Abstract
The aim of this study was to evaluate the effectiveness of physical therapy (kinesiotherapy or KT) for chronic non-specific low back pain (CNSLBP) in managing pain, improving functional and emotional state, and overall physical activity.
 Materials and methods. The study included 71 patients (17 men and 54 women) aged 1875 years (mean age 55.09 13.0 years) with CNSLBP, of whom 34 patients received standard KT and 37 patients received enhanced KT. Patients were asked to complete the Numeric Pain Rating Scale (NPRS), the Oswestry Low Back Pain Disability Questionnaire, the Hospital Anxiety and Depression Scale (HADS), and the International Physical Activity Questionnaire (IPAQ-SF) at baseline, after 7 days and 90 days.
 Results. In patients who received treatment, we observed a reduction in pain intensity as measured by the NPRS, from a score of 8 at baseline (68) to 3 (24) points after 7 days and down to 2 (04) after 3 months (p 0.0001). Depression severity decreased from 7 (59) points to 5 (37) after 7 days (p = 0.002) and 4 (36) points after 90 days (p = 0.002). Anxiety decreased from 7 (510) to 6 (48) after 7 days (p = 0.0003) and 5 (37) points after 90 days (p = 0.0003). The Oswestry Low Back Pain Disability Questionnaire score decreased from 46% (3457.77) to 28% (1235.55) after 7 days (p 0.0001), and then to 11.11% (4.4426) after 90 days (p 0.0001). Physical activity as measured by the IPAQ-SF increased from 11 (716) to 16 (1319) points after 7 days (p = 0.001) and to 23 (1526) points after 90 days (p = 0.0002).
 The patient group receiving enhanced KT had a more significant reduction in pain as measured by the NPRS after 7 days and 3 months (p = 0.02 and p = 0.055, respectively), depression as measured by the HADS (p 0.05), and disability as measured by the Oswestry Questionnaire (p = 0.015), accompanied by an increase in physical activity as measured by the IPAQ-SF after 90 days (p = 0.0002), as compared to the patient group receiving standard KT.
 Conclusion. KT not only reduces pain but also improves the functional and emotional state, and increases physical activity in patients with CNSLBP. Enhancing KT by using a personalized approach and educational programmes improves long-term treatment outcomes.
Highlights
In patients who received treatment, we observed a reduction in pain intensity as measured by the Numeric Pain Rating Scale (NPRS), from a score of 8 at baseline (6–8) to 3 (2–4) points after 7 days and down to 2 (0–4) after 3 months (p < 0.0001)
Кинезитерапия (КТ), которая основывается на регулярных физических упражнениях под контролем специалиста, выделяется как одно из наиболее эффективных направлений лечения пациента с хронической неспецифической люмбалгии (ХНЛ) [3, 5, 6]
При ведении пациентов с ХНЛ наиболее часто используется стандартная КТ, включающая групповые занятия со специалистом по лечебной гимнастике, при этом часто не учитываются индивидуальные особенности пациентов, их отношение к КТ, не используется образовательная программа по болям в спине в комбинации с КТ
Summary
ФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» (Сеченовский Университет), Москва, Россия. Цель работы — изучение эффективности физической терапии (кинезитерапии, КТ) при хронической неспецифической люмбалгии (ХНЛ) в отношении боли, функционального и эмоционального состояния пациентов, их общей физической активности. The patient group receiving enhanced KT had a more significant reduction in pain as measured by the NPRS after 7 days and 3 months (p = 0.02 and p = 0.055, respectively), depression as measured by the HADS (p < 0.05), and disability as measured by the Oswestry Questionnaire (p = 0.015), accompanied by an increase in physical activity as measured by the IPAQ-SF after 90 days (p = 0.0002), as compared to the patient group receiving standard KT. При хронической неспецифической люмбалгии (ХНЛ) наиболее эффективен комплексный (мультидисциплинарный) подход, который включает лекарственные и нелекарственные методы терапии, повышение физической и социальной активности, выработку эффективных для преодоления боли моделей поведения [3, 4]. Цель настоящего исследования — изучение ближайших и отдалённых результатов стандартной (СКТ) и расширенной КТ (РКТ) при ХНЛ не только в отношении боли и связанной с ней инвалидности, но и в отношении эмоционального состояния пациентов, их общей физической активности
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