No differece in long-term trunk muscle strength, cross-sectional area,.doc

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No differece in long-term trunk muscle strength, cross-sectional area,.doc

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No differece in long-term trunk muscle strength, cross-sectional area,

CONSORT 清单评价RCT论文论文部分条目内容评价文题摘要 1a 文题能识别是随机临床试验 No difference in long-term trunk muscle strength, cross-sectional area, and density in patients with chronic low back pain 7 to 11 years after lumbar fusion versus cognitive intervention and exercises 否 1b 结构式摘要，包括试验设计、方法、结果、结论几个部分 BACKGROUND CONTEXT: Reduced muscle strength and density observed at 1 year after lum- bar fusion may deteriorate more in the long term. PURPOSE: To compare the long-term effect of lumbar fusion and cognitive intervention and exercises on muscle strength, cross-sectional area, density, and self-rated function in patients with chronic low back pain (CLBP) and disc degeneration. STUDY DESIGN: Randomized controlled study with a follow-up examination at 8.5 years (range, 7–11 years). PATIENTS AND METHODS: Patients with CLBP and disc degeneration randomized to either in- strumented posterolateral fusion of one or both of the two lower lumbar levels or a 3-week cognitive intervention and exercise program were included. Isokinetic muscle strength was measured by a Cybex 6000 (Cybex-Lumex, Inc., Ronkonkoma, NY, USA). All patients had previous experience with the test procedure. The back extension (E) flexion (F) muscles were tested, and the E/F ratios were calculated. Cross-sectional area and density of the back muscles were measured at the L3–L4 segment by computed tomography. Patients rated their function by the General Function Score. OUTCOME MEASURES: Trunk muscle strength, cross-sectional area, density, and self-rated function. RESULTS: Fifty-five patients (90%) were included at long-term follow-up. There were no signif- icant differences in cross-sectional area, density, muscle strength, or self-rated function between the two groups. The cognitive intervention and exercise group increased trunk muscle extension signif- icantly (p!.05), and both groups performed significantly better on trunk muscle flexion tests (p!.01) at long-term follow-up. On average, self-rated function impr