背景:双重任务条件,涉及同时执行两项任务,可能会加剧疼痛并进一步损害腰背痛(LBP)患者的日常功能。了解双重任务条件对LBP患者姿势控制的影响对于制定有效的康复计划至关重要。我们的目的是研究与没有LBP的人相比,双重任务条件对LBP的姿势控制的影响。
方法:我们通过PubMed对Medline进行了全面搜索,Scopus,Cochrane中央受控试验登记册,WebofScience,和EMBASE数据库,没有语言限制,从成立到2023年1月1日。研究的主要结果指标是速度,area,振幅,相平面肖像,以及压力中心的路径/摇摆长度(CoP)。计算标准化平均差(SMD)效应大小,并使用纽卡斯尔-渥太华量表(NOS)评估研究质量。
结果:来自196项研究,5名符合纳入标准的242名成人(≥18岁).三项研究被评为高质量,而两个被认为是温和的。在纳入的研究中,140名参与者有非特异性LBP,虽然102名参与者没有报告任何症状,平均年龄为36.68(±14.21)和36.35(±15.39)岁,分别。三项研究有两种性别,其中一个只包括女性,一个人没有说明性别。主要结局的荟萃分析显示,在容易和困难的姿势任务和认知负荷的速度(容易:SMD-0.09,95%CI-0.91至0.74;困难:SMD0.12,95%CI-0.67至0.91)期间,LBP患者与无痛对照组之间的姿势控制没有显着差异。面积(容易:SMD0.82,95%CI-2.99至4.62;困难:SMD0.14,95%CI-2.62至2.89),相平面(容易:SMD-0.59,95%CI-1.19至0.02;困难:SMD-0.18,95%CI-0.77至0.42),路径/摇摆长度(容易:SMD-0.18,95%CI-0.77至0.42;困难:SMD-0.14,95%CI-0.84至0.55),和振幅(容易:SMD0.89,95%CI-1.62至3.39;困难:SMD1.31,95%CI-1.48至4.10)。
结论:目前的证据表明,在双任务条件下,非特异性LBP个体和无痛受试者之间的姿势控制参数没有显着差异。然而,由于现有研究数量有限,显著的出版偏见,和相当大的统计异质性,无法得出明确的结论。因此,需要进一步研究,包括具有更大样本量的高质量研究,以获得结论性结果.试用注册PROSPEROCRD42022359263。
BACKGROUND: Dual-task conditions, which involve performing two tasks simultaneously, may exacerbate pain and further impair daily functioning in individuals with low back pain (LBP). Understanding the effects of dual-task conditions on postural control in patients with LBP is crucial for the development of effective rehabilitation programs. Our objective was to investigate the impact of dual-task conditions on postural control in individuals with LBP compared to those without LBP.
METHODS: We conducted a comprehensive search of Medline via PubMed, Scopus, the Cochrane Central Register of Controlled Trials, Web of Science, and EMBASE databases, with no language restrictions, from inception to January 1, 2023. The primary outcome measures of the study were velocity, area, amplitude, phase plane portrait, and path/sway length of the center of pressure (CoP). Standardized mean difference (SMD) effect sizes were calculated, and the quality of the studies was assessed using the Newcastle-Ottawa Scale (NOS).
RESULTS: From 196 studies, five involving 242 adults (≥ 18 years) met the inclusion criteria. Three studies were rated as high quality, while two were deemed moderate. In the included studies, 140 participants had non-specific LBP, while 102 participants did not report any symptoms, with mean ages of 36.68 (± 14.21) and 36.35 (± 15.39) years, respectively. Three studies had both genders, one exclusively included females, and one did not specify gender. Meta-analyses of primary outcomes revealed no significant differences in postural control between patients with LBP and pain-free controls during both easy and difficult postural tasks and cognitive load for velocity (easy: SMD - 0.09, 95% CI - 0.91 to 0.74; difficult: SMD 0.12, 95% CI - 0.67 to 0.91), area (easy: SMD 0.82, 95% CI - 2.99 to 4.62; difficult: SMD 0.14, 95% CI - 2.62 to 2.89), phase plane (easy: SMD - 0.59, 95% CI - 1.19 to 0.02; difficult: SMD - 0.18, 95% CI - 0.77 to 0.42), path/sway length (easy: SMD - 0.18, 95% CI - 0.77 to 0.42; difficult: SMD - 0.14, 95% CI - 0.84 to 0.55), and amplitude (easy: SMD 0.89, 95% CI - 1.62 to 3.39; difficult: SMD 1.31, 95% CI - 1.48 to 4.10).
CONCLUSIONS: The current evidence suggests that there are no significant differences in postural control parameters during dual-task conditions between individuals with non-specific LBP and pain-free subjects. However, due to the limited number of available studies, significant publication bias, and considerable statistical heterogeneity, definitive conclusions cannot be drawn. Therefore, further research comprising high-quality studies with larger sample sizes is necessary to obtain conclusive results. Trial registration PROSPERO CRD42022359263.