo KM, Lee SY. Association Between Walking and Low Back Pain in the Korean Population: A Cross-Sectional Study. Ann Rehabil Med. 2017;41:786-92. 24. Tawashy AE, Eng JJ, Krassioukov AV, Miller WC, Sproule S. Aerobic exercise during early rehabilitation for cervical spinal cord injury. Phys Ther. 2010;90:427-37. 25. Konopka AR, Douglass MD, Kaminsky LA, et al: Molecula radaptations to aerobic exercise training in skeletalmuscle of older women. J Gerontol A Biol Sci Med Sci. 2010;65:1201-7. 26. Bayramoğlu M, Akman MN, Kilinç S, Cetin N, Yavuz N, Ozker R. Isokinetic measurement of trunk muscle strength in women with chronic low back pain. 2001. Am J Phys Med Rehabil 80:650–5. 27. Koldaş Doğan S, Sonel Tur B, KurtaişY, Atay MB. Comparison of three different approaches in the treatment of chronic low back pain. Clin Rheumatol. 2008;27:873-81. 28. Mannion AF, Müntener M, Taimela S, Dvorak J. Comparison of three active therapies for chronic low back pain: results of a randomized clinical trial with one-year follow-up. Rheumatol. 2001;40:772–8. 29. Pergolizzi JV Jr, LeQuang JA. Rehabilitation for Low Back Pain: A Narrative Review for Managing Pain and Improving Function in Acute and Chronic Conditions Pain Ther. 2020 Jan 31. doi: 10.1007/s40122-020-00149-5. 30. Tritilanunt T, WajanavisitW. The efficacy of an aerobic exercise and health education program for treatment of chronic low back pain. J Med Assoc Thai. 2001;84 (Suppl. 2):S528–33. 31. Rainville J, Jouve CA, Hartigan C, Martinez E, Hipona M. Comparison of short- and long term outcomes for aggressive spine rehabilitation delivered two versus three times per week. Spine J. 2002;2:402–7. 32. Rainville J, Hartigan C, Martinez E, Limke J, Jouve C, Finno M. Exercise as a treatment for chronic low back pain. Spine J. 2004;4:106–15. 33. Taimela S, Diederich C, Hubsch M, Heinricy M. The role of physical exercise and inactivity in pain recurrence and absenteeism from work after active outpatient rehabilitation for recurrent or chronic low back pain. Spine. 2000;25:1809–16. 34. Mbada CE, Ayanniyi O, Ogunlade SO, Orimolade EA, Oladiran AB, Ogundele AO. Influence of Mckenzie protocol and two modes of endurance exercises on health-related quality of life of patients with long-term mechanical low-back pain. Pan Afr Med J. 2014;17(Supp 1):5 35. Natour J, CazottiLde A, Ribeiro LH, Baptista AS, Jones A. Pilates improves pain, function and quality of life in patients with chronic low back pain: a randomized controlled trial. Clin Rehabil. 2015;29:59-68. 36. Vanti C, Andreatta S, Borghi S, Guccione AA, Pillastrini P, Bertozzi L. The effectiveness of walking versus exercise on pain and function in chronic low back pain: a systematic review and meta-analysis of randomized trials. Disability and Rehabilitation. 2019; 41:622-32.

Effect of aerobic exercise program in patients with non-specific chronic low back pain

Year 2020, Volume: 45 Issue: 4, 1372 - 1383, 27.12.2020
https://doi.org/10.17826/cumj.731853

Abstract

Purpose: Exercise therapy is the most commonly recommended form of treatment for patients diagnosed with non-specific chronic low back pain (NSCBP). However, it is controversial whether an exercise method is superior to other ones.
Materials and Methods: In this study, patients with NSCBP were randomized into two groups as experimental group (supervised aerobic exercise + home-based exercise) and control group (home-based exercise alone). The patients were evaluated in terms of pain severity, spinal mobility, lumbar extensor muscle endurance, presence and severity of depressive symptoms, disability, and quality of life at the time points of before treatment, treatment ends, and three months after treatment ends.
Results: In the experimental group, there was a significant improvement in all assessments, while in the control group, there was a significant improvement in pain severity, spinal mobility, and the physical component of quality of life. In the experimental group, the positive change in assessment parameters over time was significantly higher than in the control group.
Conclusion: Aerobic exercise may contribute to correcting the impairments, increasing activity and participation levels of patients with NSCBP. However, studies are needed to determine which type of aerobic exercise (frequency, duration, and intensity of that type) is more effective.

References

  • 1. vanTulder MW, Assendelft WJ, Koes BW, Bouter LM. Spinal radiographic findings and non specific low back pain. A systematic review of observational studies. Spine (PhilaPa 1976). 1997;22:427–34. 2. Main CJ, Waddell G. Behavioral responses to examination: a reappraisal of the interpretation of non organic signs. Spine. 1998; 23:2367-71. 3. Maher C, Underwood M, Buchbinder R. Non-specific low back pain. Lancet 2017;389:736-47. 4. van Middelkoop M, Rubinstein SM, Verhagen AP, Ostelo RW, Koes BW, van Tulder MW. Exercise therapy for chronic non specific low back pain. Best Pract Res Clin Rheumatol. 2010;24:193-204. 5. Verbunt JA, Seelen HA, Vlaeyen JW, van de Heijden GJ, Heuts PH, Pons K, Knottnerus JA. Disuse and deconditioning in chronic low back pain: concepts and hypotheses on contributing mechanisms. Eur J Pain. 2003;7:9-21. 6. Stoppler MC, Shiel W. Endorphins: natural pain and stress fighters: Diperoleh Tanggal. 2014. 7. Wertli MM, Rasmussen-Barr E, Held U, Weiser S, Bachmann LM, Brunner F. Fear-avoidance beliefs-a moderator of treatment efficacy in patients with low back pain: a systematic review. Spine J. 2014; 14:2658-78. 8. Hayden JA, vanTulder MW, Malmivaara A, Koes BW. Exercise therapy for treatment of non-specific low back pain. Cochrane Database SystRev. 2005; (3):CD000335. 9. Meng XG, Yue SW. Efficacy of aerobic exercise for treatment of chronic low back pain: a meta-analysis. Am J Phys Med Rehabil. 2015;94:358-65. 10. Melzack R. Theshort-form McGill Pain Questionnaire. Pain. 1987;30:191-7. 11. Yakut Y, Yakut E, Bayar K, Uygur F. Reliability and validity of the Turkish version short-form McGill pain questionnaire in patients with rheumatoid arthritis. Clin Rheumatol. 2007;26:1083-7. 12. Macrael IF, Wright V. Measurement of back movement. Ann Rheum Dis. 1969; 28:584-9. 13. Demoulin C, Vanderthommen M, Duysens C, Crielaard JM. Spinal muscle evaluation using the Sorensen test: a critical appraisal of the literature. Joint Bone Spine. 2006;73:43-50. 14. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Archives of General Psychiatry. 1961;4:561-71. 15. Hisli N. Beck depresyon envanterinin üniversite öğrencileri için geçerliği, güvenirliği. Psikoloji Dergisi 1989; 7: 3-13. 16. Roland M, Morris R. A study of the natural history of back pain. Spine. 1983;8:141-4. 17. Kucukdeveci AA, Tennant A, Elhan AH, Niyazoglu H. Validation of the Turkish version of the Roland Morris Disability Questionnaire for use in low back pain. Spine. 2001; 26:2738–43. 18. Ware JE, Jr. SF-36 health survey update. Spine (PhilaPa 1976). 2000;25:3130-9. 19. Kocyigit H, Aydemir O, Fisek G, Olmez N, Memis A. Validity and reliability of Turkish version of Short form 36: A study of a patients with romatoid disorder. Journal of Drug andTherapy (in Turkish). 1999;12:102-6. 20. Owen PJ, Miller CT, Mundell NL, Verswijveren SJ, Tagliaferri SD, Brisby H, Bowe SJ, Belavy DL. Which specific modes of exercise training are most effective for treating low back pain? Network meta-analysis. Br J Sports Med. 2019 Oct 30. pii: bjsports-2019-100886. doi: 10.1136/bjsports-2019-100886. 21. Wewege MA, Booth J, Parmenter BJ. Aerobic vs. resistance exercise for chronic non-specific low back pain: A systematicreviewand meta-analysis. J Back Musculoskelet Rehabil. 2018;31:889-99. 22. Sitthipornvorakul E, Klinsophon T, Sihawong R, Janwantanaku P. The effects of walking intervention in patients with chronic low back pain: A metaanalysis of randomized controlled trials. Musculoskelet SciPract. 2018;34:38-46. 23. Kim H, Min TJ, Kang SH, Kim DK, Seo KM, Lee SY. Association Between Walking and Low Back Pain in the Korean Population: A Cross-Sectional Study. Ann Rehabil Med. 2017;41:786-92. 24. Tawashy AE, Eng JJ, Krassioukov AV, Miller WC, Sproule S. Aerobic exercise during early rehabilitation for cervical spinal cord injury. Phys Ther. 2010;90:427-37. 25. Konopka AR, Douglass MD, Kaminsky LA, et al: Molecula radaptations to aerobic exercise training in skeletalmuscle of older women. J Gerontol A Biol Sci Med Sci. 2010;65:1201-7. 26. Bayramoğlu M, Akman MN, Kilinç S, Cetin N, Yavuz N, Ozker R. Isokinetic measurement of trunk muscle strength in women with chronic low back pain. 2001. Am J Phys Med Rehabil 80:650–5. 27. Koldaş Doğan S, Sonel Tur B, KurtaişY, Atay MB. Comparison of three different approaches in the treatment of chronic low back pain. Clin Rheumatol. 2008;27:873-81. 28. Mannion AF, Müntener M, Taimela S, Dvorak J. Comparison of three active therapies for chronic low back pain: results of a randomized clinical trial with one-year follow-up. Rheumatol. 2001;40:772–8. 29. Pergolizzi JV Jr, LeQuang JA. Rehabilitation for Low Back Pain: A Narrative Review for Managing Pain and Improving Function in Acute and Chronic Conditions Pain Ther. 2020 Jan 31. doi: 10.1007/s40122-020-00149-5. 30. Tritilanunt T, WajanavisitW. The efficacy of an aerobic exercise and health education program for treatment of chronic low back pain. J Med Assoc Thai. 2001;84 (Suppl. 2):S528–33. 31. Rainville J, Jouve CA, Hartigan C, Martinez E, Hipona M. Comparison of short- and long term outcomes for aggressive spine rehabilitation delivered two versus three times per week. Spine J. 2002;2:402–7. 32. Rainville J, Hartigan C, Martinez E, Limke J, Jouve C, Finno M. Exercise as a treatment for chronic low back pain. Spine J. 2004;4:106–15. 33. Taimela S, Diederich C, Hubsch M, Heinricy M. The role of physical exercise and inactivity in pain recurrence and absenteeism from work after active outpatient rehabilitation for recurrent or chronic low back pain. Spine. 2000;25:1809–16. 34. Mbada CE, Ayanniyi O, Ogunlade SO, Orimolade EA, Oladiran AB, Ogundele AO. Influence of Mckenzie protocol and two modes of endurance exercises on health-related quality of life of patients with long-term mechanical low-back pain. Pan Afr Med J. 2014;17(Supp 1):5 35. Natour J, CazottiLde A, Ribeiro LH, Baptista AS, Jones A. Pilates improves pain, function and quality of life in patients with chronic low back pain: a randomized controlled trial. Clin Rehabil. 2015;29:59-68. 36. Vanti C, Andreatta S, Borghi S, Guccione AA, Pillastrini P, Bertozzi L. The effectiveness of walking versus exercise on pain and function in chronic low back pain: a systematic review and meta-analysis of randomized trials. Disability and Rehabilitation. 2019; 41:622-32.
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Details

Primary Language Turkish
Subjects Rehabilitation
Journal Section Research
Authors

Volkan Tekin 0000-0001-8341-8856

Şeniz Akçay 0000-0003-2267-0702

İlker Şengül 0000-0002-7675-7814

Taciser Kaya This is me 0000-0002-8848-8420

Altınay Goksel Karatepe This is me 0000-0001-8086-9942

Publication Date December 27, 2020
Acceptance Date July 31, 2020
Published in Issue Year 2020 Volume: 45 Issue: 4

Cite

MLA Tekin, Volkan et al. “Non-Spesifik Kronik Bel ağrılı Hastalarda Aerobik Egzersiz programının Etkisi”. Cukurova Medical Journal, vol. 45, no. 4, 2020, pp. 1372-83, doi:10.17826/cumj.731853.