Выпуск 25-1, 2026

Обзорная статья

https://doi.org/10.38025/2078-1962-2026-25-1-75-83

Анализ эффективности применения лечебной физической культуры в лечении и реабилитации пациентов с дегенеративными заболеваниями позвоночника: обзор

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ORCIDМирютова Н.Ф.1,*, ORCIDГамеева Е.В.2, ORCIDСтепанова А.М.2, ORCIDТонкошкурова А.В.1

1 Федеральный научно-клинический центр медицинской реабилитации и курортологии Федерального медико-биологического агентства, Москва, Россия
2Национальный медицинский исследовательский центр реабилитации и курортологии Минздрава России, Москва, Россия


РЕЗЮМЕ

ВВЕДЕНИЕ.  Методы физической культуры широко применяются как в консервативном лечении дегенеративных заболеваний позвоночника, так и в реабилитации после хирургического лечения.

ЦЕЛЬ.  Изучить эффективность влияния физических упражнений на уровень боли и функциональных ограничений, минеральную плотность костей, качество жизни у пациентов с дегенеративными заболеваниями позвоночника, в том числе после хирургического лечения, путем анализа материалов системных обзоров и метаанализов.

МАТЕРИАЛЫ И МЕТОДЫ.  Проведено изучение материалов метаанализов и систематических обзоров за последние 5 лет (май 2020 г. — январь 2025 г.), посвященных вопросам оценки эффективности использования лечебной физической культуры при дегенеративных заболеваниях позвоночника. Рассматривались журнальные статьи: 128 российских журналов, индексируемых в РИНЦ, зарегистрированных в Science Index, и статьи 303 зарубежных журналов на платформах PubMed, eLIBRARY.RU, ResearchGate.

ОСНОВНОЕ СОДЕРЖАНИЕ ОБЗОРА.  Анализ результатов 53 систематических обзоров, в том числе 50 с метаанализом, показал эффективность применения физических упражнений в плане регресса интенсивности болевого синдрома, функциональных ограничений и повышения уровня жизнедеятельности больных с дегенеративными заболеваниями позвоночника. Получены доказательства среднего и низкого качества в пользу физических упражнений при хронической неспецифической боли в пояснице и низкого качества при хронической боли в шее. При острой и подострой боли в пояснице убедительных данных не выявлено. В единичных исследованиях получены обнадеживающие результаты: регресс боли в послеоперационном периоде дискэктомий (SMD (стандартизованная разность средних): –0,41; 95%-й доверительный интервал (95% ДИ): –1,01–0,19; p = 0,18) и снижение нетрудоспособности (р < 0,001) зафиксированы через 3 и 12 месяцев. Получены также доказательства низкого качества того, что физические упражнения повышают качество жизни больных и минеральную плотность костной ткани.

ЗАКЛЮЧЕНИЕ.  Обзор представил доказательства, основанные на результатах метаанализов и систематических обзоров, среднего и низкого качества того, что физические упражнения при дегенеративных заболеваниях позвоночника позволяют снижать интенсивность хронической неспецифической боли и функциональные ограничения в области позвоночника, а также позитивно влияют на минеральную плотность костной ткани, качество жизни и уровень трудоспособности больных, в том числе перенесших хирургическое лечение.


КЛЮЧЕВЫЕ СЛОВА: позвоночник, дегенеративные заболевания, лечение, реабилитация, физические упражнения

ДЛЯ ЦИТИРОВАНИЯ: Мирютова Н.Ф., Гамеева Е.В., Степанова А.М., Тонкошкурова А.В. Анализ эффективности применения лечебной физической культуры в лечении и реабилитации пациентов с дегенеративными заболеваниями позвоночника: обзор. Вестник восстановительной медицины. 2026; 25(1):75–83. https://doi.org/10.38025/2078-1962-2026-25-1-75-83 [Miryutova N.F., Gameeva E.V., Stepanova A.M., Tonkoshkurova A.V. Analysis of the Effectiveness of Therapeutic Physical Education in the Treatment and Rehabilitation of Patients with Degenerative Spine Conditions: A Review. Bulletin of Rehabilitation Medicine. 2026; 25(1):75–83. https://doi.org/10.38025/2078-1962-2026-25-1-75-83 (In Russ.).]

ДЛЯ КОРРЕСПОНДЕНЦИИ:

Мирютова Наталья Федоровна, E-mail: nat.mirut@gmail.com, nauka@niikf.tomsk.ru


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