Abstract

Background context

Muscle, bone and tendon respond anabolically to mechanical forces. Whether the intervertebral disc (IVD) can benefit from exercise is unclear.

Purpose

To examine whether exercise can beneficially affect IVD characteristics.

Study design/setting

This is a single-blinded 6-month randomised controlled trial (ACTRN12615001270505) in an exercise and physiotherapy clinic.

Patient sample

Forty patients with chronic non-specific low back pain (NSCLBP) are included in this study.

Outcome measures

The primary outcome was lumbar IVD T2 time (MRI). Secondary outcomes included IVD diffusion coefficient and IVD expansion with short-duration lying.

Methods

Twenty patients progressively loaded their lumbar IVDs (exercise) via an exercise programme involving progressive upright aerobic and resistance exercises targeting the trunk and major muscle groups and were compared to twenty patients who performed motor control training and manual therapy (control). Testing occurred at baseline, 3 months and 6 months.

Results

Seventeen exercise and fifteen control patients completed the interventions. There were no group-by-time differences in T2 time of the entire IVD (exercise 94.1 ± 10.0 ms vs. control 96.5 ± 9.3 ms, p = 0.549). Exercise patients had shorter T2 time in the posterior annulus at 6 months (82.7 ± 6.8 ms vs. 85.1 ± 8.0 ms, p = 0.028). Exercise patients showed higher L5/S1 apparent diffusion coefficients and decreased IVD height at 3 months (both p ≤ 0.050). After adjustments for multiple comparisons, differences lost statistical significance. Per-protocol and intent-to-treat analyses yielded similar findings.

Conclusions

This trial found that 6 months of exercise did not benefit the IVD of people with NSCLBP. Based on this index study, future studies could investigate the effect of exercise on IVD in different populations, with different types, durations and/or intensities of exercise, and using different IVD markers.

Graphic abstract

These slides can be retrieved under Electronic Supplementary Material.

中文翻译：

---

椎间盘锻炼：一项为期 6 个月的慢性腰痛随机对照试验。

摘要

背景上下文

肌肉、骨骼和肌腱对机械力产生合成代谢反应。椎间盘（IVD）是否可以从运动中受益尚不清楚。

目的

检查运动是否可以有益地影响 IVD 特征。

研究设计/设置

这是一项在运动和理疗诊所进行的单盲 6 个月随机对照试验 (ACTRN12615001270505)。

患者样本

本研究包括 40 名患有慢性非特异性腰痛 (NSCLBP) 的患者。

结果措施

主要结果是腰椎 IVD T2 时间（MRI）。次要结果包括 IVD 扩散系数和 IVD 扩张与短期躺。

方法

20 名患者通过一项包括针对躯干和主要肌肉群的渐进式直立有氧运动和阻力运动的运动计划逐渐加载他们的腰椎 IVD（运动），并将其与 20 名进行运动控制训练和手动治疗（控制）的患者进行比较。测试发生在基线、3 个月和 6 个月。

结果

17 名运动患者和 15 名对照患者完成了干预。整个 IVD 的 T2 时间没有组间差异（运动 94.1 ± 10.0 ms vs. 对照 96.5 ± 9.3 ms，p  = 0.549）。运动患者在 6 个月时后瓣环的 T2 时间较短（82.7 ± 6.8 ms 与 85.1 ± 8.0 ms，p  = 0.028）。运动患者在 3 个月时表现出更高的 L5/S1 表观扩散系数和降低的 IVD 高度（均p  ≤ 0.050）。多重比较调整后，差异失去统计学意义。符合方案和意向治疗分析得出了类似的结果。

结论

该试验发现，6 个月的锻炼对 NSCLBP 患者的 IVD 无益。基于这项指标研究，未来的研究可以调查运动对不同人群、不同类型、持续时间和/或运动强度以及使用不同 IVD 标志物的 IVD 的影响。

图形摘要

这些幻灯片可以在电子补充材料下检索。