Caitlin Lauren Siobhan Prentice, Carol Ann Flavell, Nicola Massy-Westropp, Steve Milanese
{"title":"运动处方对表现为腹外肌激活受损的持续性腰痛患者：德尔菲调查。","authors":"Caitlin Lauren Siobhan Prentice, Carol Ann Flavell, Nicola Massy-Westropp, Steve Milanese","doi":"10.1002/pri.70060","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and purpose: </strong>Exercise is commonly prescribed for patients with low back pain (LBP) and maladaptive changes in lateral abdominal muscle (LAM) activation. The literature has considered various exercise programs, but the evidence has not consistently identified exercise parameters associated with superior outcomes. The aim of this study was to determine how physiotherapists should prescribe exercise for patients with persistent LBP who present with maladaptive LAM activation.</p><p><strong>Methods: </strong>This was a three round Delphi survey. The international expert panel comprised physiotherapy clinicians with postgraduate orthopaedic manipulative physiotherapy training. Round 1 included open ended questions. Responses were collated and coded using content analysis. In Rounds 2 and 3, participants were provided with the collated responses and rated their agreement with or chose their preferred options regarding exercise prescription for patients with maladaptive LAM activation. Items were defined as meeting consensus when ≥ 70% of participants agreed/disagreed or chose the same option.</p><p><strong>Results: </strong>Twenty-three physiotherapists consented to participate. Seventeen, 20 and 15 participants completed Rounds 1, 2 and 3, respectively. The exercise prescription suggestions consisted of 46 items reaching consensus across the domains of exercise: goals, considerations, agreement on prescribing exercise for the LAM and other muscles, muscle activation during exercise, the exercise prescription and its focus.</p><p><strong>Discussion: </strong>This study provides clinically informed recommendations for physiotherapists prescribing exercise for patients with persistent LBP and maladaptive LAM activation. Findings align with motor control exercise approaches outlined in the literature. Participants emphasised the consideration of patient preferences and balancing motor control exercise with moderate/vigorous physical activity.</p>","PeriodicalId":47243,"journal":{"name":"Physiotherapy Research International","volume":"30 2","pages":"e70060"},"PeriodicalIF":1.8000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995875/pdf/","citationCount":"0","resultStr":"{\"title\":\"Exercise Prescription for Patients With Persistent Low Back Pain Who Present With Impaired Lateral Abdominal Muscle Activation: A Delphi Survey.\",\"authors\":\"Caitlin Lauren Siobhan Prentice, Carol Ann Flavell, Nicola Massy-Westropp, Steve Milanese\",\"doi\":\"10.1002/pri.70060\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and purpose: </strong>Exercise is commonly prescribed for patients with low back pain (LBP) and maladaptive changes in lateral abdominal muscle (LAM) activation. The literature has considered various exercise programs, but the evidence has not consistently identified exercise parameters associated with superior outcomes. The aim of this study was to determine how physiotherapists should prescribe exercise for patients with persistent LBP who present with maladaptive LAM activation.</p><p><strong>Methods: </strong>This was a three round Delphi survey. The international expert panel comprised physiotherapy clinicians with postgraduate orthopaedic manipulative physiotherapy training. Round 1 included open ended questions. Responses were collated and coded using content analysis. In Rounds 2 and 3, participants were provided with the collated responses and rated their agreement with or chose their preferred options regarding exercise prescription for patients with maladaptive LAM activation. Items were defined as meeting consensus when ≥ 70% of participants agreed/disagreed or chose the same option.</p><p><strong>Results: </strong>Twenty-three physiotherapists consented to participate. Seventeen, 20 and 15 participants completed Rounds 1, 2 and 3, respectively. The exercise prescription suggestions consisted of 46 items reaching consensus across the domains of exercise: goals, considerations, agreement on prescribing exercise for the LAM and other muscles, muscle activation during exercise, the exercise prescription and its focus.</p><p><strong>Discussion: </strong>This study provides clinically informed recommendations for physiotherapists prescribing exercise for patients with persistent LBP and maladaptive LAM activation. Findings align with motor control exercise approaches outlined in the literature. Participants emphasised the consideration of patient preferences and balancing motor control exercise with moderate/vigorous physical activity.</p>\",\"PeriodicalId\":47243,\"journal\":{\"name\":\"Physiotherapy Research International\",\"volume\":\"30 2\",\"pages\":\"e70060\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11995875/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Physiotherapy Research International\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1002/pri.70060\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Physiotherapy Research International","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1002/pri.70060","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"REHABILITATION","Score":null,"Total":0}
Exercise Prescription for Patients With Persistent Low Back Pain Who Present With Impaired Lateral Abdominal Muscle Activation: A Delphi Survey.
Background and purpose: Exercise is commonly prescribed for patients with low back pain (LBP) and maladaptive changes in lateral abdominal muscle (LAM) activation. The literature has considered various exercise programs, but the evidence has not consistently identified exercise parameters associated with superior outcomes. The aim of this study was to determine how physiotherapists should prescribe exercise for patients with persistent LBP who present with maladaptive LAM activation.
Methods: This was a three round Delphi survey. The international expert panel comprised physiotherapy clinicians with postgraduate orthopaedic manipulative physiotherapy training. Round 1 included open ended questions. Responses were collated and coded using content analysis. In Rounds 2 and 3, participants were provided with the collated responses and rated their agreement with or chose their preferred options regarding exercise prescription for patients with maladaptive LAM activation. Items were defined as meeting consensus when ≥ 70% of participants agreed/disagreed or chose the same option.
Results: Twenty-three physiotherapists consented to participate. Seventeen, 20 and 15 participants completed Rounds 1, 2 and 3, respectively. The exercise prescription suggestions consisted of 46 items reaching consensus across the domains of exercise: goals, considerations, agreement on prescribing exercise for the LAM and other muscles, muscle activation during exercise, the exercise prescription and its focus.
Discussion: This study provides clinically informed recommendations for physiotherapists prescribing exercise for patients with persistent LBP and maladaptive LAM activation. Findings align with motor control exercise approaches outlined in the literature. Participants emphasised the consideration of patient preferences and balancing motor control exercise with moderate/vigorous physical activity.
期刊介绍：
Physiotherapy Research International is an international peer reviewed journal dedicated to the exchange of knowledge that is directly relevant to specialist areas of physiotherapy theory, practice, and research. Our aim is to promote a high level of scholarship and build on the current evidence base to inform the advancement of the physiotherapy profession. We publish original research on a wide range of topics e.g. Primary research testing new physiotherapy treatments; methodological research; measurement and outcome research and qualitative research of interest to researchers, clinicians and educators. Further, we aim to publish high quality papers that represent the range of cultures and settings where physiotherapy services are delivered. We attract a wide readership from physiotherapists and others working in diverse clinical and academic settings. We aim to promote an international debate amongst the profession about current best evidence based practice. Papers are directed primarily towards the physiotherapy profession, but can be relevant to a wide range of professional groups. The growth of interdisciplinary research is also key to our aims and scope, and we encourage relevant submissions from other professional groups. The journal actively encourages submissions which utilise a breadth of different methodologies and research designs to facilitate addressing key questions related to the physiotherapy practice. PRI seeks to encourage good quality topical debates on a range of relevant issues and promote critical reflection on decision making and implementation of physiotherapy interventions.
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