Effectiveness of strengthening exercise plus activities of daily living instructions in reducing pain in patients with lumbar disc herniation: a randomized controlled trial

Lumbar disc herniation (LDH) is one of the most common causes of mechanical low back pain (LBP) associated with radiating leg pain. Conservative treatment, including exercise, analgesic, and physical therapy, is regarded as the first-line treatment of LDH. This randomized clinical trial was conducted to evaluate the effectiveness of back and hip strengthening exercises combined with activities of daily living instructions (ADLIs) to reduce pain intensity in patients with LDH. A total of 70 patients with LDH were randomly allocated to either the intervention group (IG) or the control group (CG). Patients in IG received different back and hip strengthening exercises five days a week for six weeks. The patients in CG were treated with Naproxen (500 mg) and Baclofen (10 mg) tablet twice a day for three weeks, followed by hot moist compression for the next three weeks. In addition, the patients in both groups were instructed to follow the ADLIs during the intervention and at least 3 months after the intervention. The straight leg raising (SLR) test and the Visual Analogue Scale (VAS) score were used to evaluate the patients' pain intensity. Outcomes were measured at baseline, at three weeks, and at six weeks of the intervention. Patients were followed up after 3 months of the intervention.腰椎间盘突出症（Lumbar disc herniation, LDH）是伴随下肢放射痛的机械性下腰痛（mechanical low back pain, LBP）最常见的病因之一。保守治疗包括运动疗法、镇痛治疗与物理治疗，被视为腰椎间盘突出症的一线治疗方案。 本随机临床试验旨在评估腰背及髋部强化训练联合日常生活活动指导（activities of daily living instructions, ADLIs）对缓解腰椎间盘突出症患者疼痛强度的临床疗效。 本研究共纳入70例腰椎间盘突出症患者，随机分配至干预组（IG）与对照组（CG）。干预组患者每周进行5次腰背及髋部强化训练，持续6周；对照组患者每日口服2次萘普生（500mg）与巴氯芬（10mg），疗程3周，随后辅以湿热敷治疗3周。此外，两组患者均需在干预期间及干预后至少3个月内遵循日常生活活动指导。 本研究采用直腿抬高试验（straight leg raising test, SLR）与视觉模拟评分法（Visual Analogue Scale, VAS）评分评估患者的疼痛强度，分别在干预前基线、干预3周时及干预6周时进行结局指标测评，并在干预结束后3个月对患者进行随访。