Učinki terapevtske vadbe na zmanjšanje bolečine pri osebah s kronično bolečino v spodnjem delu hrbta: pregled literature : diplomsko delo

Golja, Aljaž (author), Vauhnik, Renata (mentor), Hlebš, Sonja (reviewer)

Uvod: Kronična bolečina v spodnjem delu hrbta predstavlja v svetovnem merilu enega glavnih vzrokov za omejitev dejavnosti splošne populacije. Problematika vodi do zmanjšane kakovosti življenja, spremembe življenjskega sloga, daljše odsotnosti z dela ter posledično do socialno ekonomskih težav. Terapevtska vadba predstavlja eno najpomembnejših komponent zdravljenja. Kljub temu, da dokazi kažejo na sorazmerno učinkovitost terapevtske vadbe, še vedno ne vemo, katera vrsta terapevtske vadbe je najprimernejša. Namen: Analizirati učinke terapevtske vadbe na zmanjšanje bolečine pri osebah s kronično bolečino v spodnjem delu hrbta Metode dela: Iskanje literature je potekalo v podatkovni bazi PubMed. Rezultati: Analiziranih je bilo devet randomiziranih kontroliranih raziskav z ocenami po PEDro lestvici od 5 do 8. Raziskave so vključevale skupno 717 preiskovancev. Za namen ocenjevanja intenzitete bolečine je bila najpogosteje uporabljena vizualna analogna lestvica, sledila ji je numerična lestvica. V raziskavah so primerjali terapevtsko vadbo z drugo vadbo, s placebom, z nedejavnostjo ali s splošno obravnavo kronične bolečine v spodnjem delu hrbta. Intenziteta bolečine je bila v osmih analiziranih raziskavah nižja po intervenciji, v primerjavi z meritvijo pred intervencijo. V eksperimentalnih skupinah se je bolečina zmanjšala največ za 13,2 in najmanj za 4,7 na 101-stopenjski lestvici. V eksperimentalnih skupinah, v katerih so uporabili enajststopenjsko lestvico, se je bolečina zmanjšala največ za 4,7 in najmanj za 0,9. V kontrolnih skupinah se je bolečina zmanjšala največ za 14,0 in najmanj za 8,5 na 101-stopenjski lestvici, vendar pa je v eni raziskavi prišlo tudi do povečanja bolečine za 3,5. V kontrolnih skupinah, v katerih so uporabili enajststopenjsko lestvico, se je bolečina zmanjšala največ za 2,81 in najmanj za 0,1. Statistično značilno zmanjšanje bolečine so ugotovili v štirih raziskavah, vrednosti p so ob tem znašale med 0,04 in 0,001. Razprava in zaključek: Terapevtska vadba je sorazmerno učinkovit pristop pri obravnavi kronične bolečine v spodnjem delu hrbta. Izkazala se je kot učinkovit pristop za zmanjšanje bolečine kratkoročno takoj po intervenciji. Dolgoročni učinki so bili bistveno manjši, zato lahko sklepamo, da je za obvladovanje kronične bolečine v spodnjem delu hrbta potrebna vadba, ki traja daljše časovno obdobje.

• Language: Slovenian
• Keywords: diplomska dela, fizioterapija, bolečina v spodnjem delu hrbta, kronične bolečine, telesna vadba
• Work type: Bachelor thesis/paper
• Typology: 2.11 - Undergraduate Thesis
• Organization: ZF - Faculty of Health Sciences
• Place of publishing: Ljubljana
• Publisher: [A. Golja]
• Year: 2022
• Number of pages: 27 str.
• PID: 20.500.12556/RUL-139168
• UDC: 615.8
• COBISS.SI-ID: 119889411
• Publication date in RUL: 01.09.2022

Secondary language

• Language: English
• Title: The effects of exercise therapy on decreasing pain intensity in people with chronic low back pain: literature review : diploma work

Abstract

Introduction: Chronic lower back pain is one of the leading causes of activity limitation in the general population worldwide. It leads to a reduced lower quality of life, lifestyle changes, prolonged absenteeism from work and, consequently, to negative socio-economic effects. Therapeutic exercise represents one of the most important components for the treatment of lower back pain. Although evidence suggests that therapeutic exercise is relatively effective, not enough is known on which type of therapeutic exercise seems to be the most effective. Purpose: To analyse the effects of therapeutic exercise on pain reduction in people with chronic lower back pain. Methods: A literature search was performed in PubMed. Results: Nine randomised controlled trials with PEDro scores ranging from 5 and 8 were analysed. The studies included a total of 717 participants. A visual analogue scale was the most commonly used to assess pain intensity, followed by a numerical scale. The studies compared therapeutic exercise with other types of exercise, placebo, inactivity or a general treatment of chronic lower back pain. In the eight studies analysed, pain intensity was lower after the intervention in comparison with the pre-intervention measurement. In the experimental groups, pain was reduced by a maximum of 13.2 and a minimum of 4.7 on a 101-point scale. In the experimental groups, pain decreased by a maximum of 4.7 and a minimum of 0.9 on a 11-point scale. In the control groups, pain decreased by a maximum of 14.0 and a minimum of 8.5 on the 101-point scale. However, in one study pain increased by 3.5. In the control groups, pain decreased by a maximum of 2.81 and a minimum of 0.1 on the 11-point scale. Statistically significant reductions in pain were reported in four studies, with p-values ranging from 0.04 to 0.001. Discussion and Conclusion: Therapeutic exercise represents a relatively effective approach for the treatment of chronic lower back pain. It has been shown to be an effective option for short-term pain reduction immediately after the intervention. Given that long-term effects were significantly lower, we can assume that therapeutic exercise over a longer period of time is required to manage chronic lower back pain.

• Keywords: diploma theses, physiotherapy, lower back pain, chronic pain, therapeutic exercise