收稿日期: 2025-07-23
网络出版日期: 2025-11-26
基金资助
国家自然科学基金项目(82060417);新疆医科大学研究生创新创业项目(CXCY2025014)
Research progress on the multidimensional mechanisms of core training in the treatment of chronic nonspecific low back pain
Received date: 2025-07-23
Online published: 2025-11-26
非特异性腰痛是全球范围内导致生产力下降及残疾的重要原因，其发病机制尚不明确，缺乏显著的器质性病变和影像学特征，病程持续3个月以上则称为慢性非特异性腰痛。目前慢性非特异性腰痛的康复常侧重于单一的生物医学模式，且缺乏对其治疗机制的多角度分析，对于这种复杂的高患病率、高复发率病症，多维度分析其康复手段的作用机制与应用，可能有助于更精准地开展治疗。核心训练是慢性非特异性腰痛康复的重要方法，该文从生物力学、神经调控及心理适应方面，对核心训练治疗慢性非特异性腰痛的作用机制进行综述，并探讨其与虚拟现实等新兴技术的联合应用，从而提高治疗依从性和成效的可能，旨在为慢性非特异性腰痛精准化康复提供思路，实现向多因素、多学科整合模式的过渡。
冯宇泽 , 孔琦琪 , 熊道海 . 核心训练治疗慢性非特异性腰痛的多维度机制研究进展[J]. 实用医学杂志, 2025 , 41(22) : 3625 -3630 . DOI: 10.3969/j.issn.1006-5725.2025.22.022
Non-specific low back pain is a major cause of productivity decline and disability worldwide. Its pathogenesis remains unclear， lacking significant organic lesions and imaging features. When the disease course persists for more than three months， it is referred to as chronic non-specific low back pain. Currently， rehabilitation for chronic non-specific low back pain often focuses on a single biomedical model and lacks multi-perspective analysis of its therapeutic mechanism. For such a complex condition with high prevalence and high recurrence rate， a multidimensional analysis of the mechanism of action and application of rehabilitation methods may contribute to more precise treatment.core training is an important method for the rehabilitation of chronic non-specific low back pain. This article reviews the mechanism of action of core training in treating chronic non-specific low back pain from the perspectives of biomechanics， neuromodulation， and psychological adaptation， and explores its combined application with emerging technologies such as virtual reality， thereby potentially improving treatment compliance and efficacy， aiming to provide insights for chronic non-specific low back pain precision rehabilitation and to facilitate the transition toward a multifactorial， multidisciplinary integrated model.
| [1] | 王以文， 杨怀春， 陈康， 等. 慢性非特异性腰痛下肢运动模式改变与姿势控制的研究进展 ［J］. 中国康复， 2025， 40（4）： 253-256. |
| [2] | KHAN K， AHMAD A， MOHSENI BANDPEI M A， et al. Comparison of the effects of dry needling and spinal manipulative therapy versus spinal manipulative therapy alone on functional disability and endurance in patients with nonspecific chronic low back pain： An experimental study ［J］. Medicine （Baltimore）， 2024， 103（38）： e39734. doi:10.1097/md.0000000000039734 |
| [3] | 朱铃铃， 陈炎春， 方亮， 等. 动态关节松动术联合核心稳定训练治疗非特异性下腰痛的疗效 ［J］. 实用医学杂志， 2024， 40（18）： 2602-2606. |
| [4] | 李鑫， 王楚怀. 慢性腰痛的物理治疗新进展 ［J］. 中国康复医学杂志， 2021， 36（6）： 738-742. |
| [5] | FRIZZIERO A， PELLIZZON G， VITTADINI F， et al. Efficacy of Core Stability in Non-Specific Chronic Low Back Pain ［J］. J Funct Morphol Kinesiol， 2021， 6（2）： 37. doi:10.3390/jfmk6020037 |
| [6] | XU S， WANG R， MA S， et al. Interventional effect of core stability training on pain and muscle function of youth with chronic non-specific lower back pain： A randomized controlled trial ［J］. Heliyon， 2024， 10（12）： e32818. doi:10.1016/j.heliyon.2024.e32818 |
| [7] | SULAIMAN M L， KOTTEESWARAN K， KUMAR S. Efficacy of Core Muscle Stabilization in Chronic Nonspecific Low Back Pain Patients?A Systematic Review ［J］. INTI J， 2023， 2023（1）： 112-118. doi:10.61453/intij.202340 |
| [8] | NAKATA A， OSUKA S， ISHIDA T， et al. Trunk Muscle Activity and Ratio of Local Muscle to Global Muscle Activity during Supine Bridge Exercises under Unstable Conditions in Young Participants with and without Chronic Low Back Pain ［J］. Healthcare （Basel）， 2024， 12（5）： 514. doi:10.3390/healthcare12050514 |
| [9] | PUNTUMETAKUL R， SAIKLANG P， TAPANYA W， et al. The Effects of Core Stabilization Exercise with the Abdominal Drawing-in Maneuver Technique versus General Strengthening Exercise on Lumbar Segmental Motion in Patients with Clinical Lumbar Instability： A Randomized Controlled Trial with 12-Month Follow-Up ［J］. Int J Environ Res Public Health， 2021， 18（15）： 7811. doi:10.3390/ijerph18157811 |
| [10] | SOYSAL TOMRUK M， TOMRUK M， KALEMCI O. Comparisons of postural control， proprioception， muscle strength， pain and disability between individuals with acute， subacute and chronic low back pain ［J］. Somatosens Mot Res， 2024， 41（1）： 26-33. doi:10.1080/08990220.2023.2165057 |
| [11] | ACASIO J C， BUTOWICZ C M， DEARTH C L， et al. Trunk muscle forces and spinal loads while walking in persons with lower limb amputation： Influences of chronic low back pain ［J］. J Biomech， 2022， 135： 111028. doi:10.1016/j.jbiomech.2022.111028 |
| [12] | TRIANTAFYLLOU A， PAPAGIANNIS G， STASI S， et al. Lumbar Kinematics Assessment of Patien-ts with Chro-nic Low Back Pain in Three Bridge Tests Using Miniaturized Sensors ［J］. Bioengineering （Basel）， 2023， 10（3）： 339. doi:10.3390/bioengineering10030339 |
| [13] | DEEPIKA D， RANI J， PREETI P， et al. Effect of Core Stability Training on Pain and Flexibility in Patients with Mechanical Low Back Pain ［J］. Global J Res Anal， 2024，13（2）： 16-17. |
| [14] | BUDHIRAJA R， NAGPAL M， SINGH R， et al. Dynamic Sitting Exercises for Low Back Pain： A Brief Review ［J］. Int J Sci Res， 2024，13（2）： 36-38. |
| [15] | MOUSAVI S M S， MIRSAFAEI RIZI R. Effect of Central Stability and Dynamic Neuromuscular Stabilization Exercises on Pain， Flexibility， Balance， Muscle Endurance and Quality of Life in Men With No-nspecific Chronic Low Back Pain ［J］. J Guilan Univ Med Sci， 2022， 31（2）：136-149. doi:10.32598/jgums.31.2.1789.1 |
| [16] | ?ZYURT F， TAYFUR A， üLGER ?. The effect of stabilization-based exercises on kinesiophobia in patients with non-specific chronic low back pain： A systematic review and meta-analysis ［J］. Sport Sci Health， 2024， 21（1）： 1-13. doi:10.1007/s11332-024-01254-0 |
| [17] | ZOU J， HAO S. Exercise-induced neuroplasticity： A new perspective on rehabilitation for chronic low back pain ［J］. Front Mol Neurosci， 2024， 17： 1407445. doi:10.3389/fnmol.2024.1407445 |
| [18] | ZHANG C， ZHANG Z， LI Y， et al. Alterations in functional connectivity in patients with non-specific chronic low back pain after motor control exercise： A randomized trial ［J］. Eur J Phys Rehabil Med， 2024， 60（2）： 319-330. doi:10.23736/s1973-9087.24.08087-0 |
| [19] | SCHMID S， BANGERTER C， SCHWEINHARDT P， et al. Identifying Motor Control Strategies and Their Role in Low Back Pain： A Cross-Disciplinary Approach Bridging Neurosciences With Moveme-nt Biomechanics ［J］. Front Pain Res， 2021， 2： 715219. doi:10.3389/fpain.2021.715219 |
| [20] | MEDRANO-ESCALADA Y， PLAZA-MANZANO G， FERN-áNDEZ-DE-LAS-PE?AS C， et al. Structural， Functional and Neurochemical Cortical Brain Changes Associated with Chronic Low Back Pain ［J］. Tomography， 2022， 8（5）： 2153-2163. doi:10.3390/tomography8050180 |
| [21] | ALMOHIZA M A， REDDY R S， ASIRI F， et al. The Mediation Effect of Pain on the Relationship between Kinesiophobia and Lumbar Joint Position Sense in Chronic Low Back Pain Individuals： A Cross-Sectional Study ［J］. Int J Environ Res Public Health， 2023， 20（6）： 5193. doi:10.3390/ijerph20065193 |
| [22] | WANG H， FAN Z， LIU X， et al. Effect of Progressive Postural Control Exercise Versus Core Stability Exercise in Young Adults with Chronic Low Back Pain： A Randomized Controlled Trial ［J］. Pain Ther， 2022， 12（1）： 293-308. doi:10.1007/s40122-022-00458-x |
| [23] | YAN T， LIANG M， PENG J， et al. Cortical Mechanisms Underlying Effects of Repetitive Peripheral Magnetic Stimulation on Dynamic and Static Postural Control in Patients with Chronic Non-Specific Low Back Pain： A Double-Blind Randomized Clinical Trial ［J］. Pain Ther， 2024， 13（4）： 953-970. doi:10.1007/s40122-024-00613-6 |
| [24] | CEULEMANS D， MOENS M， RENEMAN M， et al. Biopsychosocial rehabilitation in the working population with chronic low back pain： a concept analysis ［J］. J Rehabil Med， 2024， 56： jrm13454. doi:10.2340/jrm.v56.13454 |
| [25] | FUJII T， OKA H， TAKANO K， et al. Association between high fear-avoidance beliefs about physical activity and chronic disabling low back pain in nurses in Japan ［J］. BMC Musculoskelet Disord， 2019， 20（1）： 572. doi:10.1186/s12891-019-2965-6 |
| [26] | IKEMOTO T， MIKI K， MATSUBARA T， et al. Psychological Treatment Strategy for Chronic Low Back Pain ［J］. Spine Surg Relat Res， 2019， 3（3）： 199-206. doi:10.22603/ssrr.2018-0050 |
| [27] | XIAO W， YANG H， HAO Z， et al. Relationship between Fear-Avoidance Beliefs and Reaction Time Changes Prior to and following Exercise-Induced Muscle Fatigue in Chronic Low Back Pain ［J］. Pain Res Manag， 2024， 2024： 9982411. doi:10.1155/2024/9982411 |
| [28] | ANGST F， LEHMANN S， SANDOR P S， et al. Catastrophizing as a prognostic factor for pain and physical function in the multidisciplinary rehabilitation of fibromyalgia and low back pain ［J］. Eur J Pain， 2022， 26（7）： 1569-1580. doi:10.1002/ejp.1983 |
| [29] | HLAING S S， PUNTUMETAKUL R， KHINE E E， et al. Effects of core stabilization exercise and strengthening exercise on proprioception， balance， muscle thickness and pain related outcomes in patients with subacute nonspecific low back pain： A randomized controlled trial ［J］. BMC Musculoskelet Disord， 2021， 22（1）： 998. doi:10.1186/s12891-021-04858-6 |
| [30] | AHN S E， LEE M Y， LEE B H. Effects of Gluteal Muscle Strengthening Exercise-Based Core Stabilization Training on Pain and Quality of Life in Patients with Chronic Low Back Pain ［J］. Medicina， 2024， 60（6）： 849-856. doi:10.3390/medicina60060849 |
| [31] | PATEL S， BAKER N A. Exploring perspectives on engagement in interactive virtual reality for chronic pain management： Insights from a content analysis study ［J］. Virtual Reality， 2024， 28（4）： 311-320. doi:10.1007/s10055-024-01054-4 |
| [32] | HEI P， ZHANG Z， WEI J， et al. The effect of dynamic neuromuscular stabilization technique combined with Kinesio Taping on neuromuscular function and pain self-efficacy in individuals with chronic nonspecific low back pain： A randomized trial ［J］. Medicine， 2025， 104（4）： e41265. doi:10.1097/md.0000000000041265 |
| [33] | KELLY J M， COPPIETERS M W， KLUVER J， et al. “It made you feel like you’ve still got it”： Experiences of people with chronic low back pain undertaking a single session of body image training in virtual reality ［J］. Physiother Theory Pract， 2022， 39（12）： 2651-2661. doi:10.1080/09593985.2022.2095313 |
| [34] | DIEZ G G， ANITUA E， CASTELLANOS N， et al. The effect of mindfulness on the inflammatory， psychological and biomechanical domains of adult patients with low back pain： A randomized controlled clinical trial ［J］. PLoS One， 2022， 17（11）： e0276734. doi:10.1371/journal.pone.0276734 |
| [35] | OLIVEIRA D S， VéLIA FERREIRA MENDON?A L， SOFIA MONTEIRO SAMPAIO R， et al. The Impact of Anxiety and Depression on the Outcomes of Chronic Low Back Pain Multidisciplinary Pain Management—A Multicenter Prospective Cohort Study in Pain Clinics with One-Year Follow-up ［J］. Pain Med， 2018， 20（4）： 736-746. doi:10.1093/pm/pny128 |
| [36] | AKODU A K， AKINDUTIRE O M. The effect of stabilization exercise on pain-related disability， sleep disturbance， and psychological status of patients with non-specific chronic low back pain ［J］. Korean J Pain， 2018， 31（3）： 199-205. doi:10.3344/kjp.2018.31.3.199 |
| [37] | JAMKAR M， AZEEM Z， GIRI S， et al. Consensus‐Building on Patient Education for Chronic Non‐Specific Low Back Pain： A Qualitative Study on Patient Physiotherapist Perspectives ［J］. Musculoskelet Care， 2025， 23（2）： e70107. doi:10.1002/msc.70107 |
| [38] | FERLITO R， BLATTI C， LUCENTI L， et al. Pain Education in the Management of Patients with Chronic Low Back Pain： A Systematic Review ［J］. J Funct Morphol Kinesiol， 2022， 7（4）： 74-80. doi:10.3390/jfmk7040074 |
| [39] | DAY M A， CIOL M A， MENDOZA M E， et al. The effects of telehealth-delivered mindfulness meditation， cognitive therapy， and behavioral activation for chronic low back pain： A randomized clinical trial ［J］. BMC Med， 2024， 22（1）： 156-162. doi:10.1186/s12916-024-03693-5 |
| [40] | CERRITELLI F， CHIERA M， ABBRO M， et al. The Challenges and Perspectives of the Integration Between Virtual and Augmented Reality and Manual Therapies ［J］. Front Neurol， 2021， 12： 700211. doi:10.3389/fneur.2021.700211 |
| [41] | HUSSEIN H， ATTEYA M， KAMEL E. Effectiveness of Virtual Reality on Rehabilitation of Chronic Non-Specific Low Back Pain Patients ［J］. Healthcare， 2024， 12（13）： 1312. doi:10.3390/healthcare12131312 |
| [42] | MCCONNELL R， LANE E， WEBB G， et al. A multicenter feasibility randomized controlled trial using a virtual reality application of pain neuroscience education for adults with chronic low back pain ［J］. Ann Med， 2024， 56（1）： 2311846. doi:10.1080/07853890.2024.2311846 |
| [43] | MURIYEDATH A， ELAYARAJA M， SALVI N M， et al. Applying a 12-Week TRX Suspension and Plyometric Training Program： Effects on Biomotor Abilities and Physiological Adaptations in Volleyball Players ［J］. Phys Educ Theory Methodol， 2025， 25（1）： 22-31. doi:10.17309/tmfv.2025.1.03 |
| [44] | BLANCO-GIMéNEZ P， VICENTE-MAMPEL J， GARGALLO P， et al. Effect of exercise and manual therapy or ki-nesiotaping on sEMG and pain perception in chronic low back pain： A randomized tril ［J］. BMC Musculoskelet Disord， 2024， 25（1）： 583. doi:10.1186/s12891-024-07667-9 |
| [45] | PEROTTI L， STAMM O， STROHM H， et al. Learning Transversus Abdominis Activation in Older Adults with Chronic Low Back Pain Using an Ultrasound-Based Wearable： A Randomized Controlled Pilot Study ［J］. J Funct Morphol Kinesiol， 2025， 10（1）： 14. doi:10.3390/jfmk10010014 |
| [46] | 聂勇， 朱俊琛， 李迎春， 等. 基于激痛点理论的针刀联合中药膏摩对胸背肌筋膜炎患者的影响及机制研究 ［J］. 实用医学杂志， 2023， 39（17）： 2265-2270. |
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