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- 您请求的操作仅限于组中的用户:==腰痛的管理==腰痛是非常常见的,它是残疾调整生命年损失的最大单一原因,也是英国残疾生活年的最大单一原因NHS England 2017。[http://www.ukssb.com/pages/Improving-Spinal-Care-Project/National-Backpain-Pathway.html National Low Back and gun Pain Pathway 2017]。典型的腰痛有反复发作的症状。大多数腰痛患者以前都有过一次发作,急性发作通常是慢性腰痛的加重。2016 [http://www.hse.gov.uk/Statistics/causdis/musculoskeletal/msd.pdf与工作相关的肌肉骨骼疾病(WRMSDs)统计,英国2016]。,英国健康与安全执行委员会的一份报告指出,2015/16年度,患病率为每10万名雇员660例,因工作相关背部疾病而损失的工作日为341.7万天,平均每例损失的天数为15.9天。对18项研究的系统回顾和荟萃分析表明,急性和亚急性腰痛的残疾与身体活动水平之间没有相关性。然而,对于慢性腰痛,研究显示,残疾程度越高的人,身体活动水平可能越低(Chung-Wei et al . 2011)。对腰痛的广泛研究表明,慢性致残症状具有复杂的生物心理社会因素,社会心理维度增加了慢性的风险。鉴于此,由于各种因素之间复杂的相互关系,很难评估体育活动和锻炼的实际效果。在英国,通过使用STarT背部分层工具,提倡使用该模型对慢性致残症状的风险进行分层(Hill et al, 2011)。两篇Cochrane综述研究了运动对腰痛的影响。Hayden et al (2005)Hayden J, van Tulder MW, Malmivaara A, Koes BW。 [http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD000335.pub2/full Exercise therapy for treatment of non-specific low back pain. Cochrane Database of Systematic Reviews 2005], Issue 3. Art. No.: CD000335. DOI: 10.1002/14651858.CD000335.pub2 analysed 16 RCTs. It was concluded that exercise was as effective as no treatment or other treatment for acute back pain. Graded activity programmes were moderately effective in improving absenteeism outcomes. Exercise therapy provided some reduction of pain and improved function in adults with chronic low-back pain, particularly in populations visiting a healthcare provider. Another reviewChoi BKL, Verbeek JH, Tam WWS, Jiang JY. [http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD006555.pub2/full Exercises for prevention of recurrences of low-back pain. Cochrane Database of Systematic Reviews 2010], Issue 1. Art. No.: CD006555. DOI: 10.1002/14651858.CD006555.pub2 evaluated 9 studies, and reported moderate quality evidence that post-treatment exercises could reduce both the rate and the number of recurrences of back pain. However, the results of exercise treatment studies were conflicting Recent UK NICE Guidance on Low back Pain and Sciatica in over 16sNICE 2016 [https://www.nice.org.uk/guidance/ng59 Low back pain and sciatica in over 16s: assessment and management. NICE guideline] [NG59] Published date: November 2016, supported by the National Low back Pain and Radicular Pain Pathway, advocate conservative management including group exercise programmes (with psychological support if required) as a key management strategy for back pain with or without sciatica.
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