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Abstract：
Low back pain (LBP) presents a significant burden globally, affecting individuals of all ages, but it is more common in adults aged 30-60 years old and demographics including race, ethnicity, and socioeconomic status. Physiotherapy interventions are commonly employed to manage LBP due to their non-invasive nature and potential for addressing underlying biomechanical dysfunctions. This comprehensive review aims to evaluate the efficacy of various physiotherapy strategies in alleviating LBP, considering a range of interventions and their associated outcomes. Through a thorough examination of existing literature from January 2017 to October 2023, this review synthesises evidence on the effectiveness of interventions such as manual therapy, exercise therapy, electrotherapy modalities, and education-based approaches. The review also scrutinizes the comparative effectiveness of different physiotherapy modalities and their suitability for specific patient populations, considering factors such as chronicity, severity, and underlying pathology. By critically evaluating the evidence base, this review aims to provide insights into the most effective physiotherapy strategies for alleviating LBP, chronic low back pain (CLBP) and chronic nonspecific low back pain (CNLBP) and guiding clinical practice toward evidence-based interventions. The Visual Analogue Scale and Numerical Pain Rating Scale for pain, Oswestry Disability Index and Roland-Morris Disability Questionnaire for disability, Modified-Modified Schober Test for measurement of lumbar flexion and extension and static and dynamic balance for assessing postural stability and balance were among the measures used to foresee enhancements in pain, disability, balance, and LBP symptoms. Twenty-one studies that fulfilled the criteria for inclusion (aged 20 to 50 years and of both genders) were added to the review. Exercises for core stability, strengthening, orthosis (a medical device designed to support, align, stabilise, or correct musculoskeletal structures and functions), transcutaneous electrical nerve stimulation, heat massage therapy, interferential current (a form of electrical stimulation used in physical therapy), Mulligan\'s mobilization (a manual therapy technique), low-level laser therapy, and McGill stabilization exercises (core exercises) were among the therapeutic strategies. The McKenzie method (back exercises), ultrasound, sensory-motor training, Swiss ball exercises, and other techniques reduced pain and enhanced strength, balance, and ease of daily activities. Every therapeutic approach has an impact on recovery rates ranging from minimal to maximal. Conventional physical therapy is less effective than most recent advanced techniques like mobilisation and exercises. In summary, the integration of manual techniques, orthoses and alternative intervention strategies with conservative therapeutic approaches can effectively alleviate pain, enhance function and yield better overall outcomes. To get more information about the optimal dosage, therapeutic modalities and long-term effects of these treatments, more admirable research is required. This paper aims to expand the scientific discourse by exploring non-traditional physiotherapy interventions and assessing their efficacy in light of the rigorous standards set forth by the latest WHO guidelines.
摘要：
下腰痛（LBP）在全球范围内带来了巨大的负担，影响所有年龄段的人，但在30-60岁的成年人和包括种族在内的人口统计学中更常见，种族,和社会经济地位。物理治疗干预通常用于管理LBP，因为它们具有非侵入性和解决潜在生物力学功能障碍的潜力。这篇综合综述旨在评估各种物理治疗策略在缓解LBP方面的疗效，考虑一系列干预措施及其相关结果。通过对2017年1月至2023年10月现有文献的全面审查，这篇综述综合了手动治疗等干预措施有效性的证据。运动疗法,电疗方式，和基于教育的方法。该综述还审查了不同物理治疗方式的相对有效性及其对特定患者人群的适用性。考虑到诸如慢性等因素，严重程度,和潜在的病理学。通过批判性地评估证据基础，这篇综述旨在提供对缓解LBP最有效的物理治疗策略的见解，慢性下腰痛（CLBP）和慢性非特异性下腰痛（CNLBP），并指导临床实践以循证干预。疼痛的视觉模拟量表和数字疼痛评分量表，Oswestry残疾指数和Roland-Morris残疾问卷，用于测量腰椎屈曲和伸展的改良Schober测试以及用于评估姿势稳定性和平衡的静态和动态平衡是用于预测疼痛增强的措施之一。残疾,balance,和LBP症状。21项符合纳入标准的研究（20至50岁，两种性别）被添加到审查中。核心稳定性练习，加强,矫形器(一种医疗设备，旨在支持，对齐,稳定，或纠正肌肉骨骼结构和功能)，经皮神经电刺激,热按摩疗法,干扰电流（物理治疗中使用的电刺激的一种形式），Mulligan的动员（一种手动治疗技术），低水平激光治疗，麦吉尔稳定运动(核心运动)是治疗策略之一。麦肯齐方法(背部练习)，超声，感觉运动训练,瑞士球练习，和其他技术减少疼痛和增强力量，balance,和日常活动的方便。每种治疗方法都对从最小到最大的恢复率产生影响。传统的物理疗法不如动员和锻炼等最新的先进技术有效。总之,手动技术的集成，矫形器和保守治疗方法的替代干预策略可以有效缓解疼痛，增强功能，产生更好的整体结果。为了获得有关最佳剂量的更多信息，这些治疗的治疗方式和长期效果，需要更多令人钦佩的研究。本文旨在通过探索非传统物理治疗干预措施并根据最新的WHO指南规定的严格标准评估其疗效，来扩展科学话语。
